Suicidal ideation among men during COVID-19: Examining the roles of loneliness, thwarted belongingness, and personality impairment

Suicidal ideation (SI) is a known precursor to suicide among men. While loneliness and thwarted belongingness (TB) have been identified as key factors influencing SI, no study has reported on all three constructs to investigate whether loneliness is associated with SI by way of TB. Furthermore, it is not clear whether personality impairment has a moderating role on this process. The present study examined the impact of loneliness on SI among men and whether TB mediated this relationship. Additionally, the study investigated whether personality impairment (i.e., self-functioning, interpersonal functioning) moderated the relationship between loneliness and TB. Canadian men (N = 434) completed an online survey that included self-report assessments of the study constructs. Conditional process modeling was used to test the indirect effect of loneliness on SI via the mediating effect of TB. Findings indicated a significant association between loneliness and SI that was mediated by TB. Further, impairment in self-functioning moderated the relationship between loneliness and TB, indicating that the relationship was stronger among men with greater difficulties in self-functioning. The findings are important to consider within the COVID-19 context, as they point to the need to reduce the detrimental impacts of loneliness, thereby potentially mitigating male SI.

Integrating the Interpersonal Theory of Suicide Into the Relations Between Cyber-Victimization and Suicidality Among Adolescents: A Short-Term Prospective Study

The relation between cyber-victimization and suicidality among adolescents has been well documented; however, the mechanisms underlying this association have not been well investigated. Drawing upon the interpersonal theory of suicide, this study aimed to examine the mediating mechanisms (i.e., thwarted belongingness and perceived burdensomeness) underlying longitudinal, bidirectional relations between cyber-victimization and suicidal ideation/attempts among adolescents and explore gender differences in the mechanisms. Participants were 497 Chinese adolescents (46.1% male; M_age = 13.28, SD = .66), who completed the assessment of cyber-victimization, thwarted belongingness, and perceived burdensomeness, suicidal ideation/attempts at three-time points. The time interval between each two assessments is two weeks. Results showed the reciprocal relations between cyber-victimization and thwarted belongingness/perceived burdensomeness, between thwarted belongingness and suicidal ideation/suicide attempts, and between perceived burdensomeness and suicide attempts. Longitudinal mediation analyses indicated that Time 2 thwarted belongingness mediated the relation between Time 1 cyber-victimization and Time 3 suicidal ideation/suicide attempts. Besides, the reverse pathway from Time 1 suicidal ideation to Time 3 cyber-victimization was also mediated by Time 2 thwarted belongingness, but it was only significant in females, as suggested by multiple-group analyses. According to the aforementioned results, the interpersonal theory of suicide provides a useful framework for understanding relations between cyber-victimization and suicidality. Findings suggest that intervention targeted at improving the need to belong may help reduce suicide risk and lower cyber-victimization. Anti-cyber-victimization should be integrated into suicide intervention and prevention programs, and gender differences should be taken into account in order to enhance the program's effectiveness.

Longitudinal mediation by perceived burden of the pathway from thwarted belonging to suicidal ideation

INTRODUCTION

Whereas the interpersonal theory of suicide entails the assumption that thwarted belongingness and perceived burdensomeness are equally important, mutually moderating, proximal causes of active ideation, evidence suggests these may not be co-moderating processes. We tested an alternative perspective, hypothesizing that burden mediates the longitudinal relationship of thwarted belonging with active ideation.

METHODS

A 6-week, four-wave prospective online survey was completed by 298 undergraduates. We tested cross-sectional and cross-lagged panel models (CLPM, with and without random effects) with belonging, burden, and ideation at 2-week lags, and post hoc models with burden as a concurrent mediator of ideation.

RESULTS

Approximately 28% of undergraduates reported active ideation at baseline. Cross-sectionally, thwarted belonging had no direct influence on ideation but indirectly affected ideation via burden. This result was not confirmed in the 2-week CLPM analyses. In post hoc analyses, we found belonging operated indirectly via later burden to influence contemporaneous ideation.

CONCLUSIONS

Findings suggest thwarted belonging influences active ideation indirectly via perceived burden. The effect of burden as a mediator appears to depend on its temporal proximity to ideation. Future research should delimit the period during which perceived burden is an active mediator, accommodate dual-process approaches, and explore other mediation alternatives to co-moderation.

