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The Association Between Emotional Intelligence and Suicidal Behavior: A Systematic Review

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Background: Some meta-analyses have demonstrated the association between emotional intelligence (EI) and different health indicators. With the increase of suicide cases in the world, more and more professionals have been interested in the link between both variables. Aim: To study all the available evidence on the association between EI and suicidal behavior. Method: We systematically reviewed all available literature (in English or Spanish) on the relationship between both variables through the main databases. Results: Twenty-five articles were included. EI and suicidal behavior correlated inversely in almost all the articles that the Emotional Quotient Inventory (EQ-i), The Emotional Intelligence Test (EIT), The Spanish Wong and Law Emotional Intelligence Scale (WLEIS), and The Schutte Emotional Intelligence Scale (EIS/SSEIT), Barchard's Emotional Intelligence Scale, were used, that is, the higher suicidal behavior level the lower the EI score. The same results were found in two out of four investigations that used the Trait Meta-Mood Scale (TMMS-24) between clarity (emotional understanding) and emotional repair (emotional regulation) and suicidal behavior. Two out of three studies that used the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) found that only the Strategic component of EI (emotional understanding and regulation) was a protective factor. Conclusions: The results appear to indicate that a high level of EI plays an important role in protecting against suicidal behavior, and should thus be integrated into suicide prevention programs.
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SYSTEMATIC REVIEW
published: 30 November 2018
doi: 10.3389/fpsyg.2018.02380
Frontiers in Psychology | www.frontiersin.org 1November 2018 | Volume 9 | Article 2380
Edited by:
Éric Laurent,
Université Bourgogne
Franche-Comté, France
Reviewed by:
Serge Brand,
Universität Basel, Switzerland
Joaquín T. Limonero,
Autonomous University of Barcelona,
Spain
*Correspondence:
Pablo Fernández-Berrocal
berrocal@uma.es
Specialty section:
This article was submitted to
Psychopathology,
a section of the journal
Frontiers in Psychology
Received: 06 April 2018
Accepted: 12 November 2018
Published: 30 November 2018
Citation:
Domínguez-García E and
Fernández-Berrocal P (2018) The
Association Between Emotional
Intelligence and Suicidal Behavior: A
Systematic Review.
Front. Psychol. 9:2380.
doi: 10.3389/fpsyg.2018.02380
The Association Between Emotional
Intelligence and Suicidal Behavior: A
Systematic Review
Elena Domínguez-García and Pablo Fernández-Berrocal*
Department of Basic Psychology, Faculty of Psychology, University of Málaga, Málaga, Spain
Background: Some meta-analyses have demonstrated the association between
emotional intelligence (EI) and different health indicators. With the increase of suicide
cases in the world, more and more professionals have been interested in the link between
both variables.
Aim: To study all the available evidence on the association between EI and suicidal
behavior.
Method: We systematically reviewed all available literature (in English or Spanish) on the
relationship between both variables through the main databases.
Results: Twenty-five articles were included. EI and suicidal behavior correlated
inversely in almost all the articles that the Emotional Quotient Inventory (EQ-i), The
Emotional Intelligence Test (EIT), The Spanish Wong and Law Emotional Intelligence
Scale (WLEIS), and The Schutte Emotional Intelligence Scale (EIS/SSEIT), Barchard’s
Emotional Intelligence Scale, were used, that is, the higher suicidal behavior level the
lower the EI score. The same results were found in two out of four investigations that
used the Trait Meta-Mood Scale (TMMS-24) between clarity (emotional understanding)
and emotional repair (emotional regulation) and suicidal behavior. Two out of three studies
that used the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) found that only
the Strategic component of EI (emotional understanding and regulation) was a protective
factor.
Conclusions: The results appear to indicate that a high level of EI plays an important
role in protecting against suicidal behavior, and should thus be integrated into suicide
prevention programs.
Keywords: emotional intelligence, suicide, suicidal behavior, suicide risk, emotional skills, emotional competence,
systematic review
INTRODUCTION
The World Health Organization (WHO) estimated that 804,000 people died from suicide in 2012
(11.4 per 100,000 people), with these numbers being higher in men than women. Over the past 45
years, the suicide rate has risen by 60% and has been established as the second cause of death among
the 15–29 year age category, with 50 non-fatal suicide attempts for each suicide. Risk factors linked
to interpersonal relationships and the community include war and disaster, discrimination, abuse,
Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
violence and conflicts, perception of isolation, and stresses of
acculturation (displaced people or indigenous persons), whilst
risks at the individual level include chronic pain, mental
disorders, poor financial situation, family history of suicide,
previous non-fatal suicide attempts, and the harmful abuse of
alcohol. Prevention strategies should be focused on encouraging
protective factors such as positive coping strategies, a strong
personal belief, and strong interpersonal relationships (WHO,
2014).
Arsenault-Lapierre et al. (2004) carried out a meta-analysis
on the psychiatric diagnosis in 3,275 suicides, in which the
results revealed that 87.3% of people who committed suicide had
been diagnosed with a mental disorder. In addition, two of the
most common mental disorders among people who committed
suicide were affective disorders (present in 43.2% of suicide cases)
and drug abuse disorders (present in 25.7% of suicide cases),
comorbidity being present in most cases.
Law and Tucker (2017) studied how repetitive negative
thinking affects the risk of suicide. Rumination—a relevant
symptom present in affective disorders—occurs due to the
perception of a discrepancy between the current state of a person
and the goals to be achieved (Watkins and Nolen-Hoeksema,
2014). It has been found that the perception of one’s inability
to use emotional regulation strategies (Miranda et al., 2013) and
change strategies in a given situation, predicts suicidal ideation
in 2 or 3 years through brooding and rumination, initiating
or maintaining a sequence from rumination to hopelessness
and thoughts of suicide. In addition, hopelessness, perception
of entrapment (Teismann and Forkmann, 2017) and lack of
optimism (Tucker et al., 2013) strengthen the relationship
between suicide ideation and rumination. The association
between the aforementioned variables may be intensified by the
impulsive use of provocative and painful behaviors when coping
with negative emotions caused by rumination. Furthermore,
suicidal behaviors have been found to correlate with depressive
symptoms (Selby et al., 2007; Chu et al., 2016).
