A trait-interpersonal analysis of suicide proneness among lesbian, gay, and bisexual community members

A psychometric evaluation of the Life Attitudes Schedule-Short Form

The Life Attitudes Schedule-Short Form (LAS-SF) is a measure of suicide proneness featuring various conceptual models. We tested four competing LAS-SF factor structures, as well as construct validity with mental health and suicide metrics. Community dwelling adults (N = 488) completed an online cross-sectional survey. Results supported a four factor (i.e., death-related, health-related, injury-related, and self-related subscales) LAS-SF structure with one higher order factor. Death-related, injury-related, and self-related subscales demonstrated moderate positive associations with mental health and suicidal ideation. Death-related and self-related subscales showed links with suicidal ideation, as well as suicide and depression risk (controlling for other factors). This study is important in highlighting suicide proneness theory may need to be refined. LAS-SF uses include possible risk screening in clinical settings and future focus on the psychological death aspects of the LAS-SF in prospective research. Study limitations include lack of sample diversity and cross-sectional design.

An Integrative Psychological Model of Risk Factors for Suicidal Ideation and Behavior Among Israeli LGBT Individuals

Lesbians, gays, bisexuals, and transgender individuals (LGBT) are at high risk for suicide. This study aimed to examine an integrative psychological model of risk factors among LGBT individuals and explore the psychological pathways connecting social stigma, mental pain, and interpersonal characteristics to suicidal ideation and behavior (SIB) in this population. LGBT adults (N = 473) responded to an online questionnaire about stigma, mental pain, interpersonal characteristics, as well as suicidal ideation and behaviors. We found group differences between LGBT respondents in the study variables: Transgender people reported the highest levels of SIB and depression, closely followed by bisexuals. The association between stigma-related variables and SIB was mediated by depression, entrapment, and perceived burdensomeness. These results highlight the role of entrapment and burdensomeness in facilitating suicide risk among LGBT adults, as they may increase the damaging effect of negative societal stigma against LGBTs and thus, elevate the suicide risk in this population.

Understanding the clinical characteristics of lesbian, gay, and bisexual military service members and adult beneficiaries within an inpatient psychiatric sample

BACKGROUND

Limited knowledge exists regarding targets for suicide-focused care among high-risk United States (U.S.) civilian and military sexual minorities.

PURPOSE

This study aimed to understand the demographic and clinical characteristics of a suicidal sexual minority sample, psychiatrically hospitalized in military treatment facilities, to advance future targeted care for this vulnerable subgroup.

METHODS

Secondary analysis of baseline data from a multisite psychotherapy randomized controlled trial was performed comparing those who self-identified as lesbian, gay, or bisexual (LGB; n = 39) to heterosexual participants (n = 170).

RESULTS

LGB participants were more likely than heterosexual participants to be younger, female, never married, and enlisted rank. LGB participants reported significantly lower family support, higher perceived burdensomeness, lower acquired capability for suicide, and were twice as likely to report that they could not control their suicidal thoughts. LGB and heterosexual participants reported similar levels of other suicide risk indicators and similar lifetime suicidal ideation and attempt histories.

CONCLUSIONS

Compared to heterosexual participants, LGB participants reported increased risk indicators for suicide yet similar lifetime suicidal ideation and attempt histories. Suicide prevention programs should address the unique needs of this vulnerable subgroup. Interventions targeting family support, perceived burdensomeness, and controllability of suicidal thoughts may be promising.

