Shame,Guilt, and Suicide Ideation among Bondage and Discipline,Dominance and Submission,and Sadomasochism Practitioners: Examining the Role of the Interpersonal Theory of Suicide

To date, no study has examined rates of suicide ideation or theory‐based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty‐seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma‐related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation.     

Race,Offense Type,and Suicide Ideation: Tests of the Interpersonal‐Psychological Theory in Juvenile Offenders

This study evaluated the synergy hypothesis of the Interpersonal‐Psychological Theory of Suicide (IPTS ), which argues thwarted belongingness and perceived burdensomeness are positively interactive in their association with suicide ideation, in a group of juvenile offenders. It also examined whether this prediction is differentially applicable across race/ethnicity or offense type. Participants included 590 adjudicated and confined male juveniles. Regression was used to test the association between suicide ideation and thwarted belongingness, perceived burdensomeness, and their interaction term. Subsequent analyses included tests of group interactions related to race/ethnicity and offense type. No interaction between thwarted belongingness and perceived burdensomeness was observed, despite adequate power. No significant group interactions were observed for race/ethnicity or offense type. However, results did show significant linear relationships between thwarted belongingness, perceived burdensomeness, and ideation, highlighting their potential utility as intervention targets in this at‐risk population. Thus, although the current results are the first to show the basic IPTS risk factors generalize across race/ethnicity and offense type, they also failed to support that those factors were interactive, a primary IPTS claim. The absence of an interaction between thwarted belongingness and perceived burdensomeness suggests their role in suicide ideation for juvenile offenders may be more parsimonious than the IPTS proposes.     

An Examination of the Interpersonal Psychological Theory of Suicidal Behavior in Physicians

Physicians are commonly reported to die by suicide more frequently than individuals in the general population. Thus far, few reasons for this elevated suicide risk have been empirically investigated. Although the interpersonal psychological theory of suicidal behavior (IPTS) has been suggested as a fruitful means of explaining physician suicidality, it has yet to be examined quantitatively. Four hundred nineteen Pennsylvania physicians were assessed on a number of demographics, as well as all components of the IPTS. Findings indicated that physician scores on IPTS components are comparable to other groups displaying increased suicidality (e.g., military populations, prior attempters). Perceived burdensomeness was a significant predictor of suicidal ideation, while thwarted belongingness predicted prior suicide attempts. Acquired capability did not distinguish between prior attempters and nonattempters. Preliminary findings indicate the IPTS may be a useful framework for understanding and predicting physician suicidality.     

Perceived Racism and Suicide Ideation: Mediating Role of Depression but Moderating Role of Religiosity among African American Adults

Suicide is a public health problem for African Americans who are young and of working age. The purpose of this study was to examine mediated and moderated effects of perceived racism on suicide ideation in a community sample of 236 African American men and women. Measures of suicide ideation, depression symptoms, intrinsic/extrinsic religiosity, and perceived racism were administered. Perceived racial discrimination was directly and indirectly associated with suicide ideation. For participants who reported low levels of extrinsic religiosity, the mediated effect of perceived racism (via depression symptoms) was significant. These findings provide some insight into suicide vulnerability for specific subgroups of African Americans.     

The moderating role of pessimism in the association between retrospective relational peer victimization,interpersonal risk factors,and suicide ideation

Peer victimization (PV) is a serious concern for youth and is associated with subsequent suicide ideation in young adulthood. The interpersonal theory of suicide may provide a framework for understanding suicide ideation in this population. Specifically, thwarted belongingness (TB) and perceived burdensomeness (PB) have been significantly associated with suicide ideation among young adults with a history of peer victimization. Additionally, the personality trait of pessimism is associated with elevated suicide ideation. Thus, this study tested the association between self-reported frequency of retrospective relational (i.e., verbal and indirect) PV in primary and secondary school, thwarted interpersonal needs (TB and PB), and current suicide ideation, as well as how these relations may vary based on current pessimism. Participants were 330 undergraduate students. Nonparametric bootstrap moderated mediation procedures were used to test hypotheses. Results indicated significant indirect effects of frequency of retrospective relational PV and suicide ideation through PB and TB. Contrary to predictions, results did not indicate significant moderated mediation; however, the association between PB and suicide ideation was stronger at lower pessimism levels. We also provide supplemental analysis with optimism as the moderator. These findings suggest that clinicians may consider targeting TB, PB, as well as pessimism and optimism among those with a history of relational PV when assessing and intervening on current suicide ideation. Implications, limitations, and future directions are further discussed.     

