Belongingness and Burdensomeness in Adolescents: Slovene Translation and Validation of the Interpersonal Needs Questionnaire

The Interpersonal Psychological Theory of Suicide in Italian University Students: Validation of the INQ-15 and the ACSS-FAD

In the frame of the interpersonal psychological theory of suicide (IPTS), Interpersonal Needs Questionnaire (INQ-15) assesses thwarted belongingness (TB) and perceived burdensomeness (PB), related to suicidal ideation (SI); Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) measures this component which contributes to lethal self-harm. The objective was to evaluate the psychometric properties of INQ-15 and ACSS-FAD in a population of Italian university students. Since the Italian INQ-15 was already validated, we translated ACSS-FAD through a multistage procedure and administered both to 1,665 Italian university students. Factor analysis confirmed a two-factor-related model of INQ-15, one factor of ACSS-FAD, and good reliability for both. We proved the association between INQ-15 and current SI and between ACSS-FAD and lifetime suicidal planning and/or suicide attempt. The convergent and discriminant validities were in line with those of previous studies. Both tools are valid and reliable to assess the constructs associated with suicide outcomes according to IPTS.

Respiratory sinus arrhythmia, negative social interactions, and fluctuations in unmet interpersonal needs: A daily diary study

INTRODUCTION

This study examined daily fluctuations in the unmet interpersonal needs of thwarted belongingness and perceived burdensomeness in response to daily negative social interactions, as well as the moderating role of respiratory sinus arrhythmia (RSA) across adolescents at lower and higher risk for suicidal ideation.

METHODS

Fifty five adolescents with major depressive disorder (MDD, i.e., higher-risk group) and without MDD (i.e., lower-risk group) completed measures of resting RSA, and daily measures of negative social interactions, perceived burdensomeness, and loneliness, as a proxy for thwarted belongingness, for 10 consecutive days. Within-person analyses examined the association between daily negative social interactions and unmet interpersonal needs, and the moderating roles of RSA and higher-risk group status. Between-person analyses also examined the association between RSA and unmet interpersonal needs across groups.

RESULTS

At the within-person level, participants reported more unmet interpersonal needs on days when they reported more negative social interactions. At the between-person level, higher RSA was associated with decreased loneliness in both groups, and decreased burdensomeness among the higher-risk group.

CONCLUSIONS

Negative social interactions are associated with daily unmet interpersonal needs. Higher RSA may serve as a protective factor mitigating risk for unmet interpersonal needs, particularly burdensomeness, among adolescents at higher risk for suicidal ideation.

Adolescent Connectedness: A Scoping Review of Available Measures and Their Psychometric Properties

Introduction

Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity.

Methods

We searched CINAHL, Embase, PsycInfo, PubMed, and Web of Science databases for relevant articles published since database inception to 7th February 2021. Our search structure contained the key words "Adolescents", "Connectedness", and "Measures". We also searched Open Gray for potentially relevant gray literature.

Results

We identified 335 measures from 960 eligible studies assessing various domains of adolescent connectedness, including school, family, community, peer, ethnic, racial, cultural, religious/spiritual, and self-connectedness. Most of the included studies (72.1%) were from North America and Europe. Most of the measures (n = 132, 39.4%) were measures of school connectedness among adolescents. Of the identified measures, 60 of them met our criteria of frequently used measures (i.e., the top five most used measures per domain of connectedness). These frequently used measures were used across 481 of the included studies with 400 of them reporting their psychometric properties. The reported reliability of these measures was adequate (Cronbach's alpha ≥ 0.70) in 89.8% of these studies. These measures also appeared to be valid in terms of their face, content, construct, criterion, convergent, discriminant, concurrent, predictive, measurement invariance, and cross-cultural validity.

Conclusions

There exists a wide array of measures of adolescent connectedness. Sixty of these measures have been frequently used across studies and appear to be reliable and/or valid. However, this evidence is mostly from North America and Europe. This is a reflection of the limitation of this review where only studies published in English were considered. It might also reflect the paucity of research in other regions of the world. More research is needed for clearer insights.