Transition from Depression to Suicidal Attempt in Young Adults: The Mediation Effect of Self-Esteem and Interpersonal Needs

BACKGROUND

Depression increases the risk of suicide. Depression and suicide attempts are significantly impacted by low self-esteem and interpersonal needs (i.e., thwarted belongingness (TB) and perceived burdensomeness (PB)). More research is required to clarify how these factors affected the change from depression to suicidal attempts, which would dramatically lower the suicide fatality rate. We sought to examine the mediating roles of self-esteem, TB, and PB in Chinese young adults, since previous research shows that self-esteem has a strong relationship with TB, while TB and PB have strong relationships with suicide attempts.

METHODS

Measures on depression, interpersonal needs, and attempted suicide were completed by a sample of 247 Chinese social media users who had stated suicidal ideation online.

RESULTS

The findings showed that people who attempted suicide had significantly higher levels of TB and PB. Suicidal attempts were also impacted by depression via the mediational chains, which included self-esteem, TB, and PB.

CONCLUSIONS

Our findings might contribute to the expansion of the interpersonal theory of suicide and have an impact on effective suicide prevention.

Development and initial validation of a parent report measure of youth belongingness and burdensomeness

OBJECTIVE

The Interpersonal Theory of Suicide (ITS) implicates thwarted belongingness and perceived burdensomeness as casually related to suicide desire. The self-report Interpersonal Needs Questionnaire (INQ) is the most commonly used measure to assess belongingness and burdensomeness, including in youth. No parent-report version of the INQ exists. The current study adapted the ten-item version of the INQ (INQ-10) for parent report of youth belongingness and burdensomeness, thereby moving ITS research in youth to a multi-informant measurement approach, and examined its factor structure and convergent and concurrent validity.

METHODS

Participants were 168 clinic-referred youths ages 9-17 years (58.9% female; M_age  = 11.91) and their parents.

RESULTS

Findings supported a two-factor structure of the parent INQ. In support of convergent and concurrent validity, parent-reported belongingness and burdensomeness were significantly associated with youth-reported belongingness and burdensomeness, suicide ideation, anxiety symptoms, depressive symptoms, and impairment.

CONCLUSIONS

The current study provides initial support the INQ-parent version as a valid measure to complement youth self-reports of belongingness and burdensomeness.

Predicting suicidal ideation in a nationally representative sample of young adults: a 12-month prospective study

BACKGROUND

Evidence-based theoretical models outlining the pathways to the development of suicidal ideation may inform treatment. The current research draws from the Interpersonal Theory of Suicide (IPT) and the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour and aims to test the interaction between perceived burdensomeness and thwarted belongingness as proposed by the IPT model, and the defeat-entrapment pathway as proposed by the IMV model, in the prediction of suicidal ideation at 12-month follow-up.

METHODS

The Scottish Wellbeing Study is a nationally representative prospective study of young people aged 18-34 years (n = 3508) from across Scotland, who completed a baseline interview and a 12-month follow-up (n = 2420). The core factors from both the IPT (perceived burdensomeness and thwarted belongingness) and the IMV model (defeat, internal and external entrapment) were measured alongside demographics, depressive symptoms and suicidal ideation at baseline. At 12-month follow-up, suicidal ideation was assessed again.

RESULTS

In multiple regression analysis perceived burdensomeness and internal entrapment, with baseline suicidal ideation, predicted 12-month suicidal ideation. No support for the interaction between perceived burdensomeness and thwarted belongingness in predicting 12-month suicidal ideation was found. However, there was evidence that internal, but not external, entrapment mediated the relationship between defeat and 12-month suicidal ideation, but no support was found for the moderation of burdensomeness and belongingness on the entrapment to suicidal ideation pathway.

CONCLUSIONS

The current findings highlight the importance of targeting perceived burdensomeness and internal entrapment to reduce the likelihood that suicidal ideation emerges in at risk individuals.

