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Lin Y, Wei Q, Luo S, Ye X, Zheng F, Zheng L, Lu X, Li H, Wu S. The risk of suicidal intention in severe mental illness: An ecological perspective. Psychol Psychother 2023; 96:1044-1061. [PMID: 37668301 DOI: 10.1111/papt.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Guided by the ecosystem theory model framework, we aimed to explore the influence of three ecological dimensions (social, family and psychological factors) on suicidal intention in people with severe mental illness (SMI). We hypothesized that three factors influence suicidal intention, and that psychological factors may play a mediating role in the influence of social and family factors on suicidal intention. METHODS We collected 994 patients with SMI aged 18 and above from May 2021 to March 2022 in the Fourth Hospital of Fuzhou City. We used logistic regression to analyse the association between social, family, psychological factors and suicidal intention. Furthermore, we explored the mediating effects among the influencing factors. RESULTS Younger male patients with schizophrenia were more likely to have suicidal intention due to psychosocial family factors (p < .05). Social factors (poor interpersonal relations, social retreat, social activities outside the home), family factors (parental functions, activities within the family, family functions), psychological factors (anxiety, depression, interest in the outside world, overt aggression, lack of accountability and planning) were all independent risk factors for suicidal intention in patients. Mediation analysis showed anxiety and depression mediated the role of social and family factors on suicidal intention (p < .05). CONCLUSION Social, family and psychological factors were important risk factors for suicidal intention, with anxiety and depression being partial mediators for suicidal intention. Therefore, interventions that enhance family and social functioning and reduce anxiety and depression may be effective in reducing suicidal intention in SMI.
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Affiliation(s)
- Yawen Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qinfei Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Suping Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoying Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fuhao Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Scientific Research Management, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Liuyan Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xinyue Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Huangyuan Li
- Department of Preventive Medicine, Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Siying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
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2
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Aboul-Ata MA, Qonsua FT, Saadi IAA. Personality Pathology and Suicide Risk: Examining the Relationship Between DSM-5 Alternative Model Traits and Suicidal Ideation and Behavior in College-Aged Individuals. Psychol Rep 2023:332941231218940. [PMID: 38029776 DOI: 10.1177/00332941231218940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND This study examines the link between personality pathology and suicide risk regarding the DSM-5 alternative model of personality disorders. METHOD The study investigates the facets, domains, internalizing, and externalizing of personality pathology and their correlation and predictive significance for suicidal ideation and behavior. This study examined a diverse and balanced sample of 1,398 college students aged between 18- and 29-year-olds from nine colleges in Kafrelshiekh University, with nearly equal representation of both genders (687 males, 711 females), a mix of rural and urban residents (807 rural, 591 urban), and a wide range of socioeconomic backgrounds (15 very low SES, 84 low SES, 878 moderate SES, 364 high SES, and 57 very high SES). The Personality Inventory for the DSM-5 (PID-5) was utilized to assess personality pathology. Columbia-Suicide Severity Rating Scale (C-SSRS) was used to evaluate suicidal ideation and behavior. RESULTS AND DISCUSSION Logistic regression reveals significant associations between personality traits and suicidal ideation (e.g., Anhedonia, Suspiciousness) and behavior (e.g., Risk Taking, Depressivity). Negative Affect and Detachment are significantly linked to suicidal ideation, while Detachment, Disinhibition, and Psychoticism are linked to suicidal behavior. Internalizing personality pathology predicts both ideation and behavior, indicating a contribution to suicidal thoughts and self-destructive acts. Externalizing is a significant predictor of suicidal behavior.
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Affiliation(s)
| | - Faten T Qonsua
- Department of Psychology, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Ibrahim A A Saadi
- Department of Psychology, University of Jeddah, Jeddah, Saudi Arabia
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3
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Vélez-Grau C, Magan IM, Gwadz M. The Burden of Not Belonging: A Qualitative Study of the Applicability of the Interpersonal Theory of Suicide Constructs of Belongingness and Burdensomeness to Ethnocultural Minoritized Youth. Behav Ther 2023; 54:777-793. [PMID: 37597957 DOI: 10.1016/j.beth.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 01/11/2023] [Accepted: 02/14/2023] [Indexed: 08/21/2023]
Abstract
Guided by the Interpersonal Theory of Suicide (IPTS), this study aims to understand the applicability of the constructs of belongingness and burdensomeness and their relevance to suicide risk and mental health among ethnocultural minoritized youth. A qualitative exploratory study was conducted using five focus groups with 29 self-identified Latinx and Black adolescents aged 13-17 years to explore the meaning they ascribed to belongingness and burdensomeness. Views of social media related to these constructs were also explored. Template analysis was used to analyze the data. Themes highlighted dimensions such as caring, self-worth, and liability, congruent with the IPTS dimensions of belongingness and burdensomeness. Notably, new themes emerged reflecting the distinctive experiences of these populations, such as the importance of being true to themselves, the burden of not belonging to families, and cultural aspects of liability, highlighting dimensions not found in the existing IPTS theoretical constructs. Consideration of the diverse experiences of ethnocultural minoritized youth can strengthen theoretical constructs, clinical practice, and aid in developing intervention strategies to increase protective factors and decrease risk factors for suicide behaviors relevant to such youth.
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Affiliation(s)
| | | | - Marya Gwadz
- New York University Silver School of Social Work; Center for Drug Use and HIV Research NYU Global Public Health
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4
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Pelton MK, Crawford H, Bul K, Robertson AE, Adams J, de Beurs D, Rodgers J, Baron‐Cohen S, Cassidy S. The role of anxiety and depression in suicidal thoughts for autistic and non-autistic people: A theory-driven network analysis. Suicide Life Threat Behav 2023; 53:426-442. [PMID: 36974940 PMCID: PMC10947106 DOI: 10.1111/sltb.12954] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Autistic adults experience more frequent suicidal thoughts and mental health difficulties than non-autistic adults, but research has yet to explain how these experiences are connected. This study explored how anxiety and depression contribute to suicidal thoughts according to the Interpersonal Theory of Suicide for autistic and non-autistic adults. METHODS Participants (autistic adults n = 463, 61% female; non-autistic n = 342, 64% female) completed online measures of anxiety, depression, thwarted belonging, and perceived burdensomeness. Network analysis explored whether: (i) being autistic is a risk marker for suicide; and (ii) pathways to suicidal thoughts are consistent for autistic and non-autistic adults. RESULTS Being autistic connected closely with feeling like an outsider, anxiety, and movement, which connected to suicidal thoughts through somatic experiences, low mood, and burdensomeness. Networks were largely consistent for autistic and non-autistic people, but connections from mood symptoms to somatic and thwarted belonging experiences were absent for autistic adults. CONCLUSION Autistic people experience more life stressors than non-autistic people leading to reduced coping, low mood, and suicidal thoughts. Promoting belonging, reducing anxiety, and understanding the role of movement could inform suicide prevention for autistic people. Research should accurately capture autistic lived experience when modeling suicide to ensure suicide prevention meets autistic needs.
