Publication: La dimensión interpersonal y su vínculo con el comportamiento suicida: un estudio transcultural
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Date
2026-07-06
Authors
Martínez Rives, Noelia Lucía
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Escuela Internacional de Doctorado
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Martín Chaparro, María del Pilar ; Kotera, Yasuhiro
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Tesis por compendio de publicaciones
Abstract
La presente tesis doctoral, realizada bajo la modalidad de compendio de artículos y con un diseño mixto, multicéntrico y comparativo, tiene como objetivo general analizar la conducta suicida en adultos jóvenes desde una perspectiva interpersonal e intercultural, integrando variables comunicativas y de apoyo social, y comparando su funcionamiento en dos contextos culturales diferenciados: España y Japón. Para ello, la investigación adopta un diseño secuencial e integrado que combina revisiones sistemáticas, un estudio de adaptación y validación transcultural de un instrumento de evaluación, análisis epidemiológicos comparativos y estudios empíricos transversales. La primera revisión sistemática analizó el papel de la comunicación y del apoyo social en la conducta suicida encontrando que las personas con mayor riesgo suicida tienden a percibir sus redes de apoyo como poco útiles, presentan dificultades para comprender o expresar mensajes con contenido emocional y muestran una menor tendencia a buscar ayuda. La segunda revisión comparó las intervenciones y estrategias de prevención del suicidio implementadas en España y Japón, revelando la existencia de enfoques comunes, como la psicoeducación y el entrenamiento en habilidades de afrontamiento, y el énfasis particular en Japón hacia la formación de agentes clave (gatekeepers). La adaptación de la versión breve del Cuestionario de Competencia Interpersonal (ICQ-15) al japonés resulta clave para garantizar la equivalencia cultural en la etapa de medición haciendo disponible una herramienta de evaluación fiable y válida. Por otro lado, el estudio epidemiológico comparativo entre España y Japón aporta una visión macro del fenómeno suicida, proporcionando un marco contextual para la interpretación de los resultados empíricos y mostrando cómo factores sociales, económicos y contextuales influyen de forma diferencial según el país, la edad y el sexo. La pandemia de la COVID-19 reveló efectos heterogéneos y selectivos, con incrementos específicos en determinados grupos poblacionales, especialmente en mujeres y en los grupos de menor y mayor edad. En último lugar, en la fase empírica de carácter transversal con muestras compuestas por adultos jóvenes españoles y japoneses, los primeros análisis se centraron únicamente en las relaciones entre las variables centrales de la Teoría Interpersonal del Suicidio (pertenencia frustrada, carga percibida y capacidad adquirida para el suicidio) sobre el riesgo suicida y la sintomatología depresiva. En los análisis posteriores, se examinaron relaciones más complejas entre dichas variables con la introducción del apoyo social percibido y la competencia interpersonal como variables moderadoras en distintos estadios del proceso suicida, explorando posibles diferencias culturales entre España y Japón. Si bien algunos mecanismos psicológicos son compartidos, su peso relativo y su expresión varían en función de normas culturales relacionadas con la autonomía, la interdependencia y la expresión emocional. Aunque la carga percibida emergió como el predictor más robusto del riesgo suicida en ambos países, su intensidad y significado fueron especialmente elevados en la muestra japonesa, lo que sugiere la influencia de presiones sociales y normativas específicas. Asimismo, mientras que en la muestra española la capacidad adquirida para el suicidio tuvo un mayor peso en la transición de la ideación a la conducta, en la japonesa cobraron mayor relevancia la pertenencia frustrada y competencias interpersonales como la autorrevelación y el inicio de relaciones. En general, los resultados evidencian que el apoyo social actúa como un factor protector potente frente a la ideación suicida y la depresión en ambos países, mientras que la competencia interpersonal muestra efectos protectores más contextuales sobre la conducta suicida, revelando que la protección frente al riesgo suicida no depende únicamente de la presencia objetiva de relaciones sociales ni de las competencias comunicativas de la persona, sino, de la vivencia subjetiva de conexión y apoyo modulada por el contexto social.