A Short‐Term,Prospective Test of the Interpersonal–Psychological Theory of Suicidal Ideation in an Adolescent Clinical Sample

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.     

The Specificity of the Interpersonal‐Psychological Theory of Suicidal Behavior for Identifying Suicidal Ideation in an Online Sample

The interpersonal‐psychological theory of suicidal behavior suggests that the combination of perceived burdensomeness and thwarted belongingness predicts suicidal ideation. However, the specificity of this prediction to suicidal ideation has not been tested. This study examined whether these constructs were consistently associated with different characteristics of suicidal ideation, and whether they were associated with mental health problems more broadly, in an online sample of 1,352 Australian adults. Findings indicated that the interaction between perceived burdensomeness and thwarted belongingness was associated only with suicidal ideation and consistent across multiple characteristics of ideation. The study broadly supported the specificity of the IPTS.     

Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American,African American,and Hispanic Emerging Adults

Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web‐based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination–suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed.     

Comparisons of the Interpersonal–Psychological Theory of Suicide Constructs Among Individuals Without Suicidality,Ideators, Planners,and Attempters

The Interpersonal–Psychological Theory of Suicide (IPTS) proposes that combinations of thwarted belongingness, perceived burdensomeness, and acquired capability lead to suicide ideation, planning, and attempting. We compared individuals with and without suicidality on thwarted belongingness and perceived burdensomeness, and compared a combined group of planners and attempters to ideators on fearlessness about death (one component of acquired capability). Individuals with suicidality had higher thwarted belongingness and perceived burdensomeness than individuals without suicidality. Planners and attempters did not have higher fearlessness about death than ideators. These findings partially support IPTS hypotheses. Assessing thwarted belongingness and perceived burdensomeness may improve suicide risk determination.     

A Trait‐Interpersonal Analysis of Suicide Proneness Among Lesbian,Gay, and Bisexual Community Members

Suicide remains a concerning issue for lesbian, gay, and bisexual (LGB) persons. The integrated effects of five‐factor model personality traits and interpersonal‐psychological theory of suicide (IPTS) constructs on suicide proneness in a community sample of 336 LGB adults were examined. Results supported a model inclusive of all five‐factor model domains predicting IPTS constructs leading to suicide proneness. Effects of neuroticism and extraversion were both mediated by perceived burdensomeness and thwarted belongingness. Thwarted belongingness mediated the effect of agreeableness on suicide proneness. Identified mediation pathways build on existing trait‐interpersonal theory and may inform clinical services for sexual minority persons.     

Perceived Burdensomeness Predicts Outcomes of Short‐Term Psychological Treatment of Young People at Risk of Suicide

The interpersonal‐psychological theory of suicide (IPTS; Joiner, 2005 ) provides a model for understanding the mechanisms underlying suicide risk, but there is limited research measuring change in the constructs over the course of treatment. This study aimed to test whether changes in perceived burdensomeness (PB) and thwarted belongingness (TB) mediated the effects of changes in depression and hopelessness on suicide risk. The sample comprised 226 Australian young people (aged 12–24; 67.7% female; 5.7% Aboriginal and Torres Strait Islander) receiving short‐term psychological treatment for suicide‐related behaviors. Change scores over the course of therapy were generated using admission and discharge measures of PB, TB, depression, hopelessness, and suicide risk. Results revealed partial support for the theory. The relationship between changes in depression and hopelessness on suicide risk was fully mediated by changes in PB. However, changes in TB did not mediate these relationships. This study offers encouragement for the potential use of the IPTS in the context of psychological treatment of young people. Assessment of the IPTS constructs may be helpful in assessing change in suicide risk and further assist in treatment.     

Seemingly Harmless Racial Communications Are Not So Harmless: Racial Microaggressions Lead to Suicidal Ideation by Way of Depression Symptoms

Racial microaggressions, a contemporary form of subtle discrimination that occurs in everyday interactions, are associated with a variety of negative mental health outcomes. Research has not extended the connection between racial microaggressions and negative mental health to include suicide risk. Given the well‐known association between negative mental health outcomes and suicide risk, the current study examined whether racial microaggressions predicted suicidal ideation through depression symptoms among 405 young adults of color. Depression symptoms mediated the relationship between racial microaggressions and suicidal ideation. This is the first study to associate racial microaggressions to suicide risk. Societal and clinical implications are discussed.     