Perceived Burdensomeness, Thwarted Belongingness, and Social Exclusion in Transgender Women: Psychometric Properties of the Interpersonal Needs Questionnaire

Transgender women (TGW) experience serious psychiatric problems and high suicide rates. According to the interpersonal theory of suicide, thwarted belongingness and perceived burdensomeness play major roles in suicidality and can be measured by the Interpersonal Needs Questionnaire (INQ). However, no study has validated the use of the INQ in TGW. This study aimed to examine the psychometric properties of the INQ among TGW. We recruited 198 TGW (mean age 38.47 years) from Shenyang, China, using snowball sampling. The construct validity of the INQ was assessed through factor analysis, and convergent and divergent validity were examined through a structural equation model with other psychosocial factors. The construct validation analysis supported a three-factor model (perceived burdensomeness, thwarted belongingness, and social exclusion) with satisfactory fit indices: χ²/df = 1.54, RMSEA = 0.052, CFI = 0.931, TLI = 0.916, SRMR = 0.053. The thwarted belongingness was significantly associated with self-esteem and social support, and the social exclusion was significantly associated with loneliness, depression, entrapment, and defeat, suggesting satisfactory convergent and divergent validity for the three-factor model. The present findings indicate that for TGW, high social exclusion is important in assessing perceived interpersonal needs, while the notable deviation from previous two-factor model warrants further study.

Social exclusion, thwarted belongingness, and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire among patients with sexually transmitted infections in Shanghai, China

Background

Sexually transmitted infections (STIs) are a serious public health problem worldwide. Patients with STIs have a high rate of psychosocial problems and may perceive unmet interpersonal needs, which is considered a proximal and sufficient cause of suicidal thoughts and behaviors. The present study examined the construct validity and psychometric properties of the 15-item Interpersonal Needs Questionnaire among patients with STIs in Shanghai, China.

Methods

We recruited 910 patients with STIs (438 males and 472 females; mean age = 38.72, standard deviation [SD] = 13.034) from the Shanghai Skin Disease Hospital using accidental sampling. Baseline descriptive statistics were calculated using R 4.0.0, and a latent variable model was developed using Mplus 7.4.

Results

The construct validity results supported a latent variable measurement model with three distinct but related constructs (thwarted belongingness, perceived burdensomeness, and social exclusion) (p < 0.001, χ2/df = 2.475, root mean square error of approximation = 0.057, comparative fit index = 0.931, Tucker–Lewis index = 0.916, standardized root mean residual = 0.044). The Cronbach’s α and McDonald’s ω values were 0.849 and 0.767 for the total scale, 0.888 and 0.889 for perceived burdensomeness, 0.764 and 0.777 for social exclusion, and 0.892 and 0.893 for thwarted belongingness. Interpersonal needs were significantly associated with low self-esteem (r = 0.539), loneliness (r = 0.573), depression (r = 0.338), entrapment (r = 0.420), defeat (r = 0.579), and low perceived social support (r = 0.424).

Conclusions

This was the first study to highlight social exclusion as a distinct but related dimension of interpersonal needs. This finding indicates that patients with STIs perceive high social exclusion. Therefore, health providers should consider the psychological status of these patients and implement strategies to support their integration into society.

Examining psychometric properties of the Interpersonal Needs Questionnaire among college students in India

BACKGROUND

With the second-highest population in the world, suicide-related deaths in India are high, and adults under 30 are particularly at an increased risk. However, empirical examinations of factors contributing to suicide in India and assessments of reliability and validity of self-report measures assessing these constructs are rare.

AIMS

The present study examined the psychometric properties of the Interpersonal Needs Questionnaire (INQ).

MATERIALS & METHODS

Undergraduate students in India (N = 432) completed the INQ and questionnaires assessing suicidal ideation, depression, fearlessness about death, and pain tolerance.

RESULTS

Confirmatory factor analyses of the 15-item INQ indicated that after removing three items assessing perceived burdensomeness, the two-factor structure of INQ demonstrated acceptable fit with good internal consistency for each of the subscales (α = .84-.90). In line with the interpersonal-psychological theory of suicidal behavior (IPTS), thwarted belongingness and perceived burdensomeness interacted to predict suicidal ideation. Additionally, these constructs were positively associated with suicidal ideation and depression, and weakly correlated with fearlessness about death and pain tolerance.

DISCUSSION

Results support the relevance of the IPTS for understanding suicidal ideation among college students in India.

CONCLUSION

The results suggest that modified INQ demonstrates strong internal consistency, as well as good construct, criterion, and discriminant validity among Indian college students.

Psychometric Properties of the Interpersonal Needs Questionnaire-15 in Spanish Adolescents

BACKGROUND

Thwarted Belongingness (TB) and Perceived Burdensomeness (PB) are considered risk factors of suicide behavior in the Interpersonal Theory of Suicide and constitute the main factors of the Interpersonal Needs Questionnaire-INQ.