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Affiliation(s)
- Mirabel K. Pelton
- Institute for Health and Wellbeing, Centre for Intelligent HealthcareCoventry UniversityCoventryUK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Kim Bul
- Institute for Health and Wellbeing, Centre for Intelligent HealthcareCoventry UniversityCoventryUK
| | - Ashley E. Robertson
- School of Psychology & NeuroscienceUniversity of Glasgow, University AvenueGlasgowUK
| | - Jon Adams
- Autistic Advocate and ResearcherPortsmouthUK
| | | | - Jacqui Rodgers
- Population Health Sciences InstituteSir James Spence Institute, Newcastle University, Royal Victoria InfirmaryNewcastleUK
| | - Simon Baron‐Cohen
- Autism Research Centre, Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Sarah Cassidy
- School of PsychologyUniversity of Nottingham, University ParkNottinghamUK
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5
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Biernesser C, Bear T, Brent D, Mair C, Zelazny J, Trauth J. Development of An Ecological Momentary Assessment of the Impact of Social Media Use Among Suicidal Adolescents. Arch Suicide Res 2022; 26:1847-1861. [PMID: 34212824 PMCID: PMC8885128 DOI: 10.1080/13811118.2021.1943581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We aimed to develop an ecological momentary assessment (EMA) measure and sampling protocol to assess the near-term impact of experiences with social media use (SMU) that are associated with risk and protective factors for adolescent suicide. METHODS To develop the EMA measure, we consulted literature reviews and conducted focus groups with the target population, adolescents at risk for suicide. Subsequently, we refined the measure through interviews with experts and cognitive interviews with adolescents, through which we explored adolescents' thought processes as they considered questions and response options. Data were recorded, transcribed, and analyzed using thematic analysis. RESULTS The initial measure had 37 items assessing a range of harmful and beneficial aspects of SMU. Through expert and cognitive interviews, we refined the measure to 4 pathways assessing positive and negative experiences with SMU as well as positive and negative in-person interactions. Each pathway included a maximum of 11 items, as well as 2 items pertaining to SMU at nighttime to be assessed once daily. Acceptable targets the EMA measure's sampling protocol included a 10-day data collection window with text message-based prompts to complete the measure triggered 2-4 times daily. CONCLUSIONS By assessing a range of risk and protective factors for youth suicide, while using methods to reduce participant burden, we established content validity for the EMA measure and acceptability for the sampling protocol among youth at high risk of suicide.HIGHLIGHTSDevelopment of an ecological momentary assessment measure and sampling protocolExploring brief momentary assessment of social media's impact on adolescent suicidal riskMulti-phase approach to establishing content validity and an acceptable sampling protocol.
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6
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VanBergen AM, Love HA. Family-of-origin rejection on suicidal ideation among a sexual minority sample. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:560-575. [PMID: 33438247 DOI: 10.1111/jmft.12484] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
Suicide is a leading cause of death in the United States. Among sexual minority populations, suicide risk is elevated; this can be explained by minority stress. One such source of minority stress is family-of-origin rejection, a known risk factor for suicide among lesbian, gay, and bisexual (LGB) adolescents; however, less is known about this association among sexual minority adults. While navigating the intersection of minority stress theory and the interpersonal theory of suicide, this study sought to evaluate the impact of family-of-origin rejection distress on suicidal ideation among a sample of adults with marginalized sexual orientations. Recruited for two larger studies, 325 LGB participants (64.3% cisgender, 35.7% transgender or nonbinary) completed an online survey concerning minority stressors, depressive symptoms, and suicide. Using cross-sectional mediation analysis, family-of-origin rejection distress was indirectly associated with suicidal thoughts through depressive symptoms. Clinical implications and suggestions for future research are discussed.
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Affiliation(s)
| | - Heather A Love
- Human Development and Family Studies, University of Alabama, Tuscaloosa, AL, USA
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7
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Bravo LG, Nagy GA, Stafford AM, McCabe BE, Gonzalez-Guarda RM. Adverse Childhood Experiences and Depressive Symptoms among Young Adult Hispanic Immigrants: Moderating and Mediating Effects of Distinct Facets of Acculturation Stress. Issues Ment Health Nurs 2022; 43:209-219. [PMID: 34524941 PMCID: PMC10955679 DOI: 10.1080/01612840.2021.1972190] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test theoretically-based mediating and moderating effects of acculturation stress on the relationship between ACEs and depression in a sample of young adult Hispanic immigrants (N = 391). Results indicated ACEs predicted depressive symptoms. Mediation and moderation effects were significant for cumulative and distinct facets of acculturation stress. Implications for mental health nurses are discussed.
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Affiliation(s)
- Lilian G. Bravo
- University of North Carolina at Chapel Hill, School of Nursing
| | - Gabriela A. Nagy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
- Duke University School of Nursing
| | | | - Brian E. McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University
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8
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Moscardini EH, Robinson A, Trachik B, Ganulin ML, LoPresti M, Dretsch MN, Calamia M, Tucker RP. Psychometric properties of the interpersonal needs questionnaire (INQ-15) in Army soldiers: Implications and future directions. MILITARY PSYCHOLOGY 2022; 34:445-454. [PMID: 38536311 PMCID: PMC10013400 DOI: 10.1080/08995605.2021.2006528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
The Interpersonal Theory of Suicide posits that two unmet interpersonal needs, thwarted belongingness and perceived burdensomeness, interact to predict suicide desire. These two constructs are frequently assessed using the 15-item Interpersonal Needs Questionnaire (INQ-15); however, this measure has never been validated in military service members. The current study analyzed the psychometric properties of the INQ-15 in a sample of (N = 1096) military personnel stationed overseas. Results indicated that the two-factor model of the INQ-15 had a poor model fit in this population; however, a bifactor model with two specific factors representing TB and PB demonstrated good fit. As seen in previous research, perceived burdensomeness was more strongly related to suicidal ideation severity than thwarted belongingness. Implications and future directions for research are discussed.
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Affiliation(s)
- Emma H. Moscardini
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Anthony Robinson
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Benjamin Trachik
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Michelle L. Ganulin
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Matthew LoPresti
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Michael N. Dretsch
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Raymond P. Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
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9
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Poindexter EK, Mitchell SM, Brown SL, Cukrowicz KC. Interpersonal Trauma and Suicide Ideation: The Indirect Effects of Depressive Symptoms, Thwarted Belongingness, and Perceived Burden. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP551-NP570. [PMID: 32383623 PMCID: PMC7648718 DOI: 10.1177/0886260520917513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
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.