Another relevant point regarding affective disorders is the
association between early maladaptive schemas of emotional
deprivation, social isolation, shame and abandonment, and
history of suicide attempts. Ahmadpanah et al. (2017) showed
that, unlike the control group, people with major depressive
disorder scored higher on the aforementioned variables. Those
with maladaptive schemas do not expect others to support or take
care of them, since they feel emotionally deprived, as if they did
not perceive enough affection, warmth, and attention. Normally
these people do not express their emotions, since they do not
expect any kind of emotional support. Depression can occur as
a result and, depending on its durability and severity, the risk of
suicide increases.
With respect to the second cause of suicide reported by
Arsenault-Lapierre et al. (2004), suicide among young people has
increased dramatically in recent decades (Peters et al., 1998), and
in young people this increase has been associated with an increase
in the consumption of drugs and alcohol (Brent, 1995; Ilomaki
et al., 2007; West et al., 2010).
The systematic review by Pompili et al. (2012) studied
the relationship between substance abuse and suicidal risk
among adolescents, showing that regular drug abuse (cannabis,
alcohol, heroine, cocaine) increases depression, hopelessness, and
disruptive and suicidal behavior.
Definition of Suicidal Behavior
The WHO defines suicide as “an act with a fatal outcome
which the deceased, knowing or expecting a fatal consequence,
had initiated and carried out with the purpose of provoking
the changes that he desired” (WHO, 1986), whilst considering
suicidal behavior as “a range of behaviors that include thinking
about suicide (or ideation), planning for suicide, attempting
suicide and suicide itself” (WHO, 2014). For the purposes of our
systematic review, we will adopt these definitions.
Emotional Intelligence (EI)
The theoretical models of EI can be categorized into two branches
(Mayer et al., 2008): EI skill models (mental abilities) and EI
mixed models (capacities, traits, and abilities). The first considers
EI as a set of abilities that are part of the cognitive processes,
and which constitute a form of intelligence that fosters the ability
to “accurately perceive, value and express emotions, the ability
to access and/or generate feelings that facilitate thinking, to
understand emotions and to reason emotionally, and finally the
ability to regulate one’s own and others’ emotions” (Mayer and
Salovey, 1997). Ability EI is mainly assessed using performance
tasks. The mixed model considers EI as a set of personality
traits that determines the tendency of a person to manage
their emotions in a certain way (Goleman, 1995; Bar-On, 1997;
Petrides et al., 2007). This theoretical approach mainly uses
self-reported questionnaires.
EI and Suicide
According to Fernández-Berrocal and Extremera (2016), there is
an increasing interest in the link between emotions and health,
prompting authors to conduct meta-analyses on the relationship
between mental and physical health and emotional skills (Schutte
et al., 2007; Martins et al., 2010). The results reveal a strong
correlation between self-report ability EI and self-report mixed EI
and health indicators. However, a moderate correlation has been
found between health and performance-based ability EI scores.
It has been demonstrated that a stable and moderate deficit
in the ability to decode mental states and emotional stimuli
can be caused by difficulties in social interaction in people with
Major Depressive Disorder (Hall et al., 2009; Kohler et al., 2011;
Manstead et al., 2013; Weightman et al., 2014). In addition,
evidence shows that a low EI score correlates negatively with
depression, and thus contributes toward reducing the ability
to understand and manage emotions, skills associated with
the prefrontal cortex (Hertel et al., 2009; Kwako et al., 2011;
Sawaya et al., 2015). Moreover, a study by Sawaya et al. (2015)
found fewer functional connections between regions involved
in emotional regulation and the anteromedial region in people
with Major Depressive Disorder. They also found a significant
correlation between MSCEIT scores and functional connectivity
in the ventromedial prefrontal cortex. The results indicate that
people with Major Depressive Disorder struggle to perceive
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Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
and manage emotions and to participate in positive social
interactions.
In contrast, Zeidner et al. (2012) have argued that emotional
skills play a crucial role in promoting positive emotions and well-
being. In particular, people with high EI are more likely to create
and maintain close relationships, improving their subjective well-
being (Lopes et al., 2005) whilst using more effective coping
strategies such as expressing emotions and feelings, rather
than maladaptive strategies such as avoidance or rumination
(Matthews et al., 2006). Moreover, they tend to experience less
emotional distress when facing a stressful situation, increasing
positive affect (Gohm et al., 2005) and are more able to maintain
higher self-esteem and self-efficacy, mitigating the influence of
negative events (Salguero et al., 2015). This has been confirmed
by several meta-analyses reporting that performance-based
measures of EI skills are associated with subjective well-being
(Sánchez-Álvarez et al., 2016). Furthermore, life satisfaction may
correlate positively with EI, as revealed in a study carried out
by Mayer et al. (1999) in which a weak to moderate correlation
was found between life satisfaction and EI measured by the
Multifactor Emotional Intelligence Scale. More recent studies
have provided support for these positive associations between
EI and current life satisfaction or retrospective life satisfaction
(Brackett et al., 2006; MacCann and Roberts, 2008; Extremera
et al., 2011; MacCann et al., 2016).
Gallagher and Miller (2018) carried out a systematic review
of the literature on suicidal thoughts and behavior in children
and adolescents, concluding that, in spite of the low number
of articles that link EI with suicidal behavior, the literature
suggests the abilities of adolescents to understand and cope
with self-emotions reduce suicidal risk and promote resilience.
Furthermore, a study by Rivers et al. (2013) examined how
emotion skills could be a protective factor for risky behaviors
among college students, and found that there was a negative
correlation between EI and risky behaviors such as substance
abuse, among other relevant variables.
These results are of clear relevance, given that EI could act
as a protective factor for the general population, particularly for
adolescents, since depression is the first cause of suicide in our
society, followed by substance abuse.
The aim of this article is to carry out, as completely as
possible, a systematic review of all the existing Spanish and
English literature to date on the relationship between EI and
suicidal behavior. On the basis of this review, the intention
is to present a perspective of the current research situation
in this field, as well as offering proposals for future lines of
research that could overcome the limitations found in the current
literature.
