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Bayliss LT, Lamont-Mills A, du Plessis C. "I Will Die by My Own Hand": Understanding the Development of Suicide Capability in the Narratives of Individuals Who Have Attempted Suicide. QUALITATIVE HEALTH RESEARCH 2024:10497323241235861. [PMID: 38914024 DOI: 10.1177/10497323241235861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Suicide capability is a multidimensional concept that facilitates the movement from suicidal ideation to suicide attempt. The three-step theory of suicide posits that three overarching contributors comprise suicide capability: acquired (fearlessness about death and high pain tolerance), dispositional (genetics), and practical (knowledge and access to lethal means) capability. Although extensive research has investigated relationships between individual contributors of capability and suicide attempts, little research has considered how an individual's capability for suicide develops as a combination of contributors. Given suicide is multifaceted and complex, our understanding of capability development is relatively limited. This potentially negatively impacts prevention and capacity reduction-focused intervention efficacy. Therefore, this study aimed to explore how suicide capability develops. Fourteen community-based suicide attempt survivors were recruited using convenience sampling. Individual narratives were collected using open-ended interviews, and data were analysed using narrative analysis. Results indicated that participant narratives contained two elements. The first included how capability development and suicide attempt facilitation were often underpinned by the relational interplay between acquired and practical contributors. For example, participants without a high pain tolerance seeking attempt methods that were perceived to be painless. The second element contained a novel finding relating to the agentic role of participants when deciding and attempting suicide. Agency was revealed within and across narratives emphasising the active role the individual plays in their movement from ideation-to-action. The role of individual agency in coming to a decision to take one's own life and then acting warrants further consideration within contemporary suicide theories.
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Affiliation(s)
- Luke T Bayliss
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
| | - Andrea Lamont-Mills
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
- Academic Affairs Division, University of Southern Queensland, Ipswich, QLD, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
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Lee CS, Sin EJ, Park M, Okazaki S, Choi Y. Cultural family processes, depressive symptoms, and suicidal ideation: A longitudinal study of Asian American youths. Suicide Life Threat Behav 2023; 53:802-817. [PMID: 37526389 DOI: 10.1111/sltb.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/22/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION This prospective study examined the direct and interactive effects of depressive symptoms and cultural family processes (i.e., intergenerational cultural conflict, academic parental control, cultural socialization parenting) on Asian American youths' suicidal ideation from adolescence to young adulthood. METHODS We utilized three-wave data of 408 Korean American and 378 Filipino American youths (M = 15.00 years, SD = 1.91 at Wave 1). For each ethnicity, we tested (1) whether depressive symptoms and cultural family processes predicted past-year suicidal ideation; and (2) whether cultural family processes moderated the depressive symptom-suicidal ideation link. RESULTS Across ethnicities, depressive symptoms significantly predicted suicidal ideation after controlling for cultural family processes. For Filipino youths, intergenerational cultural conflict significantly predicted suicidal ideation after controlling depressive symptoms and exacerbated the depressive symptom-suicidal ideation link. For Filipino youths, depressive symptoms were significantly associated with suicidal ideation only at lower levels of cultural socialization parenting. For Korean youths, academic parental control exacerbated the depressive symptom-suicidal ideation link. CONCLUSION Findings suggest that while depressive symptoms have a robust effect on Asian American youths' suicidal ideation, this effect may be moderated by cultural family processes. Different findings for Korean and Filipino youths highlight the importance of disaggregating analyses by ethnicity to guide prevention efforts.
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Affiliation(s)
- Christina S Lee
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Esther J Sin
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Michael Park
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Sumie Okazaki
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Yoonsun Choi
- Crown Family School of Social Work, Policy and Practice, University of Chicago, Chicago, Illinois, USA
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Vélez-Grau C, McTernan M, Mufson L, Lindsey MA. The role of thwarted belongingness and perceived burdensomeness in passive suicide ideation among Latinx and Black youth. Suicide Life Threat Behav 2023. [PMID: 37720934 DOI: 10.1111/sltb.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The interpersonal theory of suicide (IPTS) is used to evaluate suicide risk. Yet, it has not been sufficiently tested with ethnoracially minoritized youth. This study aimed to test whether thwarted belongingness (TB) and perceived burdensomeness (PB) were associated with passive suicide ideation (SI) among Latinx and Black youth. METHODS Data were obtained from a cross-sectional study. Some youth participants were recruited from an ongoing NIMH study of depressed Black youth in schools (N = 20). The rest were participants in a supplemental study of non-depressed Latinx and Black youth in community agencies (N = 61). Multivariate logistic regression analyses were conducted to examine the relationships between passive SI and the IPTS constructs. RESULTS Most participants identified as male (63.5%) and Latinx (59.5%), mean age 15.23 (SD = 1.4). Only TB remained significant when adjusting for age and gender, even after adding a measure of depression symptoms as a covariate. Notably, the interaction term (TBXPB) was not significantly associated with increased odds of passive SI in this sample. CONCLUSION These findings confirm the importance of examining the IPTS constructs and their relationship to passive SI in diverse populations. The relationship between TB and SI in Latinx and Black youth suggests it may be an important target for suicide prevention.
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Affiliation(s)
| | | | - Laura Mufson
- Department of Psychiatry, Columbia University, New York City, New York, USA
| | - Michael A Lindsey
- School of Social Work, New York University, New York City, New York, USA
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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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Bayliss LT, Christensen S, Lamont-Mills A, du Plessis C. Suicide capability within the ideation-to-action framework: A systematic scoping review. PLoS One 2022; 17:e0276070. [PMID: 36301944 PMCID: PMC9612581 DOI: 10.1371/journal.pone.0276070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.