Sexual Orientation and the Integrated Motivational-Volitional Model of Suicidal Behavior: Results from a Cross-Sectional Study of Young Adults in the United Kingdom

Sexual orientation minority (i.e., lesbian, gay, bisexual, queer, and other; LGBQ+) persons represent a vulnerable population with respect to suicide-related behavior. An emerging theory of suicide, the Integrated Motivational-Volitional Model of Suicide (IMV), is utilized in the present study to examine sexual orientation, as well as a number of other IMV-defined pre-motivational factors (i.e., demographics, psychological distress and personality), as they impact the IMV motivational factors of defeat, entrapment, and suicidal ideation/intent. The present investigation featured a cross-sectional online survey of young adults (ages 18-34 years; n = 418; 27% identified as LGBTQ+) across the United Kingdom. The key findings included: (1) high rates of 12-month suicidal ideation prevalence (54.5%) and willingness to enact a future suicide attempt (60.8%); (2) bisexual and other (e.g., pansexual)-identifying sexual minority persons reported higher levels of IMV-related outcomes (e.g., internal entrapment, defeat); (3) sexual orientation accounted for significant variance in predicting motivational constructs controlling for a number of other pre-motivational factors; (4) other sexual minority status, compared to heterosexual identity, predic all motivational outcomes, and; (5) extraversion, agreeableness, and emotional stability emerged as pre-motivational protective factors for varying motivational outcomes. Findings are discussed with respect to the suicide and sexual minority theories, as well as tailored suicide prevention efforts and future research.

Examining the interpersonal theory of suicide in acutely suicidal psychiatric inpatients

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.

Psychological Correlates of Self-Harm within Gay, Lesbian and Bisexual UK University Students

This study explores the association between lesbian, gay or bisexual (LGB) status and self-harm in UK higher education students. There is currently limited data on this association, and the role psychological variables have in potentially explaining this link, in UK students. We examine whether LGB status is associated with self-harm (both non-suicidal self-injury [NSSI] and suicide attempts [SA]), and whether 4 psychological variables (depression, anxiety, belongingness, self-esteem) mediate this association. A cross-sectional survey was used. UK university students (n = 707) completed an online survey including measures of self-harm, affective symptoms, belongingness, and self-esteem. Latent Variable Modelling (LVM) was used to test our hypotheses. LGB status remained associated with an elevated risk of NSSI and SA even after accounting for mediating factors. Self-esteem and (in the case of SA but not NSSI) thwarted belongingness, did, however, explain some of this association and were correlated with self-harm risk. The findings suggest that psychological factors may account for the association between LGB status and self-harm and, as such, prevention and intervention efforts directed at these psychological mediators may help to reduce self-harm risk in this population.

Minority Stress and Relational Mechanisms of Suicide among Sexual Minorities: Subgroup Differences in the Associations Between Heterosexist Victimization, Shame, Rejection Sensitivity, and Suicide Risk

Despite sexual orientation disparities in suicide, there is limited research examining factors associated with suicide risk among sexual minorities while considering subgroup differences within this group. This study identified differences between sexual minorities at risk for suicide and those not at risk. The study also examined heterosexist victimization, as one form of minority stress, and two relational mechanisms (i.e., shame and rejection sensitivity) as risk factors for suicidality. We examined a moderated-mediation model, in which we tested gender and sexual orientation differences in the mediating effects of the relational mechanisms on the association between heterosexist victimization and suicide risk. Participants were recruited online and completed an online survey. The sample included 719 sexual minority adults. Of the sample, 27.7% were at risk for suicide. Suicide risk varied by age, gender, sexual orientation, income, education, and relationship status. Heterosexist victimization, shame, and rejection sensitivity were significant risk factors for suicide. Shame and rejection sensitivity were mediators of the association between heterosexist victimization and suicide risk for subgroups of sexual minorities, mostly lesbian and gay individuals and to some extent bisexual individuals. The findings underscore minority stress, shame, and rejection sensitivity as key intervention points.