METHODS
Literature Search Procedures
A consultation was carried out through the following databases:
Web of Science, Scopus, Medline, Pubmed, PsycINFO, ProQuest,
Riuma, Dialnet, and Google Scholar. A first search was conducted
between 17 April 2017 and 21 April 2017 without any
limitations on the year of publication of the articles. Firstly,
we conducted a superficial search of articles about EI and
suicide (without the need for both factors to be related), in
order to identify the keywords in the search itself. Then, we
established the following terms to define the search criteria:
“emotional intelligence” or “emotional competence,” and one of
the following keywords: “suicide,” “suicidal behavior,” “suicidal
ideation,” “suicidal attempt,” both in English and Spanish. After
obtaining the results from the various databases, we proceeded
to read all of the titles and abstracts, selecting the possible
candidates for our review and eliminating duplicate studies.
Finally, an in-depth reading of each of the articles was carried
out. The search was completed by a reviewer and supervised by
an expert.
A new updated search was conducted in October 2018 to find
out if new studies had been published. In this case, we established
as a time limitation the studies that has been published between
2017 and 2018. The flowchart of the study selection can be seen
in Figure 1.
Criteria for Selecting Studies
The following inclusion criteria were adopted: the study must
be empirical, and based on the relationship between EI
and suicide; the work should adopt a definition of suicidal
behavior similar to the one given by WHO; the study must
employ EI instruments based on theoretical models; the work
should be published in scientific journals; and in Spanish or
English.
Materials and Instruments Used in Articles
EI Assessment
The following are the characteristics of the instruments and
tasks that have been used in the different studies, following a
classification system based on the theoretical model adopted and
the different measures used. Thus, the studies involved either
performance or self-report tasks based on the ability model of EI,
or self-report instruments based on EI mixed models (Joseph and
and Newman, 2010). The psychometric properties are indicated
if provided by the study.
Performance-based instruments based on ability models
The Mayer-Salovey-Caruso Emotional Intelligence Test
(MSCEIT; Mayer et al., 2003) consists of 141 items that measure
the ability to solve emotional problems corresponding to the
four-branch model of EI developed by Mayer and Salovey (1997)
scored in two areas: experiential EI (emotional perception and
facilitation) and strategic EI (emotional understanding and
regulation). The test has a high internal consistency (α=0.93),
good test–retest reliability and excellent construct and current
validity. Some studies have employed their version of this test for
young people, the Mayer-Salovey-Caruso Emotional Intelligence
Test: Youth Version, Research Version 1.0. (MSCEIT: YV-R;
Mayer et al., 2005).
Self-report instruments based on ability models
The Schutte Emotional Intelligence Scale (EIS/SSEIT, Schutte
et al., 1998) consists of 33 items categorized into three areas:
emotional perception and expression, emotional regulation,
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Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
FIGURE 1 | Flowchart of study selection.
and the use of emotions in problem solving. It has internal
consistency from 0.87 to 0.90, a test–retest reliability of 0.78 and
evidence of construct validity. Some authors have used a Chinese
adaptation, the Chinese Emotional Intelligence Scale (C-EIS-R;
Chan, 2003).
The Objective emotion perception test consisted of six short
stories, each one followed by seven emotions and a related
7-adjective mood scale (Mayer and Geher, 1996).
The Spanish adaptation of the Trait Meta-Mood Scale
(TMMS-24; Fernández-Berrocal et al., 2004) evaluates the three
categories of EI—attention to emotion, clarity, and emotional
repair—through 24 items, with an internal consistency of 0.90,
0.90, and 0.86, respectively, and a test–retest reliability of 0.60,
0.70, and 0.83, respectively.
The Spanish Wong and Law Emotional Intelligence Scale
(WLEIS; Wong and Law, 2002) evaluates four dimensions: self-
emotion appraisal, other-emotion appraisal, use of emotion, and
regulation of emotion. The test has been proven to have good
psychometric properties in Spanish populations.
Emotional Intelligence scales (Barchard, 2001) assess EI
through 68 items. In one article it was translated into Arabic
(Madbouly et al., 2017). Reliability was 0.67.
Self-report instruments based on mixed models
The Emotional Quotient Inventory (EQ-i; Bar-On, 1997) consists
of 133 items contained in 15 subscales and 5 major factors:
interpersonal, intrapersonal, stress management, adaptation, and
general mood. The EQ-i has very good reliability for internal
consistency. Some research studies have employed the youth
version, the EQ-i: YV, Bar-On Emotional Quotient Inventory:
Youth Version (Bar-On and Parker, 2004), which has been shown
to have internal consistency across scales ranges from r=0.67
to 0.87 for males and r=0.65 to 0.87 for females. Test–retest
reliability ranges from r=0.77 to 0.88.
In one study (Mamani et al., 2018) the Peruvian adapted
version of EQ-I (BarOn-ICE; Ugarriza Chávez and Pajares del
Águila, 2005) was used. Cronbach value of the test was 0.77.
The Emotional Intelligence Test (EIT; Chadha, 2001) is based
on Goleman’s model (1995) and assesses emotional sensitivity,
maturity, and competence.
Suicidal Behavior Assessment
The instruments used to assess suicidal behavior do not follow
a specific model. The psychometric properties are indicated if
provided by the study.
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Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
Reynolds scales
The Adult Suicidal Ideation Questionnaire (ASIQ; Reynolds,
1987) is a 25-item self-report measure that evaluates suicidal
ideation.
The Suicidal Ideation Questionnaire (SIQ; Reynolds, 1991)
assesses the frequency of suicidal ideation through 33 items.
Several studies showed that this test has good internal consistency
(α=0.94) and adequate construct validity (Pinto et al., 1997).
Beck scales
The Beck Scale for Suicide Ideation (BSSI; Beck et al., 1979)
evaluates the intensity of suicidal ideation through 19 items and
four subscales.
The Beck Depression Inventory (BDI-II: Beck et al., 1996) is
a 21-item scale questioning whether suicidal behavior is being
experienced.
