Suicidal ideation and its evaluation: A systematic review and validation of the MEntal states related to suicidal ideation scale (MESIS)

J Affect Disord. 2026 Apr 20:121821. doi: 10.1016/j.jad.2026.121821. Online ahead of print.

ABSTRACT

Reliable and valid theory-driven measurements that consider the heterogeneity of suicidal ideation are needed to accurately assess suicide risk. A nomological network grounded in emotion regulation may help disentangle the complex and nuanced functions of suicidal ideation that contribute to this risk. In Study 1, a systematic review of self-report questionnaires examined how current tools measure the frequency and intensity of suicidal ideation. Findings identified conceptual and methodological gaps, underlining the need for a new assessment instrument. Study 2 addressed this by developing and initially validating the MEntal states related to Suicidal Ideation Scale (MESIS), designed to evaluate both suicidal ideation and its emotion regulation functions. The MESIS was administered to two non-clinical samples (n = 510 and n = 488; Mage ≈ 28.3 years). Exploratory factorial analyses in the first sample were performed separately for the two sections of the instrument. In the first section, three factors emerged: “Generic Suicidal Ideation”, “Specific Suicidal Ideation”, and “Death Ideation”. In the second section, four factors were identified: “Escape”, “Relational”,”Impact”, and “Revenge”. Confirmatory factor analyses in the second sample supported these structures. Correlations with external variables suggest good external validity. Findings highlight the utility of the MESIS in supporting theoretical, empirical, and clinical advances elucidating suicidal ideation.

PMID:42019761 | DOI:10.1016/j.jad.2026.121821