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Affiliation(s)
- Erin K. Poindexter
- Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, USA
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10
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Martin CE, Pukay-Martin ND, Blain RC, Dutton-Cox C, Chard KM. Suicidal Ideation in a Veterans Affairs Residential Posttraumatic Stress Disorder Treatment Setting: The Roles of Thwarted Belongingness and Perceived Burdensomeness. J Trauma Stress 2021; 34:1188-1198. [PMID: 32598548 DOI: 10.1002/jts.22540] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 11/08/2022]
Abstract
Suicide is a significant public health concern, and, specifically, the veteran population has exhibited a 22% higher risk of death by suicide than the general population (Department of Veterans Affairs, 2017). The interpersonal psychological theory of suicide (IPTS; Joiner, 2005) appears to be the most widely researched theory to examine factors associated with suicidal ideation. The IPTS applies to veteran suicidal ideation in that veterans may feel they are burdensome to others or that they do not belong following their transition from active duty. The current study sought to (a) identify the prevalence and correlates of the IPTS constructs perceived burdensomeness and thwarted belongingness; (b) examine the main and interactive effects of these constructs on suicidal ideation; and (c) examine their indirect effects in the associations between posttraumatic stress disorder (PTSD) symptomatology, depressive symptomatology, and substance use with suicidal ideation in a sample of veterans in PTSD residential treatment (N = 125). Regression results demonstrated that perceived burdensomeness was significantly associated with suicidal ideation, β = .50, p < .001; however, thwarted belongingness and the interaction of the two were not. In the models of indirect effects, perceived burdensomeness emerged as the only significant indirect effect in the association between PTSD symptomatology and suicidal ideation, β = .01 (SE = .00), 95% CI [.0050, .0149], as well as between depressive symptomatology and suicidal ideation, β = .02 (SE = .01), 95% CI [.0109, .0311]. Study limitations and future directions are also discussed.
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Affiliation(s)
- Colleen E Martin
- Cincinnati VA Medical Center, Trauma Recovery Center, Cincinnati, Ohio, USA
| | | | - Rachel C Blain
- Cincinnati VA Medical Center, Trauma Recovery Center, Cincinnati, Ohio, USA
| | | | - Kathleen M Chard
- Cincinnati VA Medical Center, Trauma Recovery Center, Cincinnati, Ohio, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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11
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Yu J, Goldstein R, Haynie D, Luk JW, Fairman BJ, Patel R, Vidal-Ribas P, Maultsby K, Gudal M, Gilman SE. Resilience Factors in the Association Between Depressive Symptoms and Suicidality. J Adolesc Health 2021; 69:280-287. [PMID: 33431248 PMCID: PMC8479833 DOI: 10.1016/j.jadohealth.2020.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/03/2020] [Accepted: 12/04/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate whether life satisfaction and optimism might reduce the risk of suicidal thoughts and behaviors among adolescents with depressive symptoms. METHODS Participants were 1,904 youth from the NEXT Generation Health Study, a national sample of U.S. adolescents, followed over 7 years from 2009/2010 to 2015/2016. Longitudinal latent profile analysis and logistic regressions were conducted. RESULTS We identified three subgroups of adolescents with different patterns of depressive symptoms across the first six waves: "Low" (40%), "Mild" (42%), and "Moderate to Severe" (18%). The Moderate to Severe (OR = 14.47, 95% CI [6.61, 31.66]) and Mild (OR = 3.90, 95% CI [2.22, 6.86]) depression profiles had significantly higher odds of developing suicidality than the Low depression profile. Both life satisfaction and optimism moderated the association between depressive symptom profile and suicidality. The difference in suicidality risk between the Mild and Low depression profiles was significantly attenuated at high versus low levels of life satisfaction, with a difference of -.08, 95% CI [-.14, -.03]. In addition, the difference in suicidality risk between the Moderate to Severe and Low depression profiles was attenuated at high versus low levels of optimism, with a difference of -.11, 95% CI [-.21, -.01]. CONCLUSIONS For adolescents transitioning to young adulthood, resilience factors such as life satisfaction and optimism may buffer against suicidality risk in the face of mild or moderate to severe depressive symptoms.
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Affiliation(s)
- Jing Yu
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
| | - Risë Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Denise Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Jeremy W. Luk
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Brian J. Fairman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Reeya Patel
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Katherine Maultsby
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Mahad Gudal
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
| | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University
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12
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Parrish EM, Chalker SA, Cano M, Moore RC, Pinkham AE, Harvey PD, Joiner T, Lieberman A, Granholm E, Depp CA. Ecological momentary assessment of interpersonal theory of suicide constructs in people experiencing psychotic symptoms. J Psychiatr Res 2021; 140:496-503. [PMID: 34157588 PMCID: PMC8621669 DOI: 10.1016/j.jpsychires.2021.06.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/24/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND People with psychotic disorders are at an increased risk of suicide, but there is little understanding of suicidal ideation (SI) in this population. The Interpersonal Psychological Theory of Suicide posits that perceived burdensomeness (PB) and thwarted belonginess (TB) contribute to SI. To our knowledge there are no studies using ecological momentary assessment (EMA) to assess these interpersonal risk factors in a sample of individuals with psychotic disorders. This study investigated the validity and variability of PB and TB, and whether SI, EMA-measured psychotic symptoms, mood, and social context relate to PB and TB. METHOD Ninety-six participants with a psychotic disorder, including mood disorders with psychosis completed in-lab assessments of current SI, and then EMA surveys on a smartphone 3×/day for 10 days, answering questions about burdensomeness, belongingness, symptoms (i.e., hearing voices, experiencing suspiciousness), mood (i.e., happy, sad), and social context. RESULTS Burdensomeness varied within-participants less than belongingness (t (95) = -3.74, p=< .001). Participants with SI had higher mean burdensomeness ratings (t (94) = -2.70, p < .01) and lower mean belongingness ratings (t (94) = 3.68, p < .001) than did participants without SI. Being with others, greater psychotic experiences, less happiness, and greater sadness related to greater burdensomeness. SI status, being alone, greater psychotic experiences, less happiness, and greater sadness related to less belongingness. CONCLUSIONS This study examined the real-time influences of SI and psychotic symptoms on burdensomeness and belongingness. Hearing voices, suspiciousness, mood, and SI are related to interpersonal suicide-related risk factors. In this sample, social context had a differential effect on burdensomeness and belongingness.
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Affiliation(s)
- Emma M Parrish
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Samantha A Chalker
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Mayra Cano
- University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Raeanne C Moore
- University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | | | - Philip D Harvey
- University of Miami Miller School of Medicine, Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Thomas Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Amy Lieberman
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Eric Granholm
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Colin A Depp
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA.