Plutchik Suicide Risk Scale (SRS; Plutchik et al., 1989)
This is a self-report questionnaire that evaluates the risk of
suicide through 15 items adopting a dichotomous response
format. This scale presents good reliability and validity.
Self-Injurious Thought and Behaviors Interview (SITBI;
Nock et al., 2007)
This is a short structured interview that assesses the presence,
frequency, and other characteristics of the range of self-injurious
thoughts and behaviors, including suicidal ideation or non-fatal
suicide attempts. This test presents good inter-rater and test–
retest reliability and concurrent validity.
Suicidal tendency subscale of the Millon adolescent Clinical
Inventory (MACI; Millon, 2004)
This questionnaire assesses personality features, clinical
syndromes and concerns in adolescents using seven scales,
including a suicidal tendency scale (25 items).
The Child-Adolescent Suicidal Potential Index (CASPI;
Pfeffer et al., 2000)
This test evaluates the risk of suicide through 30 items
categorized into three subscales: anxiety-impulsive depression,
suicidal ideation, or non-fatal suicide attempts and family
distress. The internal consistency is 0.90 and the test–retest
reliability is 0.76.
Suicidal ideation subscale of the General Health
Questionnaire (Chan, 2005)
This is a 4-item subscale that uses a Likert-type response scale.
Some of the items are: “I feel that life does not deserve to be lived”
or “I have thoughts of ending my life.”
Suicidal Ideation Subscale of the Suicidal Risk Scale (C-SIS;
Tse and Bagley, 2002)
This test is composed of 13 items that evaluate the intensity of
suicidal ideation. This scale has been shown to have high internal
consistency (α=0.92), split-half consistency (α=0.88), and
test–retest reliability (r=0.72).
Suicidal Behaviors Questionnaire—Revised (SBQ-R; Osman
et al., 2001)
The SBQ-R consists of four items assessing lifetime suicidal
ideation and non-fatal attempts, frequency of suicidal ideation
over the past year, threat of suicidal behavior, and self-reported
likelihood of future suicidal behavior. It has been shown to have
good reliability and validity when used with both college students
and clinical samples.
MINI International Neuropsychiatric Interview (Sheehan
et al., 1998)
In the study by Kopera et al. (2018) they assessed lifetime history
of suicide attempts with a question from the MINI International
Neuropsychiatric Interview: “During your lifetime, have you ever
tried to commit suicide?”
RESULTS
EI Theories and Assessment Methods
As mentioned previously, there are several explanatory models of
EI (ability or mixed) that use their own evaluation instruments,
which usually consist of performance or self-report tasks
depending on what the theoretical model considers to be most
appropriate. In our case, of the 25 selected articles, 18 are
based on the ability model of Mayer and Salovey (MSCEIT,
MSCEIT: YV-R, TMMS-24, Barchard Emotional Intelligence
Scale, WLEIS, EIS/SSEIT, and C-EIS-R), six on the mixed
model of Bar-On (EQ-i), and one on the mixed model of
Goleman (EIT).
General Characteristics of the Included
Studies
The most relevant information from the sample in general
terms and from the studies included in this systematic review
can be viewed in Table 1 (sample in general terms), Table 2
(studies with children), Table 3 (studies with adolescents),
and Table 4 (studies with adults), respectively. In order to
present the data in a more appropriate way, we divided
the studies by age (children, adolescents, or adults), and
grouped the results according to the instrument applied in each
case.
TABLE 1 | Sample in general terms.
Males Females Sex not
specified
Total
Children (<12
years)
87 (67.44%) 42 (32.56%) 129
Adolescents
(12–18 years)
4.591 (48.8%) 4.450 (47.3%) 367 (3.9%) 9.408
Adults (>18
years)
1.375 (38.12%) 2.173 (60.24%) 59 (1.64%) 3.607
Total 6.053 (46.05%) 6.665 (50.71%) 426 (3.24%) 13.144
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Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
Results of the Selected Studies According
to Age Range
Studies With Children (Under 12 Years Old)
The study by Bodzy et al. (2016) compared a sample of
hospitalized children in psychiatric settings, dividing them
between those with suicidal ideation and those who had a
non-fatal suicide attempt according to their hospital reports
and the CASPI questionnaire, whilst their EI levels were
compared by using the EQ-i: YV-S. The total score on the EQ-
i: YV-S was higher in the group with only suicidal ideation
than in the subsample of children with a reported history
TABLE 2 | Selected studies on EI and suicidal behavior in children (7–12
years old).
Study Type of
suicidal
behavior
EI
instruments
Sample Main results
Bodzy et al.,
2016
SI and NSA EQ-i:YV-S 129 children
(42 females)
The SI group
scored higher
in the EQ-i
than in the
NSA group
SI, Suicidal ideation; NSA, Non-fatal suicide attempt; EQ-i: YV, Bar On Emotional Quotient
Inventory: Youth Version (Bar-On and Parker, 2004).
of non-fatal suicide attempts, although no subscale was an
independent predictor of suicide. The main data can be viewed
in Table 2.
Studies With Adolescents (12–18 Years Old)
Studies using self-reported EI tests
The investigations of Kwok and Shek (2010),Abdollahi and
Talib (2015), and Abdollahi et al. (2016) used EIS to analyze
the relationship between EI and suicidal ideation, among other
variables. All the studies found a negative correlation between
both variables, with EI being a protective factor. The first
article explored the role of EI in the relationship between
brooding and reflection and suicidal ideation (measured by
the SIQ) among Iranian hospitalized adolescents. The results
showed that a high level of both variables and a low level of
EI correlates with a higher suicidal ideation, with EI being a
mediator between rumination and suicidal ideation. In a later
article using the same results for the same sample, (Abdollahi
et al., 2016) found that 39% of the variance in suicidal ideation
was explained by EI and perceived stress among the depressed
adolescents. Lower suicidal ideation and lower perceived stress
was observed in non-depressed patients with high levels of
EI, as opposed to those with low levels of EI, indicating that
EI also moderated the relationship between suicidal ideation
and perceived stress. Kwok and Shek (2010) found an inverse
correlation between suicidal ideation (measured by C-SIS) and
TABLE 3 | Selected studies on EI and suicidal behavior in adolescents (12–18 years old).