The Function of Personality in Suicidal Ideation from the Perspective of the Interpersonal-Psychological Theory of Suicide

The Interpersonal-Psychological Theory of Suicide (IPTS) has been increasingly studied over the last years, responding to the demand for a valid framework addressing suicidality. Yet, only a few studies have explored the function of personality in the IPTS and none with clinical patients. We aimed to contribute to fill this gap in investigating the relationship between personality as conceptualized by the Five-Factor Model, the IPTS constructs, and a dimensional measure of current suicidal ideation. We conducted correlation, multiple linear regression, and path analyses based on a trait-interpersonal framework in a sample of 201 individuals visiting the psychiatric emergency room of a general hospital with current suicidal ideation. Neuroticism (positively) and openness (negatively) predicted perceived burdensomeness, while neuroticism (positively) and extraversion (negatively) predicted thwarted belongingness. Higher conscientiousness and lower extraversion were both predictors of the acquired capability for suicide. However, none of the models involving path analyses with IPTS variables as mediators of the relationship between personality traits and suicidal ideation was adequately adjusted to the data. Thus, it appears that personality plays a significant albeit modest role in suicidality when considered from an IPTS perspective. As personality is frequently assessed in the clinical routine, health professionals should consider it as complementary to detect individuals at risk of or presenting suicidal ideation.

The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research

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

Minority stress, psychological distress, and alcohol misuse among sexual minority young adults: A resiliency-based conditional process analysis

BACKGROUND

Sexual minority young adults experience elevated rates of distal stress (discrimination, victimization), and related psychological distress and alcohol misuse. However, few studies have examined the degree to which personality trait differences confer risk/resilience among sexual minority young adults. We hypothesized that psychological distress would mediate the relationship between distal stress and alcohol misuse, but that these relationships would be moderated by personality trait differences.

METHOD

Sexual minority young adults (N=412) were recruited nationally. Survey measures included demographic questions, minority stressors, Five Factor personality traits, and current psychological distress and alcohol misuse symptoms. We used a data-driven two-stage cluster analytic technique to empirically derive personality trait profiles, and conducted mediation and moderated mediation analyses using a regression-based approach.

RESULTS

Our results supported a two-group personality profile solution. Relative to at-risk individuals, those classified as adaptive scored lower on neuroticism, and higher on agreeableness, extraversion, conscientiousness, and openness to experience. As predicted, psychological distress mediated the relationship between distal stress and alcohol misuse. However, personality moderated these relationships to the degree that they did not exist among individuals classified as adaptive.

DISCUSSION

In the current study, we found that personality moderated the established relationships between distal stress, psychological distress, and alcohol misuse among sexual minority young adults. Future research is needed to further explicate these relationships, and in order to develop tailored interventions for sexual minority young adults at risk.

Sexual Minority Stress and Suicide Risk: Identifying Resilience through Personality Profile Analysis

BACKGROUND

Sexual minority-based victimization, which includes threats or enacted interpersonal violence, predicts elevated suicide risk among sexual minority individuals. However, research on personality factors that contribute to resilience among sexual minority populations is lacking. Using the Five-Factor Model, we hypothesized that individuals classified as adaptive (versus at-risk) would be at decreased risk for a suicide attempt in the context of reported lifetime victimization.

METHOD

Sexual minority-identified young adults between the ages of 18 and 25 (N=412) were recruited nationally and asked to complete an online survey containing measures of personality, sexual minority stress, and lifetime suicide attempts.

RESULTS

A two-stage cluster analytic method was used to empirically derive latent personality profiles and to classify respondents as adaptive (lower neuroticism and higher extroversion, agreeableness, conscientiousness, and openness) or at-risk (higher neuroticism, lower extroversion, agreeableness, conscientiousness, and openness) on the basis of their Five Factor Personality trait scores. Adaptive individuals were slightly older and less likely to conceal their sexual orientation, but reported similar rates of victimization, discrimination, and internalized heterosexism as their at-risk counterparts. Logistic regression results indicate that despite reporting similar rates of victimization, which was a significant predictor of lifetime suicide attempt, adaptive individuals evidenced decreased risk for attempted suicide in the context of victimization, relative to at-risk individuals.

DISCUSSION

These findings suggest that an adaptive personality profile may confer resilience in the face of sexual minority-based victimization. This study adds to our knowledge of sexual minority mental health and highlights new directions for future research.