Depression, anxiety, stress, and satisfaction with life: Moderating role of interpersonal needs among university students

Depression, anxiety, and stress are ranked among the top mental health concerns faced by university students in recent times perpetuated by the proliferation of digitalization. Thus, this study was performed to assess the relationship between depression, anxiety, stress, and satisfaction with life, with interpersonal needs (perceived burdensomeness and thwarted belongingness) as moderators. A cross-sectional study using a convenient sampling method was conducted among 430 Malaysian private university students (Mean aged= 20.73 years; SD = 1.26 years). A self-administered questionnaire comprising the Depression, Anxiety and Stress Scale (DASS-21), Satisfaction with Life Scale, and Interpersonal Needs Questionnaire were used. Students who experienced lower depression and anxiety reported higher satisfaction with life under the influence of low perceived burdensomeness. Perceived burdensomeness, when coupled with depression (β = 0.76, p < 0.01) and anxiety (β = 0.79, p < 0.01), contributed 15.8% of variance in satisfaction with life. Students who experienced stress reported higher satisfaction with life under the influence of high thwarted belongingness (β = 0.73, p < 0.01), contributing 17.3% of the variance in satisfaction with life. For university students who experienced depression and anxiety symptoms, mental health practitioners may need to be cognizant of how to support students' education and management of their perceived burdensomeness perceptions.

Self-injury in young bisexual people: A microlongitudinal investigation (SIBL) of thwarted belongingness and self-esteem on non-suicidal self-injury

BACKGROUND

Bisexual people are at an elevated risk for non-suicidal self-injury (NSSI). Psychological factors including self-esteem and thwarted belongingness may help explain this risk. The aim of the current study was to investigate associations between self-esteem, thwarted belongingness and NSSI urges and behavior in young bisexual people.

METHODS

Participants aged 16-25 from 25 countries took part in this microlongitudinal online survey study (N = 207). Mixed-effects linear and logistic regression were used for analysis, given the nested structure of data. Analysis examined the relationship between self-esteem and thwarted belongingness on NSSI urges and behavior at the same point in time, and lagged by one week.

RESULTS

At the same timepoint, self-esteem and thwarted belongingness both had significant between- and within-person associations with NSSI urges and behavior. For lagged models, self-esteem had significant between-person effects on urges, and thwarted belongingness had significant within-person effects. For NSSI behavior, both variables were only associated with between-person effects.

CONCLUSION

Findings support previous research suggesting the importance of self-esteem in explaining NSSI among sexual minorities. Preventative and intervention strategies to improve self-esteem may help reduce NSSI risk. Future studies should focus upon the experiences of bisexual people with intersecting identities and ensure that studies are statistically powered from inception to detect effects.

Thwarted Belongingness Hindered Successful Aging in Chinese Older Adults: Roles of Positive Mental Health and Meaning in Life

Aging of population has brought great challenges to many regions throughout the world. It has been demonstrated that interpersonal relationship is closely related to the experiences of aging for older adults. However, it still remains unknown how and under what conditions thwarted belongingness links to successful aging. This study examined the relationship between thwarted belongingness and successful aging and tested the mediating role of positive mental health and the moderating role of meaning in life. Community-dwelling older adults (n = 339) aged 60-75 years recruited in Chongqing, China completed self-measures of thwarted belongingness, successful aging, meaning in life, and positive mental health. Correlation analyses showed that successful aging was associated with less thwarted belongingness, better positive mental health, and higher levels of meaning in life. Positive mental health was found to totally mediate the negative effect of thwarted belongingness on successful aging. Moderated mediation analyses further revealed that two components of meaning in life (present of meaning and search for meaning) attenuated the indirect effect of thwarted belongingness on successful aging via positive mental health. This study highlights the protective roles of positive mental health and meaning in life and addressed cultural aspects in the process of successful aging among Chinese older adults.

Moderating effects of brooding on the link between functional impairment and interpersonal needs in survivors of serious trauma

OBJECTIVES

Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study examined the impact of brooding on the association of functional impairment with burdensomeness and belongingness among trauma-exposed undergraduates (N = 262).

METHOD

Trauma was assessed via clinical interview with questionnaires for study variables. Regression models examined the unique and interactive effects of physical impairment, emotional impairment, and brooding on burdensomeness and thwarted belongingness.

RESULTS

An interaction of brooding and impairment due to emotional difficulties was observed for burdensomeness with impairment linked to elevated burdensomeness at high (β = -0.46; p < 0.001), but not low (β = -0.07; p = 0.476) brooding. Impairment due to emotional difficulties (β = -0.38; p < 0.001) and brooding (β = 0.25; p < 0.001) were associated with belongingness.