Study Type of suicidal
behavior
EI instruments Sample Main results
Abdollahi et al., 2016 SI EIS 202 adolescents (105 females) High levels of EI correlate with low SI and low
perceived stress. EI moderates both variables
Abdollahi and Talib, 2015 SI EIS 202 adolescents (105 females) Same
sample of the previous study
EI moderates the link between brooding,
reflective styles and SI. EI correlates negatively
with SI in non-attempters
Kwok et al., 2015 SI C-EIS-R 127 adolescents (251 females) No association between EI and SI was found
Kwok and Shek, 2010 SI C-EIS-R 5.557 adolescents
students (46,9% females)
There is a negative correlation between SI and
EI. EI negatively predicts SI
Extremera et al., 2018 SI WLEIS 1660 adolescents (50.4% females) Lower EI scores are associated with a higher
suicidal risk in cyberbullyism victims
Limonero et al., 2018 SI TMMS-24 144 young university students (105
females)
Low levels of clarity and emotional regulation
correlates with a higher suicidal risk
Alizadeh and Aveh, 2016 SI EQ-i 367 adolescent students EI predicts and correlates negatively with SI
Mamani et al., 2018 SI EQ-I (BarOn ICE) 33 females with SI Intervention improved suicide ideation and EI in
the components of intrapersonal, stress
management and general mood scale
Zavala and López, 2012 SI EQ-i: YV 829 adolescent students (435
females)
High EI correlates inversely with depression
and suicide
Madbouly et al., 2017 NSA Barchard’s
Emotional
Intelligence Scale
36 adolescents with SA (89%
females)
Intervention improved suicide risk and EI, but
there was no significant correlation between
these variables
Cha and Nock, 2009 SI and NSA MSCEIT:YV-R 54 adolescents (46 females) Strategic EI is a protective factor for suicidal
behavior
SI, Suicidal ideation; NSA, Non-fatal suicide attempt; EIS, Schutte Emotional Intelligence Scale (Schutte et al., 1998); C-EIS-R, Chinese Emotional intelligence Scale (Chan, 2003); EQ-i,
The Emotional Quotient Inventory (Bar-On, 1997); TMMS-24, The Spanish adaptation of Trait Meta Mood Scale (Fernández-Berrocal et al., 2004); EQ-i:YV, Bar-On Emotional Quotient
Inventory: Youth Version (Bar-On and Parker, 2004); MSCEIT: YV-R, Mayer-Salovey-Caruso Emotional Intelligence Test: Youth Version, Research Version 1.0 (Mayer et al., 2005).
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Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
TABLE 4 | Selected studies on EI and suicidal behavior in adults (over 18 years).
Study Type of suicidal
behavior
EI instrument Sample Main results
Aradilla-Herrero et al., 2014 SI TMMS-24 92 nursery students (75 females) Emotional attention predicts SI
SI correlates negatively with clarity and repair
Caballero et al., 2015 SI TMMS-24 44 college students (32 females) Low SI correlated with better understanding
and regulation of negative emotions. High SI
correlated with a higher emotional attention
Ceballos and Suárez, 2012 SI TMMS-24 157 college students (106 females) EI and SI correlate negatively
Extremera and Rey, 2016 SI WLEIS 1.125 unemployed adults (619
women)
EI moderates the relationship between
happiness and life satisfaction and SI. Low EI
correlates with higher SI
Mérida-López et al., 2018 SI WLEIS Study 1: 438 students (270 females)
Study 2: 330 students (264 females)
EI correlated negatively with suicidal thoughts
and behaviors in both studies and EI may act
as a protective factor against suicidal risk
Ciarrochi et al., 2002 SI EIS
Objective emotion
perception test
302 college students (232 females) High emotional perception correlates positively
with SI, as opposed to a high management of
other’s emotion and SI
Kopera et al., 2018 SI and NSA SSEIT 80 inpatients entering an alcohol
treatment program (56 females)
Mood regulation fully mediated the association
between depression and history of suicide
attempts. No correlation was found between
this latter variable and other EI components
(emotional perception, understanding and
utilization of emotions)
Kwok, 2014 SI C-EIS-R 302 college students (228 females) EI negatively correlates and predicts SI
Moayedi et al., 2014 NSA EQ-i 100 adults (50 females with SA) NSA group scored significantly lower in EI, as
opposed to the control group
Rahgozar et al., 2011 NSA EQ-i 60 adults (30 with SA) NSA group scored significantly lower in EI, as
opposed to the control group
Hazra and Dasgupta, 2011 SI EIT 200 adult students (100 females) EI negatively correlates with SI
Karim and Shah, 2014 SI MSCEIT 192 college students (91 females) Strategic component of EI predicts SI
Paradiso et al., 2016 SI MSCEIT 185 war veteran males (46 with SI) Lower EI levels are associated with greater SI
SI, Suicidal ideation; NSA, Non-fatal suicide attempt; TMMS-24, The Spanish adaptation of Trait Meta Mood Scale (Fernández-Berrocal et al., 2004); WLEIS, The Spanish Wong and Law
Emotional Intelligence Scale (Wong and Law, 2002); EIS/SSEIT, The Schutte Emotional Intelligence Scale (Schutte et al., 1998); C-EIS-R, Chinese Emotional intelligence Scale (Chan,
2003); EQ-i, The Emotional Quotient Inventory (Bar-On, 1997); EIT, Emotional Intelligence Test (Chadha, 2001); MSCEIT, Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer et al.,
2003).
emotional self-regulation, social skills, and use of emotion, as
measured by subscales of the Chinese version of EIS (C-EIS-
R, Chan, 2003) in adolescents from 42 schools in Hong Kong,
the New Territories, and Kowloon. In contrast, in a later study
by Kwok et al. (2015), using the same instruments, suicidal
ideation was not found to be significantly associated with EI.
However, empathy was found to moderate the relationship
between physical abuse and suicidal ideation, but only in
females.
