Valued living, life fulfillment, and suicide ideation among psychiatric inpatients: The mediating role of thwarted interpersonal needs

Association between perceived social support and suicide ideation distress among psychiatric inpatients: The role of thwarted interpersonal needs

INTRODUCTION

The interpersonal theory of suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) are proximal risk factors for suicide ideation; however, there are mixed results regarding this hypothesis among psychiatric inpatients.

OBJECTIVE

The current study examined the mediating role of TB and PB in the relationship between perceived social support (i.e., support from family, friends, a significant other, and total) and suicide ideation distress among psychiatric inpatients.

METHODS

Participants (short-term psychiatric inpatients; N = 139) were administered self-report assessments cross-sectionally.

RESULTS

Nonparametric mediation results indicated that the total (additive) indirect effects of TB and PB, in parallel, were significant in all models, yet there were only significant specific (unique) indirect effects of PB.

CONCLUSION

TB and PB, in combination, may be proximal risk factors for suicide ideation distress among psychiatric inpatients with lower perceived social support from family, friends, a significant other, and in total. These findings are congruent with the interpersonal theory of suicide's propositions that the combination of TB and PB increases the risk for suicide ideation. Clinicians may consider using interventions that target increasing perceived social support and decreasing TB and PB (i.e., cognitive behavioral therapy and social skills training) for this population.

Integrating the interpersonal theory of suicide and the dualistic model of passion among adults at risk for suicide

The dualistic model of passion proposes two passion types, harmonious and obsessive, representing adaptive and maladaptive passion, respectively. Studies suggest interpersonal experiences explain harmonious passion benefits and obsessive passion negative consequences. However, research has not examined passion among individuals with clinically elevated suicide risk, nor the associations between passion types and suicide-related outcomes. The present study presents a conceptual model linking the dualistic model of passion and the interpersonal theory of suicide constructs [specifically, thwarted belongingness (TB) and perceived burdensomeness (PB)]. U.S. adults with clinically elevated suicide risk (N = 484) completed online, cross-sectional assessments of harmonious and obsessive passion, TB, PB, and future dispositions (i.e., positive focus, negative focus, and suicide orientation). A mediation model indicated the effects of harmonious and obsessive passion on positive and negative focus and suicide orientation were largely explained by TB and PB. The present findings suggest engaging in a passion activity may be meaningfully related to suicide-related interpersonal perceptions (i.e., TB and PB).

The impact of stigma on engaged living and life satisfaction among people with mental illness in Hong Kong

PURPOSE

The present study aimed to investigate how the interpersonal (experienced discrimination) and intrapersonal (anticipated stigma and internalized stigma) manifestations of psychiatric stigma may affect engaged living and life satisfaction among people with mental illness. In this study, we developed and evaluated a conceptual model to clarify how experienced discrimination may lead to anticipated stigma and internalized stigma and thereby impede engaged living and reduce life satisfaction.

METHODS

A total of 205 Hong Kong Chinese people with mental illness completed standardized questionnaire measures of experienced discrimination, anticipated stigma, internalized stigma, engaged living, and life satisfaction. The associations among these variables were analyzed using path analyses and bootstrap analyses.

RESULTS

Path analyses showed that experienced discrimination was related to higher levels of anticipated stigma and internalized stigma, which were, in turn, linked to lesser engaged living and consequently lower life satisfaction. Bootstrap analyses further revealed that experienced discrimination had significant indirect effects on life satisfaction via anticipated stigma and engaged living and via internalized stigma and engaged living.

CONCLUSIONS

Theoretically, our study uncovers how the interpersonal and intrapersonal manifestations of psychiatric stigma may adversely affect engaged living and life satisfaction among people with mental illness. Practically, our study points to the importance of developing and implementing stigma-related interventions at societal and individual levels in order to enable people with mental illness to live fulfilling and satisfying lives.

Values engagement as a predictor of eating disorder severity in a residential sample of female adolescents with eating disorders

Values are freely chosen life directions and/or qualities of being that can motivate behavior change. There is nascent support for the utility of values work as a part of the therapeutic process across treatments, particularly in third wave therapy approaches (e.g., acceptance and commitment therapy). However, therapeutic values work is underresearched in clinical samples of youth. The aim of the present study is to examine the role of the two distinct values processes (engagement and obstruction), body image inflexibility, alongside other common comorbid symptoms of eating disorders (anxiety, depression) in a sample of female adolescents with eating disorders attending a residential eating disorder treatment program. Participants (N = 75) were patients at a residential eating disorder treatment facility and completed a battery of measures at time of admission. Correlational analyses and multiple regression were performed. Results found correlations between eating disorder severity, values engagement, values obstruction, body image flexibility, anxiety, and depression in the expected directions. Regression results found body image inflexibility, progression towards values, and anxiety as significant predictors of eating disorder severity (adjusted R² = .54). This study points to the importance of emphasizing values engagement in youth with eating disorders, highlighting a potential treatment target for future research.

Evaluating a Recovery-Oriented Intensive Outpatient Program for Veterans at Risk for Suicide

Background: Suicide is the 10th leading cause of death in the United States and suicide risk is elevated among military veterans. Risk for suicide is inherently transdiagnostic, complex, and multifaceted, which means a comprehensive psychotherapeutic approach to risk mitigation is required. Aims: Our aims were to summarize findings from an evaluation of an interdisciplinary, recovery-oriented intensive outpatient program (IR-IOP) that includes evidence-based suicide prevention stategies for veterans with varying psychiatric diagnoses who are at risk for suicide. Method: Veterans completed the Patient Health Questionnaire-9 and the Beck Scale for Suicide Ideation prior to and following their participation in the IR-IOP. Results: A significant decrease in the severity of suicide ideation was found between pre- and posttreatment. Limitations: This program evaluation utilized archival data and, as such, there was not a control group and posttreatment follow-up data were not collected. Conclusion: Preliminary findings suggest an IR-IOP for veterans with heterogenous psychiatric diagnoses utilizing a multifaceted psychotherapeutic approach to suicide prevention may be effective in reducing suicide ideation.

RD, Poindexter EK. Thwarted Interpersonal Needs and Suicide Ideation Distress Among Psychiatric Inpatients: The Moderating Role of Criminal Associates

Psychiatric inpatients are at elevated risk of suicide, and approximately half are criminal justice-involved. Their involvement with criminal associates may be linked to increased suicide ideation distress; however, this has not been examined. This study tested main effects of, and interactions between, thwarted belongingness (TB) or perceived burdensomeness (PB), time spent with associates, and associates' criminal involvement predicting suicide ideation distress. In our study, psychiatric inpatients (n = 139) completed assessments cross-sectionally. Results indicated that TB, PB, and associates' criminal involvement were significantly related to greater suicide ideation distress. A significant three-way interaction indicated participants who endorsed high TB, spent more time with associates, and had associates high in criminal involvement had the greatest probability of "Extreme" suicide ideation distress. These findings suggest that spending time with criminal associates may increase suicide ideation distress more than not having social interactions. Implications and limitations of this study are discussed.