CONCLUSIONS

Findings identify brooding as a potential target for assessment and intervention in trauma-exposed individuals.

Suicide Ideation and Thwarted Interpersonal Needs among Psychiatric Inpatients: A Network Approach

We aimed to demonstrate the utility of an item-level network analysis approach to suicide risk by testing the interpersonal psychological theory of suicide (IPTS) among 402 psychiatric inpatients. We hypothesized specific thwarted belongingness (TB) or perceived burdensomeness (PB; Interpersonal Needs Questionnaire items) facets would positively relate to passive or active suicide ideation, and these facets would positively relate to each other and form distinct clusters. We also tested TB and PB facets central to the networks as predictors of suicide ideation compared to the full TB and PB subscales. Face-valid items congruent with latent constructs proposed by the IPTS (i.e., feelings of burden on society, feeling that one does not belong) were the only two facets uniquely predictive of passive and active suicide ideation. Facets of TB and PB did not form distinct clusters. Item-level network analysis may have important conceptual, assessment, predictive, and clinical implications for understanding suicide risk.

Interpersonal Trauma and Suicide Ideation: The Indirect Effects of Depressive Symptoms, Thwarted Belongingness, and Perceived Burden

Suicide risk is elevated among college-aged students and individuals exposed to cumulative interpersonal trauma. This study used the interpersonal theory of suicide as a framework to test the relation between cumulative interpersonal trauma and suicide ideation through the indirect effects of cumulative interpersonal trauma via depression, thwarted belongingness (TB), and perceived burdensomeness (PB), in serial. Participants were 261 college students who endorsed prior trauma and completed cross-sectional study measures online. An atemporal serial mediation model indicated that cumulative interpersonal trauma significantly and indirectly related to suicide ideation through depressive symptoms, TB, and PB. The relation between cumulative interpersonal trauma and suicide ideation was explained by greater depressive symptoms, TB, and PB, in serial. Therefore, depressive symptoms, TB, and PB may be important modifiable clinical targets for college students with a history of cumulative interpersonal trauma.

The Interpersonal-Psychological Theory of Suicide in Medical Students: Comparisons of Individuals without Suicidality, Ideators, and Planners

The aim of this study was to explore the interpersonal–psychological theory of suicide (IPTS) in medical students. Higher levels of thwarted belongingness and perceived burdensomeness were expected in medical students with suicidality compared with medical students without suicidality, and a high level of acquired capability was expected in planners compared with ideators. Recruited for the study were 178 undergraduate medical students at the Université Libre de Bruxelles (ULB): 95 subjects without suicidality, 24 subjects with lifetime suicidality, 28 subjects with recent suicidal ideation, and 26 planners. An ad hoc questionnaire evaluated the risk of suicide as well as the “Suicidal thoughts and wishes” item of the BDI-II. The Interpersonal Needs Questionnaire (INS) measured thwarted belongingness (TB) and perceived burdensomeness (PB). The Acquired Capability for Suicide Scale (ACSS) measured notably fearlessness of death or pain tolerance and depression was rated using the revised version of the Beck Depression Inventory (BDI). Cognitive–affective symptoms of depression (CA-BDI) were assessed using six items of the BDI. Analyses of variance showed significant differences between groups for TB and PB but not for ACSS. Analyses of covariance, controlling for the CA-BDI scores, confirmed the significance of differences in TB and PB. Post hoc tests showed that (1) high levels of TB were characteristic of subjects with recent suicidal ideation and planners compared with subjects without suicidality; and (2) high levels of PB were characteristic of planners compared with the three other groups. Among the three characteristics of the IPTS, PB could be a strong predictor of severe suicide risk in medical students.

Meaning in Life Buffers the Association between Perceived Burdensomeness, Thwarted Belongingness, and Frequency of Non-Suicidal Self-Injuries in Spanish Adolescents

BACKGROUND

Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents.

AIMS

(a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI.

METHOD

The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed.

RESULTS

No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI.

CONCLUSIONS

Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI.