Extremera et al. (2018) explored the relationship between
EI, suicidal risk, self-esteem, and cyberbullying victimization in
adolescents and examined whether EI could play a role as a
moderator of the relationship between those variables. They used
WLEIS to assess EI and SBQ-R to evaluate suicide risk, along
with other questionnaires to test the other variables. The results
revealed that adolescents with greater EI were less likely to show
symptoms of low self-esteem and suicidal ideation in comparison
with those whose EI scores were lower.
Madbouly et al. (2017) carried out a pre–post intervention
with the aim of exploring the effects of an intervention on suicide
ideation and EI. The questionnaires used were the Barchard’s
Emotional Intelligence Scale and Beck’s Suicidal Ideation Scale.
The intervention improved both variables, but there was no
significant correlation between suicide ideation and EI.
The study by Limonero et al. (2018) analyzed the relationship
between perceived EI (by using the TMMS-24) and negative
affect, life satisfaction, and suicide risk in adolescents (by
using the SRS). The results showed that suicidal risk correlated
negatively with clarity and emotional regulation and life
satisfaction, emotional regulation being a predictor of suicidal
risk.
Zavala and López (2012) and Alizadeh and Aveh (2016), who
used the EQ-i to measure EI, found similar results, concluding
that there was a negative correlation between EI and suicidal
tendency, with EI being a predictor of suicidal tendency. While in
the first study the relationship between EI and suicidal tendency
among adolescents in Gachsaran (Iran) was measured by using
the BSSI, the second investigation evaluated, through the MACI,
certain psychosocial risk factors (including suicidal tendency),
and their relationship with perceived EI through the EQ-i: YV in
adolescents from León (Mexico). Zavala and López (2012) found
that only the interpersonal component of EI correlated negatively
Frontiers in Psychology | www.frontiersin.org 7November 2018 | Volume 9 | Article 2380
Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
with suicidal tendency. The remaining scales of the EQ-i: YV
showed no significant correlation with autolytic behavior.
Mamani et al. (2018) carried out a test–retest design study in
which they evaluated the effect of an intervention on emotional
intelligence and suicidal risk by using the BSSI and the Peruvian
adaptation of EQ-i. The results indicate a post-intervention
improvement of emotional intelligence levels and a decrease in
suicidal risk.
Studies using performance EI tests
Cha and Nock (2009) analyzed, among other aspects, the
relationship between EI (measured by MSCEIT: YV-R) and
suicidal behavior (measured by SITBI) in adolescents from
various nationalities that had been sexually abused in their
childhood, both with and without a history of non-fatal suicide
attempts. The results revealed that EI moderated the relationship
between the history of sexual abuse and suicide behavior in the
past, finding a strong relationship between suicidal tendency
in participants with low IE. Specifically, the Strategic area of
EI (understanding and emotional regulation) appeared to be a
protective factor against suicide behavior.
The main data can be viewed in Table 3.
Studies With Adults (Over 18 Years Old)
Studies using self-reported EI tests
Aradilla-Herrero et al. (2014) assessed the relationship between
suicide risk and EI among a sample of nursing students by
using the SRS and the Spanish version of TMMS-24, respectively.
The linear regression analysis revealed the predictive role of
emotional attention in suicidal risk, whereas suicidal behavior
showed a significant negative correlation with clarity and
emotional repair. A study by Ceballos and Suárez (2012) with
Psychology university students from Colombia again evaluated
EI with the same instrument, and suicidal ideation through the
BSSI, finding a negative correlation between emotional repair
and suicidal ideation. However, no significant association was
found with the other variables. As in the previous studies, the
investigation by Caballero et al. (2015) revealed similar results in
other students from the same university, showing that the greater
the emotional attention, the greater the risk of suicide, while the
improvement in clarity and emotional repair was associated with
a lower suicidal tendency.
In a sample of unemployed Spanish adults, Extremera and
Rey (2016) evaluated the association between EI (WLEIS) and
suicidal ideation (SBQ-R) along with other variables, finding that
lower scores in perceived EI increased the likelihood of suicidal
behaviors, whilst perceived EI additionally moderated the
relationship between suicidal ideation and life satisfaction and
happiness. The same authors conducted two new independent
studies (Mérida-López et al., 2018) with the same instruments.
In the first study, they evaluated the associations between self-
report EI, suicide risk and psychological distress, with the
expectation that this last variable would operate as a mediator
of the relationship with suicide risk. In the second study, they
prospectively tested the proposed model in a sample of college
students, assessing the effects of self-report EI on suicide risk
over a 2-month period. The results revealed that EI correlated
negatively with suicidal thoughts and behaviors in both studies
and that EI may act as a protective factor against suicidal risk.
EIS was used as a measure of EI in two investigations.
Ciarrochi et al. (2002), assessed the relationship between EI
(through EIS and the Objective emotion perception test) and
suicidal ideation through ASIQ. The analysis of the data
showed that a greater emotional perception was associated with
higher levels of depression and suicidal ideation in stressful
situations. However, participants who scored high on regulating
the emotions of others responded to stress with a lower level
of suicidal ideation and depression. Kwok (2014) assessed the
relationship between EI (C-EIS-R) and suicidal ideation (C-SIS),
finding that all components of EI, but not empathy, correlated
inversely with suicidal ideation, with EI being a predictor of this
variable.
Kopera et al. (2018) explored the association between self-
reported EI (by using the SSEIT) and prevalence of suicide
attempts (by using a question from the MINI International
Neuropsychiatric Interview). It was found that individuals
with lower self-reported emotional regulation were more
likely to show a higher prevalence of attempted suicide. In
contrast, emotional perception, understanding, and utilization
of emotions were not related to suicidal attempts. However,
emotion regulation was found to mediate the association between
depression and history of suicide attempts, and the association
between neuroticism and suicide attempts.
Rahgozar et al. (2011) and Moayedi et al. (2014) used
the EQ-i as a measure of EI and obtained the same results.
In both studies, groups with a history of non-fatal suicide
attempts scored significantly lower on EI than the control group,
with the latter group scoring higher on all subscales. Similar
results were also found by Hazra and Dasgupta (2011). They
evaluated the relationship between EI (EIT) and suicidal ideation
(ASIQ) among students from Kolkata (India), finding an inverse
correlation between both variables.