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van Alphen RHB, Schout G, Koudstaal AJ, de Vreugd M, Abma T, Vermeiren RRJM. Family group conferences for suicidal adolescents: Promising results from naturalistic case study research. DEATH STUDIES 2021; 46:2445-2455. [PMID: 34549666 DOI: 10.1080/07481187.2021.1967514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Can thwarted belongingness and perceived burdensomeness, risk factors for suicidal adolescents, be turned around by family group conferences? In this case study on Nick, a 17-year-old who undertook six suicide attempts, we (including Nick) share insights and learning opportunities on how family group conferences can be used. The thematic analysis suggests that family group conferences might be a promising intervention for suicidal adolescents. For Nick, the conference was a turning point in his life, correcting perceptions of being a burden, pushing back passiveness, and boosting connection with and support from the broad social network.
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Affiliation(s)
- Roosmarijn H B van Alphen
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Gert Schout
- Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands
| | - Agaath J Koudstaal
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Martin de Vreugd
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
| | - Tineke Abma
- Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center-Curium, Leiden, The Netherlands
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Bayliss LT, Lamont-Mills A, du Plessis C, Morgan T. Suicide capacity within the ideation-to-action framework: a scoping review protocol. BMJ Open 2021; 11:e043649. [PMID: 33589461 PMCID: PMC7887362 DOI: 10.1136/bmjopen-2020-043649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION A core facilitator of the transition from suicidal thoughts to suicide attempt is the individual's capacity for suicide. Suicide capacity is a theoretically universal concept adaptable for specific groups that is hypothesised to comprise three contributing factors: acquired capability, for example, previous self-harm; dispositional, such as genetic influences and practical, knowledge of and access to lethal means. Given that suicide capacity as a concept is continuing to develop, a review and synthesis of the current literature is timely to ensure future research and development of suicide prevention strategies are based on evidential knowledge. The aim of this review is to map the available evidence to provide an overview of factors that contribute to an adult's capacity for suicide. METHODS AND ANALYSIS This review will encompass five stages. Studies will be identified through broad search strings applied to 11 academic databases: Academic Search Ultimate, APA PsycArticles, APA PsycINFO, CINAHL, Psychology & Behavioural Sciences, & Sociology Source Ultimate via EBSCOHost Megafile Ultimate; PubMed; Science Direct; Wiley Online; Taylor & Francis and ProQuest dissertations and theses. Grey literature databases and key suicide organisations will also be searched for relevant literature. Two reviewers will independently screen titles and abstracts then review full texts to identify articles meeting inclusion criteria. Articles will be assessed for eligibility based on suicide attempt history, primary research study design, language and publication date. Data from eligible full texts will be extracted using a predesigned template for analysis. The synthesisation method will be textual narrative synthesis with an incorporated quality appraisal checklist tool. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review as no human participants are involved. Study findings will be shared with key suicide organisations, through peer-reviewed publications, and conference presentations.
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Affiliation(s)
- Luke T Bayliss
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Andrea Lamont-Mills
- School of Psychology and Counselling, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Carol du Plessis
- School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Talia Morgan
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Ipswich, Queensland, Australia
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Smith PN, Kuhlman S, Wolford-Clevenger C. Examining the interpersonal theory of suicide in acutely suicidal psychiatric inpatients. DEATH STUDIES 2020; 46:1785-1791. [PMID: 33236966 DOI: 10.1080/07481187.2020.1852337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study examined hypotheses related to the development of suicidal ideation as directed by the interpersonal theory within a sample of acutely suicidal psychiatric inpatients. Consistent with ideation-to-action models, we distinguished suicidal desire from resolved plans and preparations. Although thwarted belongingness and perceived burdensomeness were correlated with suicidal desire, only perceived burdensomeness was associated with suicidal desire controlling for depression and thwarted belongingness. Depression alone was related to plans and preparations. Findings are interpreted as challenging the mechanisms hypothesis of the interpersonal theory and suggest that alternative conceptualizations of the development of suicidal desire may be warranted.
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Affiliation(s)
- Phillip N Smith
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Shane Kuhlman
- Canandaigua VA Medical Center, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
| | - Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Hjelmeland H, Knizek BL. Epistemological differences in the discussion of the interpersonal theory of suicide: A reply to the response. DEATH STUDIES 2019; 45:163-165. [PMID: 31074364 DOI: 10.1080/07481187.2019.1614112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper is a reply to Smith and colleagues' response to our critique of the interpersonal theory of suicide (IPTS). They believe that we mischaracterize and misinterpret aspects of the IPTS. Here, we argue that the problem rather seems to be that we are discussing the IPTS from two different epistemological "planets."
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Affiliation(s)
- Heidi Hjelmeland
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Birthe Loa Knizek
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Klonsky ED. The role of theory for understanding and preventing suicide (but not predicting it): A commentary on Hjelmeland and Knizek. DEATH STUDIES 2019; 44:459-462. [PMID: 30985259 DOI: 10.1080/07481187.2019.1594005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hjelmeland and Knizek suggest that parsimonious theory is inappropriate for explaining a highly complex and contextual phenomenon like suicide. Similar suggestions have been made by others. In this commentary, I counter that the pursuit of parsimonious theory is at the core of any scientific enterprise, including health sciences and suicide science. Using examples from physics and psychology, I illustrate that parsimonious theories have been essential for understanding highly complex and contextual phenomena like the motion of objects and the behavior of people. I further illustrate that these theories, despite their undeniable validity and enormous utility, have limited value for predicting future real-world events; thus, it is important not to conflate valid theory with highly accurate prediction of the future. To conclude, I offer suggestions for better evaluating and advancing suicide theory, and I affirm that the pursuit of parsimonious suicide theory is important and worthwhile, and must continue.
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Affiliation(s)
- E David Klonsky
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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