Thwarted belongingness predicts greater neural reactivity to a novel social exclusion image set: Evidence from the late positive potential

INTRODUCTION

Thwarted belongingness (TB) is among the most well-researched risk factors for suicidal ideation (SI). Yet, there is little research examining neural mechanisms underlying this construct. The present study used a novel social exclusion image set in concert with the late positive potential (LPP) to test the role of neural reactivity social exclusion in TB and SI.

METHODS

Participants (n = 243) were recruited based on elevated suicide risk and completed an emotional picture viewing task. The LPP was used to index neural reactivity to a novel set of social exclusion images and international affective picture system (IAPS) neutral, positive, and negative images.

RESULTS

Greater TB predicted a larger social exclusion ΔLPP (social exclusion LPP relative to neutral LPP) and social exclusion LPP even when accounting for SI, biological sex, age, negative affect, and perceived burdensomeness. Moreover, the social exclusion LPP was uniquely related to TB beyond the LPP to other images. Last, a larger social exclusion LPP predicted greater SI via elevations in TB.

CONCLUSION

Reactivity to social exclusion stimuli may play an important role in SI via elevated TB, but not perceived burdensomeness. Future research should further explore the neural mechanisms underlying other IPT constructs.

Psychometric Properties of Interpersonal Needs Questionnaire-15 for Predicting Suicidal Ideation among Migrant Industrial Workers in China

OBJECTIVE

Interpersonal theories of suicide suggest that the Interpersonal Needs Questionnaire (INQ) can be used to measure suicidal ideation, but few studies have focused on migrant people, a group with a high prevalence of suicidal ideation. The aim of this study was to validate the psychometric properties of the INQ-15 and its prediction of suicidal ideation among migrant industrial workers in China.

METHOD

A stratified multi-stage sample of 2023 industrial workers was recruited from 16 factories in Shenzhen, China. There were 1805 nonlocal workers, which we defined as migrant workers with a mean age of 32.50 ± 8.43 years old who were 67.3% male. The structure of the Chinese version of the INQ-15 and its correlation and predictive utility for suicidal ideation were examined through factor analysis, the Item Response Theory, the M2 test, logistic regression, and receiver operating characteristic (ROC) analysis.

RESULTS

Different from studies among various samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and social isolation. The model fit statistics of three-factor INQ were 0.075 for RMSEA, 0.945 for CFI, 0.932 for TLI, and 0.067 for SRMR. The model standard estimated factor loadings ranged from 0.366 to 0.869. The summed scores of INQ and perceived burdensomeness predicted suicidal ideation after controlling for sociodemographic characteristics such as age, gender, and income with AUC of 0.733 (95% CI: 0.712/0.754) and 0.786 (95% CI: 0.766/0.804). In the meantime, the comparison of the predictive ability between INQ total scores and PB scores was significant with p < 0.05.

CONCLUSION

The INQ has good psychometric properties and can be used to assess how migrant workers living in the Shenzhen perceive meeting interpersonal psychological needs and shows good predictive ability of suicidal ideation. Perceived burdensomeness appears to play a role in suicide and may be a point of intervention, yet the notable deviation from previous findings and the relative weakness of two of the other factors warrant further study.

Predicting suicidal ideation in a longitudinal high-risk sample: Multilevel analyses and 12-month trajectories

BACKGROUND

The Interpersonal Theory of Suicide states that suicidal ideation (SI) results from perceived burdensomeness (PB) and thwarted belongingness (TB). Cross-sectional studies found associations with SI. This study examined the prospective prediction of SI.

METHODS

Three hundred and eight inpatients reporting severe SI or a recent suicide attempt were assessed four times within 12 months. The prediction of SI was examined using multilevel analyses, group comparisons, and logistic regression analyses.

RESULTS

Cross-sectionally, PB and TB were associated with SI. Prospectively, neither PB nor TB predicted SI. We found no autocorrelation of SI over time. Patients with persistent and fluctuating SI reported higher PB at T0. PB predicted the persistence of SI over 12 months.

CONCLUSION

Results emphasize cross-sectional associations between PB, TB, and SI. PB and TB could not predict the intensity of SI over time. SI did not predict itself over time. PB was associated with a persistent trajectory of SI over 12 months.