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13
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Rath D, Teismann T, Hoeller I, Glaesmer H, Paashaus L, Schönfelder A, Juckel G, Forkmann T. Predicting suicidal ideation in a longitudinal high-risk sample: Multilevel analyses and 12-month trajectories. J Clin Psychol 2021; 77:2353-2369. [PMID: 34126652 DOI: 10.1002/jclp.23159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/31/2021] [Accepted: 04/16/2021] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Dajana Rath
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Inken Hoeller
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
| | - Laura Paashaus
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
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14
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Champion A, Oswald F, Pedersen CL. Technology-facilitated sexual violence and suicide risk: A serial mediation model investigating bullying, depression, perceived burdensomeness, and thwarted belongingness. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2021. [DOI: 10.3138/cjhs.2020-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Technology-facilitated sexual violence (TFSV) is a comprehensive term used to encompass all sexually aggressive and harassing behaviours involving technology. Although there is a growing knowledge base investigating the prevalence and consequences of TFSV, relatively little is known about the extent of aversive consequences experienced by victims and the pathways from victimization to suicidal affect, cognition, and behaviour. TFSV victimization and subsequent suicide has been a subject of several high-profile media cases in recent years. We examine TFSV in relation to two main constructs embedded within the interpersonal theory of suicide (ITS), perceived burdensomeness (PB) and thwarted belongingness (TB). Quantitative survey data ( N = 521) were used to evaluate PB and TB in the context of TFSV victimization. The objective was to analyze mechanisms underlying the relationship between TFSV victimization and suicide risk, exclusively accounting for mediating factors of interpersonal victimization, depression, TB, and PB. Pathway results showed that TFSV victimization increased suicide risk (i.e., suicidal affect, cognition, and behaviour) serially through bullying, depression, and PB—suggesting a cascade of victimization experiences. TB was not a significant mediator. The present results provide novel quantitative data substantiating the devastating risks of TFSV victimization and thus evidencing the importance of legal protections for victims of TFSV.
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Affiliation(s)
- Amanda Champion
- Department of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Flora Oswald
- Departments of Psychology and Women’s, Gender, & Sexuality Studies, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Cory L. Pedersen
- Department of Psychology, Kwantlen Polytechnic University, Surrey, British Columbia, Canada
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15
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Wang J, Xu J, Ma Z, Jia C, Wang G, Zhou L. The Mediating Role of Depressive Symptoms, Hopelessness, and Perceived Burden on the Association Between Pain Intensity and Late-Life Suicide in Rural China: A Case-Control Psychological Autopsy Study. Front Psychiatry 2021; 12:779178. [PMID: 34966310 PMCID: PMC8710711 DOI: 10.3389/fpsyt.2021.779178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Few studies have investigated the roles of psychosocial factors such as depressive symptoms and hopelessness on the relationship between pain and suicide with inconsistent results. The study aimed to analyze the impact of pain intensity on suicide death and to estimate the degree to which depressive symptoms, hopelessness, and perceived burden may explain the association in Chinese rural elderly. Methods: Using a 1:1 matched case-control design, we collected data from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including sociodemographic characteristics, pain intensity, depression, hopelessness, perceived burden, physical diseases, and social support. Conditional logistic regression was employed to assess the association between pain intensity and completed suicide. Mediation analysis using the KHB method was applied to explore the mediation effects from depressive symptoms, hopelessness, and perceived burden. Results: The result of multivariable logistic regression showed that unemployment [odds ratio (OR) = 5.06, 95% confidence interval (CI): 1.76-14.49], higher levels of hopelessness (OR = 7.72, 95% CI: 3.49-17.10), depressive symptom (OR = 15.82, 95% CI: 4.53-55.25), and severe pain (OR = 3.46, 95% CI: 1.31-9.13) were significantly associated with elevated suicide risk in older adults in rural China. Depressive symptoms, hopelessness, and perceived burden significantly mediated 43.71% of the pain-suicide association (p = 0.020), with 17.39% due to depressive symptoms, 17.63% due to hopelessness, and 8.69% due to perceived burden. Conclusions: Regular screening of pain, depressive symptoms, hopelessness, and perceived burden using simple but sensitive questions or scales for older adults with pain is vital for the prevention and early detection of suicide risk in Chinese rural areas. Moreover, the importance of pain management and psychological interventions targeted on depressive symptoms and hopelessness should be emphasized.
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Affiliation(s)
- Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiahuan Xu
- Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | | | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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16
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Cui R, Fiske A. Relation Between Depression Symptoms and Suicide Risk in Adults and Older Adults: A Brief Report. J Appl Gerontol 2020; 41:176-180. [PMID: 33174516 DOI: 10.1177/0733464820970849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Depression symptoms are key risk factors for suicide; however, older adults differ from younger adults in types of depression symptoms experienced and thus their risk factors for suicide. The present brief report investigated relations between different symptoms of depression and suicide risk and whether these relations are moderated by age. Participants were 944 community-dwelling adults (N = 512, M = 39) and older adults (N = 432, M = 66) from the United States recruited through Mechanical Turk. Participants completed self-report measures on depression symptoms and suicide risk. Age was found to moderate the relation between cognitive-affective and somatic symptoms and suicide risk. Younger age exacerbated the negative effects of these symptoms on suicide risk. The study is the first to investigate whether older adults differed from younger adults in the association between types of depression symptoms and suicide risk and found that the risk posed by cognitive-affective and somatic symptoms was greater for younger adults.
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Affiliation(s)
| | - Amy Fiske
- West Virginia University, Morgantown, USA
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17
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Hielscher E, DeVylder J, Connell M, Hasking P, Martin G, Scott JG. Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts. Acta Psychiatr Scand 2020; 141:241-253. [PMID: 31721142 DOI: 10.1111/acps.13128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation-to-attempt transition in adolescents, including their direct and indirect effect via potential mediators. METHOD Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12-17 years); of which a subsample endorsing baseline suicidal ideation (n = 216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self-Harm Behaviour Questionnaire. The Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. RESULTS Among adolescents reporting suicidal ideation at baseline (n = 216), 6.5% had attempted suicide during follow-up. The size of auditory HEs' univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR = 2.40; 95%CI = 0.76-7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine-fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR = 4.09), whereas IPTS constructs were poor explanatory variables in most models. CONCLUSION Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation-to-attempt transition are warranted.
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Affiliation(s)
- E Hielscher
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, Qld, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
| | - J DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - M Connell
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - P Hasking
- School of Psychology, Curtin University, Perth, WA, Australia
| | - G Martin
- Department of Psychiatry, The University of Queensland, Brisbane, Qld, Australia
| | - J G Scott
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, Qld, Australia.,QIMR Berghofer Medical Research Institute, Herston, Qld, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
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18
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Simons JS, Simons RM, Walters KJ, Keith JA, O'Brien C, Andal K, Stoltenberg SF. Nexus of despair: A network analysis of suicidal ideation among veterans. Arch Suicide Res 2020; 24:314-336. [PMID: 30734645 PMCID: PMC7206527 DOI: 10.1080/13811118.2019.1574689] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The objective of this study was to estimate a network model of risk and resilience factors of suicidal ideation among veterans. Two network models of suicidal ideation among Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn veterans (N = 276) incorporated key disorders, traumatic stress, and resilience constructs to contextualize suicidal ideation. Childhood trauma was positively connected with suicidal ideation and harassment and inversely connected with social support and distress tolerance. This exemplifies long-lasting associations between childhood trauma and re-victimization, emotion regulation, and ability to form supportive social relationships. A subsequent model including lower-order facets indicated that combat trauma was predominantly associated with posttraumatic stress disorder-intrusion symptoms. This study highlights the importance of addressing both risk and resilience to reduce suicide risk among veterans and increases understanding of factors that contribute to suicidal ideation.