Studies using performance EI tests
Karim and Shah (2014) and Paradiso et al. (2016) used MSCEIT
to evaluate the relationship between EI and suicidal ideation,
finding in both investigations a negative correlation between
these constructs. In the first article, the results showed that the
Strategic component of EI—and not the Experiential—was a
significant predictor of suicidal ideation as measured through
the General Health Questionnaire in students from Pakistan and
France. In the second article, a negative correlation was found
between most of the EI components (understanding, facilitation,
and emotional regulation) and suicidal ideation (assessed by the
BDI-II) in a sample of adult war veterans.
The main data can be viewed in Table 4.
DISCUSSION
In this systematic review, we have analyzed the existing literature
on the relationship between EI and suicidal behavior, finding a
total of 25 articles with relevant results. Although some meta-
analyses have previously been conducted on the relationship
between EI and different health indicators (Schutte et al., 2007
Frontiers in Psychology | www.frontiersin.org 8November 2018 | Volume 9 | Article 2380
Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
and Martins et al., 2010), to our knowledge, no systematic
review or meta-analysis has yet been completed with the variables
studied in the present research.
According to the results obtained, in almost all the articles that
EQ-i, EIT, WLEIS, and EIS were used as a self-reported measure
of EI, a significant inverse correlation was found between this
variable and suicidal behavior, with EI also being a good predictor
of suicidal behavior.
It is important to note that both Ciarrochi et al. (2002)
and other (later) studies found that an extremely high level
of emotional perception is positively associated with suicidal
behavior, while a high level of emotion regulation of others
correlates negatively with this construct.
With respect to the studies that used the TMMS-24
to evaluate EI, two out of four investigations obtained a
positive correlation between emotional attention (perception
and emotional identification) and suicidal behavior, which is
in agreement with previous research. In contrast, in almost
all the articles that used the same EI measurement, clarity
(emotional understanding) and emotional repair (emotional
regulation) are inversely related to suicidal behavior. Consistent
with these results, two out of three studies found that, when using
the MSCEIT, only the Strategic component of EI (emotional
understanding and regulation) was a protective factor for suicidal
behavior. However, in the last study (Paradiso et al., 2016),
emotional facilitation (included in the Experiential component)
was also added as a protective element.
Similar results were found across all age periods, even though
the samples of participants were composed of different groups
and countries.
The results strongly agree with those found in the literature
on the association between suicide risk and EI, and the role of
the latter as a protective factor. The reasons for why EI has a
protective capacity could be linked to its negative correlation with
depression and risky behaviors such as substance abuse; its role
in promoting positive emotions and resilience; the creation and
maintenance of close relationships; the use of effective coping
strategies rather than maladaptive strategies; the experience of
less emotional distress when coping with a stressful situation; the
maintenance of higher self-esteem and self-efficacy that mitigates
the influence of negative events; and the increase of subjective
well-being and life satisfaction, as mentioned above.
Some limitations of this study are worth noting. First, analysis
of the results was made difficult by the fact that each one
adopted a different theoretical model and, consequently, different
instruments. In addition, we do not know the effect size of the
correlation between both variables, so it would be interesting to
carry out a meta-analysis in the future. In some studies, certain
socio-demographic data are not correctly specified, so the total
number of people corresponding to each sex is unknown, and
this may be a variable of interest when analyzing the data. It
is important to point out that almost all the studies are quasi-
experimental and transversal investigations and in only two cases
was a test–retest design employed. It is thus more complicated
to generalize the results to certain groups, whilst it is also
challenging to analyze the persistence of results in the long-term.
Finally, only two studies applied an intervention but, despite
the post-test improvement in EI and suicide risk, there was no
significant correlation between both variables.
Future research should focus on studying gender differences
since there are variations in suicidal risk, with males showing
a higher frequency of Serious Suicide Attempts (SSA) than
females (Freeman et al., 2017). Furthermore, the literature shows
that self-report ability EI and gender moderate the association
between EI and Major Depressive Disorder (Fernández-Berrocal
and Extremera, 2016), which could improve the quality of
life in people with affective disorders, preventing the risk of
suicide.
Even though WHO has proposed strategies and intervention
guidelines that have proved useful (WHO, 2014), it is still
necessary to design definitive programs that address all
aspects related to suicide, depending on the age and the
characteristics of the population. The goal of preventing
suicidal behavior will be crucial in childhood and adolescence,
a period in which it may be beneficial to introduce a
number of interventions including EI training, paying attention
to mental disorders and other associated risk factors, and
enhancing protective factors through the development of
programs that could increase their effectiveness such as “Signs
of Suicide” (SOS; Schilling et al., 2016). Similarly, validating
both prevention and intervention programs in adulthood could
be an interesting approach for improving existing programs,
such as the elderly suicide prevention programs (Lapierre et al.,
2011).
Certain social and emotional-learning validated programs
such as the SEL Training Intervention (Castillo-Gualda et al.,
2017) or RULER (Nathanson et al., 2016) have significantly
improved the emotional skills of both young students and
adults. The former was a 3-year intervention, the aim of which
was to improve the following EI skills: accurate perception,
appraisal, and expression of emotions; awareness of feelings and
ability to generate emotions to facilitate thought; understanding
of emotions, regulation of emotions in order to promote
emotional and intellectual growth. RULER is an EI program
for students, which has shown to be effective in enhancing
student outcomes and includes a set of practical exercises.
Five skills are enhanced during the intervention: perception
of emotions in the self and others, understanding emotions,
labeling emotions with a diverse and accurate vocabulary,
expressing emotions, and effectively regulating emotions. These
programs could be used to reduce suicidal risk by improving EI
skills.
In conclusion, according to Mayer and Salovey’s theory
(Salovey and Mayer, 1990; Mayer and Salovey, 1997; Mayer
et al., 2016), EI is a mental ability, and thus it can be learned
and improved by implementing intervention programs such as
RULER. In addition, the literature reports that, regardless of age,
nationality, or EI instruments, it has been found that the EI
variable plays an important role as a protective factor for suicidal
behavior, which has opened up a new field of research in which
relevant results are emerging. This could be of interest when
designing new suicide prevention programs worldwide.