AIMS

The present study analyzes the internal consistency, construct validity, and invariance across sex and age of the INQ-15, which comprises two subscales, in a sample of Spanish community adolescents.

METHODS

Participants were 1,536 adolescents from 12 to 19 years old. The INQ-15, the total number of non-suicidal self-injuries (NSSI), the Hopelessness Scale, and the Purpose in Life Test-Adolescents (PIL-A) were used.

RESULTS

The INQ-15 showed good internal consistency for TB ( ω ¯ = 0.88) and PB ( ω ¯ = 0.78) subscales and construct and concurrent/discriminant validity in the whole sample. Both the PB and TB subscales showed a good fit { S B χ 2 ( 9 ) = 6.448, p = 0.694, CFI = 1.000, RMSEA = 0.000 [90% CI (0.000, 0.022)] and S B χ 2 ( 27 ) = 248.973, p = 0.000, CFI = 0.922, RMSEA = 0.073 [90% CI (0.065, 0.082)]}, respectively. Regarding the invariance analyses, we found (1) non-invariance in the PB subscale across sex groups and metric, scalar, and stric invariance across age groups, and (2) that it was not possible to perform the invariance analysis for the TB subscale across both sex and age because the fit was not adequate for both boys and 12-15 years old groups. Positive and significant relationships were found between the INQ-15 subscales and hopelessness and NSSI frequency, and negative and significant correlations with meaning in life.

CONCLUSIONS

The INQ-15 is a valid instrument for assessing TB and PB in Spanish adolescents. Future studies should analyze the invariance of this instrument in adolescents across sex and age.

Application of the Interpersonal Psychological Theory of Suicide in a non-clinical community-based adolescent population

BACKGROUND

The Interpersonal Psychological Theory of Suicide (IPTS) provides a theoretical model of suicide behavior that explains the emergence of suicidal ideation and suicide attempt. Limited research has tested the IPTS with adolescents. The aim of the current study is to test the full IPTS model in a non-clinical community-based sample of adolescents.

METHODS

Data for the current study are drawn from the pre-intervention survey of the school-based Sources of Strength Australia Project, which included 1,382 adolescents aged 12-17 years. Participants completed measures of perceived burdensomeness, thwarted belongingness, capability for suicide (fearlessness about death), and suicidal ideation and behavior. The IPTS models were tested using hierarchical linear and logistic regression analyses.

RESULTS

Perceived burdensomeness and thwarted belongingness, and their interaction, were significantly (p< 0.001) associated with higher levels of suicidal ideation in the past month. The three-way interaction of perceived burdensomeness, thwarted belongingness and capability for suicide was not significantly associated with having had at least one suicide attempt in the past 12 months (p= 0.052).

LIMITATIONS

The data are cross-sectional and due to the low prevalence of suicide attempts in the sample, the study may be underpowered to fully test effects for suicidal behavior.

CONCLUSIONS

The results of the current study support the predictions of the IPTS in relation to suicidal ideation in adolescents. Given the clear associations between perceived burdensomeness and thwarted belongingness with suicide risk in adolescents there may be value in targeting these factors in the assessment and prevention of suicide in this population.

Exploring the relations between interpersonal risk and adolescent suicidality during treatment

OBJECTIVE

Despite considerable evidence that supports perceived burdensomeness (PB) and thwarted belongingness (TB) as risk factors for suicidal ideation (SI), far less is known about the direction of effects between these constructs in treatments for suicidal adolescents. The present study examined bidirectional relations between PB, TB, and adolescents' suicidal ideation (SI) during a 16-week randomized clinical trial.

METHOD

129 depressed and suicidal adolescents completed PB, TB, and SI measures at three time points: baseline (T1), mid-treatment (T2), and treatment completion (T3). Random-intercept cross-lagged panel models (RI-CLPM) examined within-subject direction of effects between interpersonal variables (PB & TB) and suicidal ideation (SI) in the first and second halves of treatment.

RESULTS

Within-subjects, autoregressive paths indicated significant carryover in PB and SI. In the first half of treatment, a significant cross-lagged path indicated that T1 PB predicted change in T2 SI, and in the last half of treatment change in T2 SI predicted change in T3 PB. There were no significant auto-regressive or cross-lagged effects for TB.

