the relationship between defense mechanisms and suicidal ideation in women: the mediating role of psychological pain and difficulties in emotion regulation

Background: suicidal ideation persists as a pressing public health concern, especially in women. dysfunctional defense mechanisms and their complex interplay with emotional and cognitive processes warrant further scholarly investigation.  objectives: this study investigates the mediating roles of psychological pain and difficulties in emotion regulation in the relationship between defense mechanisms and suicidal ideation in women.method: this descriptive-correlational study used structural equation modeling to examine direct and indirect pathways in women with suicidal ideation from karaj counseling centers (2024). a convenience sample of 350 participants (mean age = 32.0 years, sd = 7.8) completed the defense style questionnaire-40 (immature/dysfunctional subscale), beck scale for suicide ideation, mental pain scale, and difficulties in emotion regulation scale. data analysis used spss-27 and amos-27. the study received ethics approval, included informed consent, and high-risk participants (bssi ≥17) were referred to crisis services.results: findings indicated a significant direct effect of dysfunctional defense mechanisms on suicidal ideation (β=0.22, p<0.001). psychological pain (β=0.15, 95% ci [0.10, 0.20], p<0.001) and difficulties in emotion regulation (β=0.10, 95% ci [0.05, 0.15], p<0.001) partially mediated this relationship, with the direct effect remaining significant, confirmed through 5,000 bootstrap resamples. the model exhibited strong fit (cfi=0.92, tli=0.91, rmsea=0.06), underscoring the mediators’ salience in suicidal ideation.  conclusion: this study highlights the need for multidimensional interventions targeting dysfunctional defenses, psychological pain, and emotion regulation to prevent and treat suicidal ideation in women.