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Affiliation(s)
- Jeffrey S Simons
- The University of South Dakota, Vermillion, South Dakota.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota
| | - Raluca M Simons
- The University of South Dakota, Vermillion, South Dakota.,Sioux Falls VA Health Care System, Sioux Falls, South Dakota
| | - Kyle J Walters
- The University of South Dakota, Vermillion, South Dakota
| | | | | | - Kate Andal
- Sioux Falls VA Health Care System, Sioux Falls, South Dakota
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19
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Trujillo A, Forrest LN, Claypool HM, Smith AR. Assessing Longitudinal Relationships among Thwarted Belongingness, Perceived Burdensomeness, and Eating Disorder Symptoms. Suicide Life Threat Behav 2019; 49:1609-1620. [PMID: 30730079 DOI: 10.1111/sltb.12541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 01/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Past work has documented a cross-sectional relationship between eating disorders (ED) and suicidality, but few studies have examined the directionality of this relationship. Informed by the interpersonal-psychological theory of suicide (IPTS), this study examines the bidirectional, longitudinal relationship between ED symptoms and two determinants of suicide ideation-thwarted belongingness (TB) and perceived burdensomeness (PB). METHOD Ninety-two treatment-seeking individuals with ED (94.5% White, 95.6% female) completed baseline (T1) measures of ED symptoms along with TB and PB. Of those, 75 (81.5%) completed a follow-up assessment eight weeks later (T2). RESULTS Separate linear regression models revealed that T1 ED symptoms did not predict T2 TB (b = .03, p = .42) or T2 PB (b = -.01, p = .68). Similarly, T1 TB did not predict T2 ED symptoms (b = .25, p = .37). T1 PB did significantly predict T2 ED symptoms (b = 0.52, p = .04). Further, among participants with AN/sub-AN, T1 TB and PB predicted T2 ED symptoms (p's ≤ .03). CONCLUSION Our results reveal the need for a nuanced understanding of the relationship between ED and suicidality. This study found that PB predicts greater ED symptoms and, among the AN/sub-AN sample, TB does as well.
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20
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Guzmán EM, Cha CB, Ribeiro JD, Franklin JC. Suicide risk around the world: a meta-analysis of longitudinal studies. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1459-1470. [PMID: 31485691 DOI: 10.1007/s00127-019-01759-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/20/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Suicidal thoughts and behaviors (STBs) have been a persistent problem worldwide. Identifying risk factors for STBs across distinct areas of the world may help predict who or where requires the greatest attention. However, risk factors for STBs are infrequently explored cross-nationally. The present study examined whether psychopathology prospectively predicts STBs across different areas of the world, and whether certain country-level factors moderate the degree of risk conferred. METHODS We conducted a meta-analysis of 71 longitudinal studies from 30 different countries that featured psychopathology-related variables predicting STB outcomes. Meta-regression was used to evaluate whether the following country-level factors modified risk: geographic region, income level, and degree of mental health structural stigma. RESULTS Over 90% of studies had been conducted in North America and Europe. When assessed by country income level, it was found that only one longitudinal study on psychopathology and STB was conducted outside of a high-income country. Moreover, less than 10% of studies were conducted in high structural stigma contexts. Meta-regression findings revealed that the variation in risk effect sizes across studies was not explained by models including country-level factors. CONCLUSIONS Our findings show critical underrepresentation of low- and middle-income countries, which account for a large proportion of global suicide deaths. This reveals a need to broaden the scope of longitudinal research on STB risk, such that countries across more regions, income levels, and degrees of structural stigma are fully accounted for. Such lines of research will improve generalizability of findings, and more precisely inform prevention efforts worldwide.
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Affiliation(s)
- E M Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 West 120th Street, Box 102, New York, NY, 10027, USA
| | - C B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 West 120th Street, Box 102, New York, NY, 10027, USA.
| | - J D Ribeiro
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahasee, FL, 32306, USA
| | - J C Franklin
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahasee, FL, 32306, USA
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21
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Bryson CN, Cramer RJ, Schmidt AT. Need for Affect, Interpersonal Psychological Theory of Suicide, and Suicide Proneness. Arch Suicide Res 2019; 23:634-647. [PMID: 30118623 DOI: 10.1080/13811118.2018.1494650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The present study expands upon the Interpersonal Psychological Theory of Suicide (IPTS), examining its relationship with the need for affect (NFA), a construct explaining attitudes toward seeking both positive and negative emotions. A sample of 576 emerging adults completed measures of NFA, IPTS, suicide proneness, and demographics online. Findings include NFA accounting for a small significant amount of suicide proneness, a positive association between approaching emotions and one indicator of suicide proneness, negative association between approaching emotions and thwarted belongingness, and positive associations between avoidance of emotions with both perceived burdensomeness and thwarted belongingness. Findings are discussed concerning NFA as a theoretically and practically relevant factor for understanding suicide.
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22
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Eaddy M, Zullo L, Horton SE, Hughes JL, Kennard B, Diederich A, Emslie GJ, Schuster L, Stewart SM. A Theory-Driven Investigation of the Association Between Emotion Dysregulation and Suicide Risk in a Clinical Adolescent Sample. Suicide Life Threat Behav 2019; 49:928-940. [PMID: 29745436 DOI: 10.1111/sltb.12472] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 04/16/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Emotion dysregulation has been consistently linked to suicide ideation and attempt, but an explanatory model for this relationship has not been adequately investigated in adolescents. This study examined the concurrent relationship among emotion dysregulation, variables from the Interpersonal-Psychological Theory of Suicide (IPTS), and suicide risk (operationalized as a continuous variable that increases in intensity from nonspecific to active suicide ideation to suicide ideation with a plan) in a clinical adolescent sample. METHOD A total of 151 adolescents (aged 12-17) were recruited from an inpatient psychiatry unit. Cross-sectional analyses were conducted to determine whether the relationship between emotion dysregulation and suicide risk was explained by the variables of perceived burdensomeness (PB), thwarted belongingness, and capability for suicide, as proposed by the IPTS. RESULTS As hypothesized, the relationship between emotion dysregulation and suicide risk was explained by PB and capability for suicide. Depressive symptoms had an independent relationship with suicide risk after controlling for IPTS variables. CONCLUSIONS The results from this study suggest that effective treatment strategies that reduce negative cognition tied to PB and depressive symptoms would address the most proximal variables related to suicide risk in adolescents. Enhancing emotion management would serve to maintain low levels of proximal influences on risk.