Economic Stress and Suicide: Multilevel Analyses

ABSTRACT: This paper reports the second of two studies of the hypothesis that the economy affects suicide; both studies were based in the same community during approximately the same time period. Although many aggregate-level tests have been conducted using archival measures of unemployment and suicide (the approach used in Part 1), the impact of economic climate on suicidal ideation has not been measured at the individual level. In the study reported here, aggregate economic indicators were combined with individual-level measures of stressful events, symptoms, and suicidal ideation obtained in a survey of Los Angeles from 1978 to 1982. Each of the two studies revealed small associations between economic stress and suicide or suicidal ideation, but they were inconsistent with respect to specific subgroups.     

Cognitive and Interpersonal Vulnerability to Suicidal Ideation: A Weakest Link Approach

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.     

Testing the Four Main Predictions of the Interpersonal–Psychological Theory of Suicidal Behavior in an Inpatient Sample Admitted Due to Severe Suicidality

This study aimed to evaluate four main predictions of the Interpersonal Psychological Theory of Suicide (IPTS): the importance of perceived burdensomeness (PB), thwarted belongingness (TB), hopelessness (H), and capability for suicide (CS) for (passive/active) suicide ideation, suicide intent and suicide attempts. N = 308 psychiatric inpatients admitted due to severe suicidality (53.6% female: n = 165; age: M = 36.82, SD = 14.30, range: 18–81) completed self-report measures of TB, PB, H, CS and suicide ideation as well as interviews on suicide intent and suicide attempts. TB and PB were associated with (passive/active) suicidal ideation, whereas the three-way interaction PB, TB, and H was not associated with active suicide ideation. Fearlessness about death in conjunction with active suicidal ideation was not associated with suicide intent and the interaction of PB, TB, and CS was neither predictive of recent suicide attempt status nor lifetime number of suicide attempts. Given the cross-sectional nature of the data, conclusions on causality should be handled carefully. The results challenge the theoretical validity of the IPTS and its clinical utility—at least within the methodological limitations of the current study. Yet, findings underscore the importance of PB in understanding suicidality.     

The Interrelations of Agency,Depression, and Suicidal Ideation Among Older Adults

The high rates of suicide among older men are cause for concern, and have prompted the investigation of factors that might explain these elevated rates. The current research examined whether the gender role construct agency was associated with depression and suicidal ideation among older adults. The results, based on self‐report data from a sample of older Australian men (n = 69) and women (n = 90), indicated that depression mediated the relation between agency and suicidal ideation. In addition, for older men only, agency moderated the depression‐suicidal ideation relation. The results suggest that older adults, and particularly men, with low levels of agency should be the targets for interventions aimed at increasing levels of agency and improving mental health.     

Mindfulness Moderates the Association Between Perceived Burdensomeness and Suicide Ideation in Adults With Elevated Depressive Symptoms

A conceptual model in which the associations between perceived burdensomeness and suicide ideation, and between thwarted belongingness and suicide ideation, are moderated by mindfulness was examined. Participants were 218 undergraduates (mean age = 20.81) with moderate‐to‐severe depressive symptoms. Mindfulness significantly moderated the association between perceived burdensomeness and suicide ideation; participants with thoughts of burdensomeness experienced lower levels of suicide ideation if they were high, as opposed to low, in mindfulness. Mindfulness did not significantly moderate the association between thwarted belongingness and suicide ideation. Implications for intervention and elaboration of the interpersonal psychological theory of suicide are discussed.     

师范生职业认同与自杀意念的关系:抑郁的中介作用及其性别差异

基于心理健康的社会学模型和社会-文化模型,本研究考察师范生职业认同与自杀意念之间的关系,以及性别的调节效应和抑郁的中介效应。被试为700名师范生,研究工具包括师范生职业认同感量表、自杀意念自评量表、流调中心用抑郁自评量表。结果表明：（1）职业认同得分、自杀意念检出率的性别差异显著;（2）职业认同与抑郁、自杀意念均呈显著的负相关,自杀意念和抑郁呈显著的正相关;（3）性别在职业认同负向预测自杀意念的关系中起到调节作用,该调节作用还部分通过抑郁这一中介变量来实现。     

Under Reporting of Suicide Ideation in US Army Population Screening: An Ongoing Challenge

Previous research in US Army Soldiers shows rates of mental health concerns as two to four times higher on anonymous surveys than on postdeployment health assessments. In this study, Soldiers presenting for health reassessment completed two questionnaires on suicide risk factors: one linked to the health assessment and one anonymous. About 5.1% of respondents reported suicide ideation on the anonymous questionnaire, 3.0% on the linked questionnaire, and 0.9% on the health reassessment. About 56.4% who reported suicide ideation anonymously told nobody of their thoughts. Current screening procedures identify only one in seven Soldiers experiencing suicide ideation and highlight the need for alternative risk‐detection strategies.