CONCLUSIONS

In the first half of treatment, baseline PB predicted fewer reductions in SI suggesting that PB initially moderated adolescents' response to treatment. However, in the last half of treatment, initial reductions in SI predicted subsequent reductions in PB suggesting that adolescents' initial response to treatment decreased their perceptions of burdening others. The clinical and treatment implications of these bidirectional findings are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

Psychometric properties of the Italian version of the Interpersonal Needs Questionnaire-15 (INQ-15-I)

OBJECTIVE

The Interpersonal Needs Questionnaire (INQ-15) is a self-report measure of thwarted belongingness and perceived burdensomeness, two constructs associated with suicidal ideation. The objective of the current study was to translate the INQ-15 from English to Italian (INQ-15-I) and to test its factor structure, reliability, and validity in Italian samples.

METHOD

We examined (a) whether the components of the hypothesized two-factor measurement model are invariant across a community sample (N = 510) and a clinical sample (N = 259); (b) the relations between the INQ-15-I factors and measures of depression (Beck Depression Inventory-II), hopelessness (Beck Hopelessness Scale), and suicidal ideation (Beck Scale for Suicide Ideation); (c) the reliability and psychometric properties of the INQ-15-I.

RESULTS

Results from multigroup confirmatory factor analyses supported the adequacy of the two-factor model to represent thwarted belongingness and perceived burdensomeness. The model is invariant across community and clinical groups, showing excellent fit. The two INQ-15-I scales measure highly intercorrelated constructs. Both significantly correlate with depression, hopelessness, and suicidal ideation, and correlations are high in the clinical sample.

CONCLUSION

The INQ-15-I is a valid and reliable measure of thwarted belongingness and perceived burdensomeness. Implications for research, assessment, and intervention in suicidal ideation are discussed.

Performance of the interpersonal needs questionnaire in adolescent clinical samples: Confirmatory factor analyses and evaluation of measurement invariance

OBJECTIVE

This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents.

METHOD

Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation.

RESULTS

Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12-item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12-item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age.

CONCLUSIONS

Findings support the use of this reduced 12-item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12-item version of the INQ that avoids valence changes within subscales.

Suicide-related interpersonal needs of young Iranian people: A preliminary validation of thwarted belongingness and perceived burdensomeness constructs

The aim of the current study was to validate the Interpersonal Needs Questionnaire (INQ-15) and to test its reliability in Persian-speaking Iranian undergraduate students. In this cross-sectional study, 485 undergraduate students (age: 20.66 ± 1.42, 60% female) were assessed on the two subscales of perceived burdensomeness (PB) and thwarted belongingness (TB) and the Suicide Behavior Questionnaire-Revised (SBQ-R). Exploratory structural equation modelling (ESEM) confirmed the construct validity of INQ-14, excluding INQ#9. In addition, INQ#8, articulated in an equivalent Persian phrasing, loaded well on TB. The measurement model tested by confirmatory factor analysis (CFA) suggested INQ#11 to be eliminated, resulting in INQ-13-P to consist of PB and TB-7. The internal consistency and convergent/discriminant validity were established. The concurrent validity of PB was solidly established in terms of past year suicidal ideation (PY-SI) above and beyond anxiety, depression, prior suicidality, and TB-7. The effect of PB on PY-SI was stronger, where prior suicidality had already occurred or the perceived likelihood of future suicide (PLFS) was high. Moreover, TB-7 could only indicate PY-SI, where prior suicidality had already occurred or PLFS was high, albeit when PB was omitted. The interaction term was significant; however, beyond anxiety and depression, the effect of TB-7 on PY-SI was significant where PB was very high (n = 40, 8.25%). Therefore, future studies can utilize INQ-13-P as a valid and reliable instrument in Persian-speaking populations. However, further studies should examine the construct validity of TB and its relationship with suicide ideation in different populations.

Psychometric evaluation of the Interpersonal Needs Questionnaire (INQ) using item analysis according to the Rasch model

The Interpersonal Needs Questionnaire (INQ) assesses Thwarted Belongingness (TB) and Perceived Burdensomeness (PB), two predictors of suicidal thoughts. Up to now, the use of item response theory (IRT) for the evaluation of the INQ has been restricted to a single study with clinically depressed and suicidal youth. Therefore, the psychometric properties of the two INQ-15-subscales TB and PB were now evaluated in a general population sample (N = 2508) and a clinical adult population sample (N = 185) using IRT, specifically the Rasch model (RM) and the graphical log-linear Rasch model (GLLRM). Of special interest was whether the INQ-subscales displayed differential item functioning (DIF) across the two different samples and how well the subscales were targeted to the two sample populations. For the clinical sample, fit to a GLLRM could be established for the PB-subscale and fit to a RM was established for a five-item version of the TB-subscale. In contrast, for the general population sample fit to a GLLRM could only be achieved for the PB-subscale. Overall, there was strong evidence of local dependence (LD) across items and of some age- and gender-related DIF. Both subscales exhibited massive DIF related to the sample, indicating that they don’t work the same across the general population and clinical sample. As expected, targeting of both INQ-subscales was much better for the clinical population. Further investigations of the INQ-15 under the Rasch approach in a large clinical population are recommended to determine and optimize the scale performance.