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Affiliation(s)
- Michael Eaddy
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Lucas Zullo
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Sarah E Horton
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | | | - Betsy Kennard
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Andrew Diederich
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Graham J Emslie
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Lisa Schuster
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
| | - Sunita M Stewart
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Medical Center, Dallas, TX, USA
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23
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Shim EJ, Lee SH, Kim NJ, Kim ES, Bang JH, Sohn BK, Park HY, Son KL, Hwang H, Lee KM, Hahm BJ. Suicide Risk in Persons with HIV/AIDS in South Korea: a Partial Test of the Interpersonal Theory of Suicide. Int J Behav Med 2019; 26:38-49. [PMID: 30255219 DOI: 10.1007/s12529-018-9749-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE The high disease burden associated with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is linked to the elevated suicide risk in this population. Informed by the interpersonal theory of suicide, this study examined how and under which conditions depression is related to suicide risk in people living with HIV/AIDS. METHODS A total of 202 outpatients with HIV/AIDS participated in a cross-sectional and multi-center survey involving four university hospitals in South Korea. This self-reported survey included the Hospital Anxiety and Depression Scale, Interpersonal Needs Questionnaire, and Mini-International Neuropsychiatric Interview suicidality module. RESULTS Participants' mean age was 48.6 (SD = 13.4) and the majority was male (89.1%). The proportions of those at high, medium, and low suicide risk were 18.5%, 20%, and 15.4%, respectively. Depression was associated with suicide risk directly and indirectly by increasing perceived burdensomeness (PB) and the indirect effect of depression on suicide risk mediated by PB was contingent on the level of thwarted belongingness (TB). PB was associated with suicide risk even after controlling for depression, suggesting its independent effect on suicide risk. CONCLUSIONS PB and TB are potential mechanisms through which depression is associated with suicide risk, supporting the applicability of the interpersonal theory of suicide to understanding a complex interplay of risk factors in people with HIV/AIDS. Moreover, given the independent association of PB with suicide risk, as well as a protective effect of TB in suicide risk, monitoring and management of these factors should be included in the care of people with HIV/AIDS.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, South Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Hwan Bang
- Division of Infectious Diseases, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Seoul, South Korea.,Department of Psychiatry, Inje University College of Medicine, Busan, South Korea
| | - Hye Youn Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Heesung Hwang
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwang-Min Lee
- Public Health and Medical Service, Seoul National University Hospital, Seoul, South Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
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24
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Measuring the relationship between social media use and addictive behavior and depression and suicide ideation among university students. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2018.05.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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25
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King JD, Horton SE, Hughes JL, Eaddy M, Kennard BD, Emslie GJ, Stewart SM. The Interpersonal-Psychological Theory of Suicide in Adolescents: A Preliminary Report of Changes Following Treatment. Suicide Life Threat Behav 2018; 48:294-304. [PMID: 28370278 DOI: 10.1111/sltb.12352] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/17/2017] [Indexed: 11/28/2022]
Abstract
This study investigated change in suicide risk in the framework of the interpersonal theory of suicide. Fifty-four adolescents completed measures of interpersonal needs, acquired capability, depressive symptoms, and suicide risk at entry and exit from treatment. There was a significant drop following treatment in unmet interpersonal needs but not in acquired capability, consistent with the theory. Both change in the interaction between interpersonal needs and in depressive symptoms contributed unique prediction to change in suicide risk. These findings extend the research in understanding changes in suicide risk and inform treatment by suggesting cognitive targets for intervention.
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Affiliation(s)
- Jessica D King
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Sarah E Horton
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Jennifer L Hughes
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Michael Eaddy
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Betsy D Kennard
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Graham J Emslie
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
| | - Sunita M Stewart
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA.,Children's Health Children's Medical Center Dallas, Dallas, TX, USA
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26
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Dueweke AR, Schwartz-Mette RA. Social-Cognitive and Social-Behavioral Correlates of Suicide Risk in College Students: Contributions from Interpersonal Theories of Suicide and Depression. Arch Suicide Res 2018; 22:224-240. [PMID: 28422574 DOI: 10.1080/13811118.2017.1319310] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Joiner's interpersonal-psychological theory of suicide (IPTS) is predated by literature examining maladaptive interpersonal behaviors associated with depression; however, research has not examined the potential relevance of such behaviors for the IPTS. The current study aimed to expand understanding of suicide risk by examining two maladaptive interpersonal behaviors in the context of Joiner's IPTS model. Structural equation modeling examined associations between depressive symptoms, social-cognitive predictors of suicide, maladaptive interpersonal behaviors, and suicide risk in 228 college students (53.9% female; M = 19.5 years, SD = 1.8). Social-cognitive IPTS variables mediated the relation between depressive symptoms and maladaptive interpersonal behavior. Both social-cognition and maladaptive interpersonal behavior mediated the effect of depressive symptoms on suicide risk. Findings have the potential to add to our understanding of the interplay of social-cognitive factors and interpersonal behaviors associated with suicide risk. Directions for future research are discussed.
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Medrano JLJ, Lopez Rosales F, Gámez-Guadix M. Assessing the Links of Sexting, Cybervictimization, Depression, and Suicidal Ideation Among University Students. Arch Suicide Res 2018; 22:153-164. [PMID: 28287925 DOI: 10.1080/13811118.2017.1304304] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The main objective of this study was to analyze the direct and indirect relationships among sexting, cybervictimization, depression, and suicidal ideation. The sample consisted of 303 university students from Mexico (mean age = 19.73, SD = 1.73) who completed a questionnaire about the variables of interest. The relationships among the variables were analyzed using structural equation modeling. The results show that sexting was associated with being the victim of cyberbullying, which, in turn, was related to depressive symptoms. In addition, sexting, cybervictimization, and depressive symptoms were significantly associated with suicidal ideation. These results contribute to a better understanding of the relationship between online risk behaviors, such as sexting, and their possible negative consequences, such as cybervictimization, depression, and suicidal ideation.