The present doctoral thesis, conducted under the compilation of articles modality, with a mixed, multicenter, and comparative design, aims to analyze suicidal behavior in young adults from an interpersonal and intercultural perspective, integrating communicative and social support variables and comparing their functioning across two distinct cultural contexts: Spain and Japan. To this end, the research adopts a sequential and integrated design combining systematic reviews, a crosscultural adaptation and validation study of an assessment instrument, comparative epidemiological analyses, and cross sectional empirical studies. The first systematic review examined the role of communication and social support in suicidal behavior, finding that individuals at higher risk tend to perceive their support networks as less helpful, exhibit difficulties in understanding or expressing messages with emotional content, and show a lower tendency to seek help. The second review compared suicide prevention interventions and strategies implemented in Spain and Japan, revealing common approaches, such as psychoeducation and coping skills training, as well as Japan's particular emphasis on training key agents (gatekeepers). The adaptation of the short version of the Interpersonal Competence Questionnaire (ICQ 15) into Japanese proved crucial to ensure cultural equivalence during the measurement stage, making a reliable and valid assessment tool available. Furthermore, the comparative epidemiological study between Spain and Japan provides a macro level perspective of suicidal behavior, offering a contextual framework for interpreting empirical results and illustrating how social, economic, and contextual factors differentially influence outcomes depending on country, age, and sex. The COVID 19 pandemic revealed heterogeneous and selective effects, with specific increases observed in certain population groups, particularly women and both younger and older age groups. Finally, in the cross sectional empirical phase with samples of young Spanish and Japanese adults, initial analyses focused solely on the relationships between the core variables of the Interpersonal Theory of Suicide (thwarted belongingness, perceived burdensomeness, and acquired capability for suicide) and suicidal risk as well as depressive symptomatology. Subsequent analyses examined more complex relationships by introducing perceived social support and interpersonal competence as moderating variables at different stages of the suicidal process, exploring potential cultural differences between Spain and Japan. Although some psychological mechanisms are shared, their relative weight and expression vary depending on cultural norms related to autonomy, interdependence, and emotional expression. While perceived burdensomeness emerged as the most robust predictor of suicidal risk in both countries, its intensity and meaning were particularly elevated in the Japanese sample, suggesting the influence of specific social pressures and normative expectations. Likewise, in the Spanish sample, acquired capability for suicide had greater weight in the transition from ideation to action, whereas in the Japanese sample, thwarted belongingness and interpersonal competencies, such as selfdisclosure and initiating relationships, were more relevant. Overall, the results indicate that social support acts as a strong protective factor against suicidal ideation and depression in both countries, while interpersonal competence exhibits more context dependent protective effects on suicidal behavior. This demonstrates that protection against suicidal risk does not depend solely on the objective presence of social relationships or an individual's communicative skills, but rather on the subjective experience of connection and support modulated by the social context.
The present doctoral thesis, conducted under the compilation of articles modality, with a mixed, multicenter, and comparative design, aims to analyze suicidal behavior in young adults from an interpersonal and intercultural perspective, integrating communicative and social support variables and comparing their functioning across two distinct cultural contexts: Spain and Japan. To this end, the research adopts a sequential and integrated design combining systematic reviews, a crosscultural adaptation and validation study of an assessment instrument, comparative epidemiological analyses, and cross sectional empirical studies. The first systematic review examined the role of communication and social support in suicidal behavior, finding that individuals at higher risk tend to perceive their support networks as less helpful, exhibit difficulties in understanding or expressing messages with emotional content, and show a lower tendency to seek help. The second review compared suicide prevention interventions and strategies implemented in Spain and Japan, revealing common approaches, such as psychoeducation and coping skills training, as well as Japan's particular emphasis on training key agents (gatekeepers). The adaptation of the short version of the Interpersonal Competence Questionnaire (ICQ 15) into Japanese proved crucial to ensure cultural equivalence during the measurement stage, making a reliable and valid assessment tool available. Furthermore, the comparative epidemiological study between Spain and Japan provides a macro level perspective of suicidal behavior, offering a contextual framework for interpreting empirical results and illustrating how social, economic, and contextual factors differentially influence outcomes depending on country, age, and sex. The COVID 19 pandemic revealed heterogeneous and selective effects, with specific increases observed in certain population groups, particularly women and both younger and older age groups. Finally, in the cross sectional empirical phase with samples of young Spanish and Japanese adults, initial analyses focused solely on the relationships between the core variables of the Interpersonal Theory of Suicide (thwarted belongingness, perceived burdensomeness, and acquired capability for suicide) and suicidal risk as well as depressive symptomatology. Subsequent analyses examined more complex relationships by introducing perceived social support and interpersonal competence as moderating variables at different stages of the suicidal process, exploring potential cultural differences between Spain and Japan. Although some psychological mechanisms are shared, their relative weight and expression vary depending on cultural norms related to autonomy, interdependence, and emotional expression. While perceived burdensomeness emerged as the most robust predictor of suicidal risk in both countries, its intensity and meaning were particularly elevated in the Japanese sample, suggesting the influence of specific social pressures and normative expectations. Likewise, in the Spanish sample, acquired capability for suicide had greater weight in the transition from ideation to action, whereas in the Japanese sample, thwarted belongingness and interpersonal competencies, such as selfdisclosure and initiating relationships, were more relevant. Overall, the results indicate that social support acts as a strong protective factor against suicidal ideation and depression in both countries, while interpersonal competence exhibits more context dependent protective effects on suicidal behavior. This demonstrates that protection against suicidal risk does not depend solely on the objective presence of social relationships or an individual's communicative skills, but rather on the subjective experience of connection and support modulated by the social context.
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