Testing the Four Main Predictions of the Interpersonal-Psychological Theory of Suicidal Behavior in an Inpatient Sample Admitted Due to Severe Suicidality

This study aimed to evaluate four main predictions of the Interpersonal Psychological Theory of Suicide (IPTS): the importance of perceived burdensomeness (PB), thwarted belongingness (TB), hopelessness (H), and capability for suicide (CS) for (passive/active) suicide ideation, suicide intent and suicide attempts. N = 308 psychiatric inpatients admitted due to severe suicidality (53.6% female: n = 165; age: M = 36.82, SD = 14.30, range: 18-81) completed self-report measures of TB, PB, H, CS and suicide ideation as well as interviews on suicide intent and suicide attempts. TB and PB were associated with (passive/active) suicidal ideation, whereas the three-way interaction PB, TB, and H was not associated with active suicide ideation. Fearlessness about death in conjunction with active suicidal ideation was not associated with suicide intent and the interaction of PB, TB, and CS was neither predictive of recent suicide attempt status nor lifetime number of suicide attempts. Given the cross-sectional nature of the data, conclusions on causality should be handled carefully. The results challenge the theoretical validity of the IPTS and its clinical utility-at least within the methodological limitations of the current study. Yet, findings underscore the importance of PB in understanding suicidality.

Ethnic Identity and Suicide Risk among Hispanic/Latinx Young Adults: The Impact of Perceived Burdensomeness and Thwarted Belongingness

Hispanic/Latinx college students experience SI/behaviors at high rates, yet there is a dearth of research on suicide risk and sociocultural correlates of suicide risk among Hispanic/Latinx individuals. This study examined the impact of ethnic identity on suicide risk among 63 Hispanic/Latinx young adults. Further, we tested a model in which ethnic identity is integrated into the Interpersonal Psychological Theory of Suicide Behavior (IPTS). Lower levels of ethnic identity attachment were related to greater suicide risk. Further, moderated mediation analyses indicated that perceived burdensomeness mediated the relation between ethnic identity and suicide risk at higher levels of thwarted belongingness. Findings highlight the importance of sociocultural factors in understanding the utility of the IPTS model among Hispanic/Latinx individuals.

Thwarted Belongingness and PTSD Symptom Severity among Firefighters: The Role of Emotion Regulation Difficulties

The present investigation examined the associations among thwarted belongingness (TB), emotion regulation difficulties (ERD), and posttraumatic stress disorder (PTSD) symptom severity among firefighters. First, the associations of TB and ERD with PTSD symptom severity were evaluated. Second, the indirect effect of TB on PTSD symptom severity through ERD was examined. The sample included 246 trauma-exposed firefighters (M age = 40.21, SD = 9.93, 93.1% male) who completed an online questionnaire battery. Results demonstrate significant, positive associations among TB, ERD, and PTSD symptom severity; and an indirect effect of TB on PTSD symptom severity through heightened ERD (β = 0.17; CI [0.08, 0.29]). Alternate indirect effect models were also significant, underscoring the potentially bidirectional associations of these variables. These findings suggest that there is merit in investigating the role of interpersonal factors and ERD among firefighter populations to better understand PTSD symptomatology. Clinical and empirical implications are discussed.

Chinese versions of the Interpersonal Needs Questionnaire: Psychometric properties, measurement invariance across gender and cultures

Associations between unmet interpersonal needs and different aspects of suicide have been observed in both Western and non-Western cultures using the Interpersonal Needs Questionnaire (INQ). However, measurement invariance is a prerequisite for comparing differences between culturally different groups, and to date, no studies have examined measurement invariance of INQ across cultures. This study aimed to (a) validate Chinese versions of the INQ, (b) assess measurement invariance across gender for the Chinese INQ, (c) assess measurement invariance across Australian and Chinese cultures for the INQ, and (d) comprehensively assess the association of interpersonal needs with suicide ideation. A sample of 469 Australian undergraduates and a sample of 854 Chinese undergraduates were used in this study. For testing measurement invariance across gender, the sample of Chinese undergraduates was split by gender into the Chinese male and Chinese female samples. Five versions of INQ (10-, 12-, 15-, 18- and 25-item) were tested. The 10- and 15-item Chinese INQ demonstrated adequate psychometric properties through various analyses (i.e., reliability, confirmatory factor analysis, and structural equation modeling) and also demonstrated measurement invariance across gender via multigroup confirmatory factor analysis. The 10-item INQ demonstrated measurement invariance across Australian and Chinese cultures. Of the two interpersonal factors, only perceived burdensomeness was significantly associated with suicide ideation. Multigroup structural equation modeling demonstrated that perceived burdensomeness may be a greater risk factor of suicide among Australian undergraduates than among Chinese undergraduates. Practical and theoretical contributions of this study are discussed.