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The reciprocal associations between identity disturbance, relationship disturbance, and suicidal ideation among Chinese adolescents: A three-wave cross-lag study. J Clin Psychol 2017; 74:1174-1188. [DOI: 10.1002/jclp.22573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 10/03/2017] [Accepted: 10/19/2017] [Indexed: 11/07/2022]
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Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, Rogers ML, Podlogar MC, Chiurliza B, Ringer-Moberg FB, Michaels MS, Patros C, Joiner TE. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull 2017; 143:1313-1345. [PMID: 29072480 PMCID: PMC5730496 DOI: 10.1037/bul0000123] [Citation(s) in RCA: 570] [Impact Index Per Article: 81.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide. A growing number of studies have tested these posited pathways in various samples; however, these findings have yet to be evaluated meta-analytically. This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct meta-analyses testing the interpersonal theory hypotheses, and (c) evaluate the influence of various moderators on these relationships. Four electronic bibliographic databases were searched through the end of March, 2016: PubMed, Medline, PsycINFO, and Web of Science. Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples. Findings supported the interpersonal theory: the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation; and the interaction between thwarted belongingness, perceived burdensomeness, and capability for suicide was significantly related to a greater number of prior suicide attempts. However, effect sizes for these interactions were modest. Alternative configurations of theory variables were similarly useful for predicting suicide risk as theory-consistent pathways. We conclude with limitations and recommendations for the interpersonal theory as a framework for understanding the suicidal spectrum. (PsycINFO Database Record
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Affiliation(s)
- Carol Chu
- Florida State University, Department of Psychology, Tallahassee, FL
- McLean Hospital, Belmont, MA
- Harvard Medical School, Department of Psychiatry, Cambridge, MA
| | | | - Ian H. Stanley
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Melanie A. Hom
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Raymond P. Tucker
- Louisiana State University, Department of Psychology, Baton Rouge, LA
| | | | - Megan L. Rogers
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | - Bruno Chiurliza
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | | | - Connor Patros
- Temple University, Department of Psychology, Philadelphia, PA
| | - Thomas E. Joiner
- Florida State University, Department of Psychology, Tallahassee, FL
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Pelton MK, Cassidy SA. Are autistic traits associated with suicidality? A test of the interpersonal-psychological theory of suicide in a non-clinical young adult sample. Autism Res 2017; 10:1891-1904. [PMID: 28685996 PMCID: PMC5697632 DOI: 10.1002/aur.1828] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/28/2017] [Accepted: 06/05/2017] [Indexed: 11/08/2022]
Abstract
Autism spectrum conditions (ASC) has recently been associated with increased risk of suicidality. However, no studies have explored how autistic traits may interact with current models of suicidal behavior in a non-clinical population. The current study therefore explored how self-reported autistic traits interact with perceived burdensomeness and thwarted belongingness in predicting suicidal behavior, in the context of the Interpersonal-Psychological Theory of Suicide (IPTS). 163 young adults (aged 18-30 years) completed an online survey including measures of thwarted belonging and perceived burdensomeness (Interpersonal Needs Questionnaire), self-reported autistic traits (Autism Spectrum Quotient), current depression (Centre for Epidemiological Studies Depression Scale), and lifetime suicidality (Suicide Behavior Questionnaire-Revised). Results showed that burdensomeness and thwarted belonging significantly mediated the relationship between autistic traits and suicidal behavior. Both depression and autistic traits significantly predicted thwarted belonging and perceived burdensomeness. Autistic traits did not significantly moderate the relationship between suicidal behavior and thwarted belonging or perceived burdensomeness. Results suggest that the IPTS provides a useful framework for understanding the influence of autistic traits on suicidal behavior. However, the psychometric properties of these measures need be explored in those with clinically confirmed diagnosis of ASC. Autism Res 2017, 10: 1891-1904. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY Recent research has shown that people with high autistic traits are more likely to attempt suicide. However, no studies have explored why. We found that people with high autistic traits were more likely to experience feelings that they do not belong in the world, are a burden on others, and depression, which may increase their likelihood of attempting suicide. These results suggest that promoting inclusion and independence in those with high autistic traits could help prevent people attempting suicide.
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Affiliation(s)
- M. K. Pelton
- Centre for Research in PsychologyBehaviour and Achievement, Coventry UniversityCoventryUK
- School of PsychologyUniversity of BirminghamBirminghamUK
| | - S. A. Cassidy
- Centre for Research in PsychologyBehaviour and Achievement, Coventry UniversityCoventryUK
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Podlogar T, Žiberna J, Poštuvan V, C R Kerr D. Belongingness and Burdensomeness in Adolescents: Slovene Translation and Validation of the Interpersonal Needs Questionnaire. Suicide Life Threat Behav 2017; 47:336-352. [PMID: 27418450 DOI: 10.1111/sltb.12276] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 05/09/2016] [Indexed: 12/01/2022]
Abstract
The Interpersonal Needs Questionnaire (INQ) for assessing thwarted belongingness (TB) and perceived burdensomeness (PB) has not been validated with community adolescents. We translated and administered the INQ to 307 Slovenian adolescents twice over 2-3 months and found that the 15-item version (INQ-15) did not fit without modification. TB and PB scales correlated with concurrent and later suicide ideation and lifetime suicide attempt history. The latent PB factor was associated with concurrent and later ideation controlling for TB, age, gender, depressive symptoms, binge drinking, and peer victimization. Suicide ideation and binge drinking were independently related to attempt history. Assessing and intervening on PB and binge drinking may be promising approaches to suicide prevention with community adolescents.
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Affiliation(s)
- Tina Podlogar
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Janina Žiberna
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - Vita Poštuvan
- Andrej Marušič Institute, Slovene Centre for Suicide Research, University of Primorska, Koper, Slovenia
| | - David C R Kerr
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
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Shim EJ, Song YW, Park SH, Lee KM, Go DJ, Hahm BJ. Examining the Relationship Between Pain Catastrophizing and Suicide Risk in Patients with Rheumatic Disease: the Mediating Role of Depression, Perceived Social Support, and Perceived Burdensomeness. Int J Behav Med 2017; 24:501-512. [DOI: 10.1007/s12529-017-9648-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Teismann T, Glaesmer H, von Brachel R, Siegmann P, Forkmann T. A Prospective Examination of Perceived Burdensomeness and Thwarted Belongingness As Risk Factors for Suicide Ideation In Adult Outpatients Receiving Cognitive-Behavioral Therapy. J Clin Psychol 2017; 73:1393-1402. [DOI: 10.1002/jclp.22441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/14/2016] [Accepted: 12/04/2016] [Indexed: 11/06/2022]
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Hapenny JE, Fergus TA. Cognitive fusion, experiential avoidance, and their interactive effect: Examining associations with thwarted belongingness and perceived burdensomeness. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2016.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lutz J, Fiske A. Perceived Burdensomeness in Older and Younger Adults: Evaluation of the Psychometric Properties of the Interpersonal Needs Questionnaire. J Clin Psychol 2016; 73:1179-1195. [PMID: 27977043 DOI: 10.1002/jclp.22415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 09/15/2016] [Accepted: 10/09/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We evaluated measurement invariance of the Interpersonal Needs Questionnaire (INQ-15) Perceived Burdensomeness subscale across younger and older adult age groups as well as the construct validity of the Perceived Burdensomeness subscale by comparing nomological networks across age groups. METHOD We used nested multigroup confirmatory factor analyses to address measurement invariance and Fisher's r-to-z transformations to compare correlations between perceived burdensomeness and other constructs in younger and older samples. RESULTS Results generally supported measurement invariance, but signals of differences in fit in older adults were present. The INQ-15 Perceived Burdensomeness subscale exhibited a significantly lower correlation with depressive symptoms in older adults compared to younger adults. Correlations between perceived burdensomeness and all other constructs were similar across age groups. CONCLUSION This study provides marginal support for measurement invariance of the INQ-15 Perceived Burdensomeness subscale across younger and older adults, but results also suggest age differences in the perceived burdensomeness construct.
