Shared and distinct psychosocial network patterns of suicidal ideation across four countries

Cross-national examinations can clarify whether associations among theory-derived and social-cognitive factors related to suicidal ideation (SI) are shared or context-specific, yet evidence remains scarce. This study estimated an overall psychosocial network of SI and compared its structure across four countries. In a cross-sectional online survey conducted between June 2025 and January 2026, 2018 adults aged 18-60 years from Italy, Korea, the UK, and the US were recruited through online survey panels. Recruitment aimed for similar age and gender profiles across the countries. Participants completed measures of SI and related psychosocial factors, which were analysed using network and relative importance analyses. The overall cross-country network comprised 39 edges, with the strongest associations between ability- and opinion-based comparison, defeat and internal entrapment, and fear of social disapproval and moral objections. SI was directly associated with perceived burdensomeness, defeat, and internal entrapment, and negatively associated with survival and coping beliefs. Defeat showed the highest centrality, whereas perceived burdensomeness showed the highest relative importance, followed by defeat and internal entrapment. The model explained 25.1% of the variance in SI severity. Cross-national networks showed broadly similar structures, although direct associations with SI varied across countries, with higher explained variance in the UK and Italy than in the US and Korea. Defeat and internal entrapment may occupy central positions within the psychological network of SI, whereas perceived burdensomeness may represent a more proximal correlate of SI. Cross-national variation highlights the importance of considering both shared and context-dependent associations in understanding SI.