Potentially morally injurious events and depression symptoms among a trauma-exposed sample: Examining the roles of interpersonal needs and emotion dysregulation

The current study examined a conceptual model of the association between potentially morally injurious events (PMIEs) and depression symptoms. It was hypothesized that interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness) would independently mediate the relationship between PMIEs and depression symptoms, while emotion dysregulation would moderate the associations. Individuals who experienced a traumatic event and were residing in the United States (N = 147) completed a cross-sectional questionnaire containing measures of PMIEs, interpersonal needs, emotion dysregulation and depression symptoms. Results indicated that the indirect effect through perceived burdensomeness was significant at high levels of emotion dysregulation, whereas the indirect effect through thwarted belongingness was non-significant. Additionally, emotion dysregulation moderated each pathway, with the exception of the direct effects from PMIEs to depression symptoms. The proposed model may be informative for researchers and clinicians interested in the association between PMIEs and depression symptoms. The results may encourage the use of emotion regulation strategies to assist patients suffering from depression symptoms, especially when exposure to a PMIE has occurred.

Theoretical Mapping of Suicidal Risk Factors During the COVID-19 Pandemic: A Mini-Review

Suicide prevention in times of COVID-19 pandemic has become more challenging than ever due to unusual circumstances. The common risk factors identified with regard to suicidal behavior are fear of COVID-19, economic instability, poor access to healthcare facilities, pre-existing psychiatric disorders, and social disconnect. The studies done so far have reported either case studies or have made an effort to understand the risk factors. An understanding of the underlying causal pattern from existing theories, behind these risks, will enable adopting appropriate prevention mechanisms. Hence, this review examines evidence related to risk factors of suicides that occurred during COVID 19 and discusses it in the light of three major theoretical approaches: interpersonal model, stress diathesis model, and cognitive model. The insights obtained from the three viewpoints reveal that perceived burdensomeness, thwarted belongingness, stress sensitivity, cognitive errors such as magnification, catastrophic thinking, arbitrary inference, and mind-reading are likely reasons behind these risk factors for suicide. It is suggested that awareness regarding COVID-19 stressors, use of community-based approaches like gatekeeper training, and brief online psychotherapy by using techniques of mindfulness, interpersonal psychotherapy, and cognitive behavior therapy can be useful in reducing suicide risk during COVID-19.

The Interpersonal-Psychological Theory of Suicide to Explain Suicidal Risk in Eating Disorders: A Mini-Review

Suicide is a major cause of death in Eating Disorders (EDs) and particularly in anorexia nervosa (AN). The aim of the present mini-review was to summarize the literature focusing on the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner, as applied to explain suicidal risk in EDs. PubMed database was used to search articles focused on IPTS in EDs; 10 studies were eventually included. The majority of the included studies reported data from the same sample, even though the hypotheses and analyses for each study were unique. The investigated suicidal outcomes were suicidal ideation (SI) (40%), non-suicidal self-injury (10%), suicide attempt (40%) and suicide (10%). In ED patients Perceived Burdensomeness (PB) may play an important role, especially regarding SI risk. ED patients may feel like a burden to their close ones, and actually some of the ED symptoms may be an expression of anger and hate against the self. Overall, currently available research has supported some IPTS derived predictions (i.e., ED symptoms may increase PB and thereby SI), but not others (i.e., the elevated suicide rate in AN may be due to higher acquired capability for suicide). Further research on IPTS tenets as well as on other theoretical perspectives and constructs (e.g., interoceptive awareness), hopefully with a longitudinal design and adequate follow-up duration, might allow a more thorough understanding of the complex topic of suicidal behavior in ED patients.

Investigation of the interpersonal theory of suicide in the context of attention-deficit/hyperactivity disorder symptomatology and suicide ideation

OBJECTIVE

The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression.

METHOD

Participants were 217 college students with elevated depressive symptoms (M_age  = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%).

RESULTS

In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation.

CONCLUSION

Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.