Testing Basic Assumptions of the Interpersonal Needs Questionnaire-15 in a Sample of Clinically Depressed and Suicidal Youth

OBJECTIVE

Suicide is a leading cause of death in adolescence. The mechanisms of adolescent suicidality, however, are not fully understood. Although the Interpersonal-Psychological Theory of Suicide, as assessed by the Interpersonal Needs Questionnaire-15 (INQ), may be a promising framework, systematic study of its utility during adolescence is lacking.

METHOD

To this end, we utilized factor analyses and hierarchical regression analyses to test the factor structure, correlates, and predictive validity of the INQ in a sample of clinically depressed and suicidal adolescents (N = 120, aged 12-18). The sample was mostly female (81.9%), ethnically diverse (68.2% non-White) and with nearly a third identifying as a sexual minority (31.8%).

RESULTS

Contrary to studies including adult samples in which a two-factor solution is identified, results within this sample indicated three factors: perceived burdensomeness, thwarted belongingness, and perceived isolation. Perceived burdensomeness and the interaction between perceived burdensomeness and perceived isolation predicted suicide ideation above and beyond depression, but thwarted belongingness and perceived isolation did not.

CONCLUSION

Perceived burdensomeness appears to play a role in adolescent suicidality and may be a point of intervention, yet the notable deviation from previous findings and the relative weakness of two of the factors warrant further study.

Relevance of the interpersonal theory of suicide in an adolescent psychiatric inpatient population

The interpersonal theory of suicide (IPTS) has been widely studied in adults, but not adolescent populations at acute risk for suicide. Accordingly, this study aimed to evaluate IPTS clinical utility in a high-risk sample of suicidal adolescent inpatients. We assessed whether constructs of the IPTS (1) are associated with suicidal thoughts and behaviors (STBs) on admission to a psychiatric hospitalization, and (2) prospectively predict suicide attempt (SA) or psychiatric rehospitalization 90 days after discharge. On admission, adolescent patients self-reported recent STBs, perceived burdensomeness (PB), thwarted belongingness (TB), and depression. Parents reported their child's rehospitalization and suicide attempts 90 days after discharge. Generalized linear regression modelling was used to determine how key constructs of the IPTS are associated with STBs prior to admission and whether they prospectively predict SA or rehospitalization 90 days after discharge. IPTS constructs did not predict rehospitalization or SA within 90 days of discharge. Although PB and TB interacted to associate with prehospitalization SI frequency, and PB, TB and NSSI interacted to associate with prehospitalization SA, the nature of these interactions were not as the IPTS predicts. IPTS constructs are relevant proximal predictors of prehospitalization STB in adolescents, but may operate differently than in adults.

Validation of the Korean Version Interpersonal Needs Questionnaire

OBJECTIVE

The Interpersonal Psychological Theory of Suicide posits thwarted belongingness and perceived burdensomeness as the constructs of suicidal desire. This study examined the psychometric properties of the Interpersonal Needs Questionnaire (INQ), which measures thwarted belongingness and perceived burdensomeness, in Korean university students.

METHOD

A series of exploratory and confirmatory factor analyses were conducted to identify the latent structure of the 15-item INQ. Then, its psychometric properties were examined through a correlation analysis and a hierarchical regression analysis. The study included 313 Korean students of which 113 were male and 200 were female. The mean age was 21.51 years.

RESULTS

The factor analyses supported a two-factor model. However, item 12 cross-loaded on both thwarted belongingness and perceived burdensomeness. While the correlation analysis supported convergent validity, discriminant validity was observed only through a more elaborative measure. Furthermore, the hierarchical regression analysis revealed perceived burdensomeness and the interaction between the two constructs as significant predictors of current suicide ideation.

CONCLUSION

The difference in the structure of the INQ may be due to cultural influences. Nevertheless, the high predictability of suicide ideation that it produces even when controlling for depression implies its clinical usefulness when assessing suicidal risk in Koreans.

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