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Teismann T, Forkmann T, Rath D, Glaesmer H, Margraf J. Perceived burdensomeness and suicide ideation in adult outpatients receiving exposure therapy for anxiety disorders. Behav Res Ther 2016; 85:1-5. [PMID: 27494708 DOI: 10.1016/j.brat.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/27/2016] [Accepted: 07/26/2016] [Indexed: 11/15/2022]
Abstract
Perceived burdensomeness is considered a proximal risk factor for suicide ideation. However, there is a lack of prospective studies. Furthermore, it is unclear in as much psychotherapy for anxiety disorders is associated with a decrease in suicide ideation. A total of 105 adult outpatients suffering from panic disorder, agoraphobia, or specific phobia received manualized exposure-therapy. Perceived burdensomeness was considered as predictor of suicide ideation concurrently, after the fourth and the tenth therapy session and posttreatment - controlling for baseline symptom distress, suicide ideation, number of therapy sessions and age. Furthermore, pre-to post-changes in suicide ideation and perceived burdensomeness were assessed. Perceived burdensomeness emerged as a significant predictor of suicidal ideation concurrently and after the fourth and the tenth therapy session, but not at the end of therapy. Treatment had no effect on suicide ideation and only a marginal effect on perceptions of burdensomeness. In conclusion, the current study highlights the importance of perceptions of burdensomeness in understanding suicide ideation.
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Affiliation(s)
- Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany.
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Dajana Rath
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University Leipzig, Germany
| | - Jürgen Margraf
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
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Miller AB, Esposito-Smythers C, Leichtweis RN. A Short-Term, Prospective Test of the Interpersonal-Psychological Theory of Suicidal Ideation in an Adolescent Clinical Sample. Suicide Life Threat Behav 2016; 46:337-51. [PMID: 26456085 DOI: 10.1111/sltb.12196] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
The present prospective study tested a portion of the interpersonal-psychological theory of suicide (IPTS) in an adolescent clinical sample. Participants were 143 adolescents consecutively admitted to a partial hospitalization program who completed assessments at intake and discharge from the program. Results partially supported the IPTS and suggest that (1) perceived burdensomeness may be an important socially based cognition for understanding concurrent risk for suicidal ideation (SI); (2) thwarted belongingness affects depression symptom severity over time, which indirectly predicts SI over a short follow-up time frame; and (3) the IPTS constructs may function differently in a high-risk clinical adolescent sample, compared to adults, although findings are preliminary.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology, George Mason University, Fairfax, VA, USA.,Inova Kellar Center, Fairfax, VA, USA
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The German version of the Interpersonal Needs Questionnaire (INQ)--Dimensionality, psychometric properties and population-based norms. J Affect Disord 2016; 195:191-8. [PMID: 26896813 DOI: 10.1016/j.jad.2016.01.045] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/18/2016] [Accepted: 01/31/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE The Interpersonal Needs Questionnaire (INQ) assesses the two interpersonal constructs perceived burdensomeness (PB) and thwarted belongingness (TB) that lead to suicidal ideation, according to the interpersonal theory of suicide (IPTS). The present study investigates dimensionality and psychometric properties of the German version of the INQ in a population-based representative sample and delivers norm values. METHODS The German INQ as well as measures of depression and past suicidality were administered to a population-based representative sample of the German general population (n=2513) to analyze its dimensionality and construct validity by confirmatory factor analysis and correlational analysis. RESULTS Results of the confirmatory factor analysis were in line with the assumption of two-dimensionality of the INQ. The two subscales showed very good internal consistencies (α ≥ 0.89) as well as correlations with depression and suicidality that indicate convergent validity. There were no gender effects but slight age effects in the scores of both subscales. Population-based norms are provided. LIMITATIONS Convergent validity was solely examined with measures of depression and suicidal thoughts instead of further suitable constructs like loneliness and social support. Divergent validity was not investigated in the study. CONCLUSION The German version of the INQ shows good psychometric properties making it a promising tool for assessing PB and TB. The provided norms enable researchers to compare INQ scores of their samples with reference values of a population-based representative sample.
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Mandracchia JT, Smith PN. The interpersonal theory of suicide applied to male prisoners. Suicide Life Threat Behav 2015; 45:293-301. [PMID: 25312533 PMCID: PMC4397103 DOI: 10.1111/sltb.12132] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 11/30/2022]
Abstract
The interpersonal theory of suicide proposes that severe suicide ideation is caused by the combination of thwarted belongingness (TB) and perceived burdensomeness (PB), yet few studies have actually examined their interaction. Further, no studies have examined this proposal in male prisoners, a particularly at-risk group. To address this gap, the current study surveyed 399 male prisoners. TB and PB interacted to predict suicide ideation while controlling for depression and hopelessness. High levels of both TB and PB were associated with more severe suicide ideation. The interpersonal theory may aid in the detection, prevention, and treatment of suicide risk in prisoners.
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Stewart SM, Eaddy M, Horton SE, Hughes J, Kennard B. The Validity of the Interpersonal Theory of Suicide in Adolescence: A Review. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:437-449. [DOI: 10.1080/15374416.2015.1020542] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kleiman EM, Riskind JH, Stange JP, Hamilton JL, Alloy LB. Cognitive and interpersonal vulnerability to suicidal ideation: a weakest link approach. Behav Ther 2014; 45:778-90. [PMID: 25311287 PMCID: PMC6659116 DOI: 10.1016/j.beth.2014.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 05/04/2014] [Accepted: 05/19/2014] [Indexed: 11/16/2022]
Abstract
In contrast with traditional models of risk for suicidal ideation that combine multiple vulnerability components into one composite measure, weakest link perspectives posit that individuals are as vulnerable as their most vulnerable component (or "weakest link"). Such a perspective has been applied to depression, but has not been evaluated with respect to suicidal ideation. Thus, the goal of the present study was to apply a weakest link perspective to the study of suicidal ideation. We hypothesized that an individual's "weakest link" among vulnerability components from the hopelessness theory (HT) and interpersonal psychological theory of suicide (IPTS) would interact with high levels of stress to predict increases in suicidal ideation over a 6-week period better than the traditional conceptualizations of HT or IPTS. Participants were 171 college students who completed measures of cognitive vulnerability, stress, and suicidal ideation twice over a period of 6 weeks. Bayesian regression analyses supported our hypotheses. The data fit the weakest link model using HT and IPTS components better than traditional conceptualizations of HT and IPTS. This study implies that weakest link models from depression may be useful in understanding which individuals are most vulnerable to experiencing suicidal ideation in the context of stress.
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