Given the potential usefulness of this research, future studies
should aim to overcome the limitations of the current literature.
Frontiers in Psychology | www.frontiersin.org 9November 2018 | Volume 9 | Article 2380
Domínguez-García and Fernández-Berrocal Emotional Intelligence and Suicidal Behavior
AUTHOR CONTRIBUTIONS
ED-G and PF-B participated in the concept and writing of
this manuscript. Both authors approved the final version of the
manuscript.
FUNDING
This work was supported by a project to PF-B from The Spanish
Ministry of Economy, Industry and Competitiveness (PSI2017-
84170-R).
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Conflict of Interest Statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
Copyright © 2018 Domínguez-García and Fernández-Berrocal. This is an open-
access article distributed under the terms of the Creative Commons Attribution
License (CC BY). The use, distribution or reproduction in other forums is permitted,
provided the original author(s) and the copyright owner(s) are credited and that the
original publication in this journal is cited, in accordance with accepted academic
practice. No use, distribution or reproduction is permitted which does not comply
with these terms.
Frontiers in Psychology | www.frontiersin.org 12 November 2018 | Volume 9 | Article 2380
... The instrument assesses three dimensions: attention to feelings, mood clarity and emotional repair, which can be addressed separately (Hodzic et al., 2016). For instance, clarity and repair were negatively related to symptoms of depression and anxiety as well as suicidal behavior, while the relationship between attention and mental health problems was positive (Domínguez-García & Fernández-Berrocal, 2018;Salguero et al., 2012). Similarly, adolescents with enhanced clarity and repair showed less perceived stress (Extremera et al., 2009), however, adolescents with high levels of attention presented higher levels of perceived and physiological stress (Ciarrochi et al., 2002;Villanueva et al., 2017). ...
... Thus, participants of this study who perceived themselves with the ability to understand and regulate emotional mood states accurately before the pandemic, presented less symptoms of depression during the first wave of and this might be explained because they had previously developed a higher level of self-esteem. These findings are in line with previous studies that stated the protective role of self-esteem and emotional intelligence on mental health symptoms (Domínguez-García & Fernández-Berrocal, 2018;Orth et al., 2016;Salguero et al., 2012). However our findings provide further evidence regarding the longitudinal positive impact of prepandemic personal and emotional strengths on adolescent mental health during the COVID-19 pandemic, highlighting the meditating role of self-esteem (Persich et al., 2021;Preston & Rew, 2021;. ...
... Furthermore, the tested mediation models with attention to feelings at T1 as predictor variable for mental health problems at T2 were not found to be significant because attention was not significantly related to mental health problems at T2. This finding is consistent with previous studies, which have indicated that the attention to feelings seems to be neither beneficial nor detrimental for mental health and well-being (Lischetzke & Eid, 2003), while other studies have indicated attention to be a risk factor for different health indicators such as perceived stress and suicidal behavior (Domínguez-García & Fernández-Berrocal, 2018;Villanueva et al., 2017). ...
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Objective: This study examined the protective role of self-esteem and perceived emotional intelligence on mental health problems in Spanish adolescents during COVID-19 pandemic. Design: Participants (N = 139; Mage = 13.83 years, SD = 0.96; 63.8% female) completed measures before the outbreak of COVID-19 (T1) and during the first wave of the pandemic in Spain (T2). Main outcome measures: Participants self-reported emotional intelligence, self-esteem, mental health problems and suicidal behavior. Results: Adolescent mental health problems were equally affected by COVID-19 pandemic according to gender, age and lockdown conditions. Adolescents with low levels of emotional intelligence and self-esteem at T1 showed a significant decrease in self-reported anxiety, depression, stress and suicidal behavior at T2. However, adolescents with average or high levels of emotional intelligence and self-esteem at T1 showed no significant changes in mental health problems at T2. Self-esteem at T1 meditated the relationships between emotional intelligence at T1 (clarity and repair) and emotional symptoms at T2 (depression, anxiety and stress). Furthermore, the relationship between self-esteem and anxiety symptoms was moderated by the number of people living together during COVID-19 lockdown. Conclusion: Our findings highlight the protective role of pre-pandemic development of self-esteem and emotional intelligence in mitigating the impact of COVID-19 outbreak on adolescent mental health during the pandemic.
... Evidence suggests that emotional intelligence (EI), referring to a set of emotional skills for processing and regulating affective information, is a key protective factor against suicide and depression (Davis et al., 2019;Domínguez-García and Fernández-Berrocal, 2018). Those adolescents showing greater levels of EI are less likely to experience depressive symptomatology after stressful events than counterparts with lower EI (Castilho et al., 2017;Resurrección et al., 2014). ...
... These findings may enable us to advance the knowledge of the link between suicide ideation and personal resources in bully-victims. The theoretical implications of this work are in line with previous findings about how depressive symptoms and EI may underlie processes involved in STB and with promising evidence that personal resources protect against the development of psychopathology (Domínguez-García and Fernández-Berrocal, 2018;Quintana-Orts et al., 2019). Furthermore, this study posits that EI is a potential protective factor closely associated with the reported depressive symptoms that should be considered by professionals in suicide preventive efforts when adolescents are involved in the bully-victim dual role. ...
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The aim of this study is to explore a model examining how emotional intelligence (EI), sex, depressive symptoms and suicidal thoughts and behaviours (STB) may interact. The sample included 380 Spanish adolescent bully-victims (61.6% boys; mean age = 14.38 years). The results indicated that EI is a significant negative predictor of decreased STB and that this relation is fully mediated by depressive symptoms. This effect was moderated by sex, such that the mediation is stronger for girls compared to boys. The promotion of EI may be core in the development of prevention programmes for suicide, especially among female bully-victims.
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p>This title was first published in 2002: Why are rates of suicidal behaviour in Chinese adolescents so high? What factors in school, community, family and interpersonal relationships cause this tragedy? Using key new research from leading researchers and social workers with first hand knowledge of these problems in Hong Kong, this enthralling study examines those most at risk and signposts the most effective interventions in therapy and strategic prevention programmes. The result is a highly original and readable account which will be compulsive reading for social workers and academics around the world.</p
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