Abstract
This study examined the relationships between adverse childhood experiences (ACEs) and personality organization with suicidal thoughts through the mediating role of psychache using structural equation modeling (SEM). A total of 200 adult outpatients with mental disorders were included in the descriptive cross-sectional study using the purposive sampling method based on self-referral. The data were collected using the Beck Scale for Suicidal Ideation (BSSI), Adverse Childhood Experience International Questionnaire (ACE-IQ), Inventory of Personality Organization (IPO) and Orbach and Mikulincer Mental Pain Scale (OMMP). The results indicated that ACEs, personality organization and psychache explained 72.3% of variations in suicidal thoughts. ACEs, personality organization and psychache have significant positive direct associations with suicidal thoughts. ACEs and personality organization have significantly positive indirect connections to suicidal thoughts through the mediating role of psychache. This study has shown a fitted SEM for the direct and indirect relationships of ACEs and personality organization with suicidal thoughts concerning the mediating role of psychache. These results have implications for the development of psychodynamic interventions and community-based initiatives for individuals dealing with suicidal thoughts.