A Formal Test of the Interpersonal Psychological Theory of Suicide and A Closer Look at the Role of Social Support in Adolescent Suicidal Ideation and Behavior
Date
2014-08
Authors
Miller, Adam Bryant
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Abstract
The purpose of this dissertation project was to examine the theoretical and empirical importance of perceptions of interpersonal relationships to suicidal ideation (SI) and behavior in an adolescent clinical sample. The first study offered a rigorous test of the interpersonal-psychological theory of suicide as it applies to SI in a sample of adolescents at risk for suicide. Specifically, the association between the two interpersonal states central to this theory, perceived burdensomeness and thwarted belongingness, and severity of SI, was tested across three separate models. The first was a cross-sectional model, the second a short-term prospective model, and the third a competing developmentally sensitive mediational model that used a short-term prospective study design. Participants were 143 adolescents (64% female, 81% white, range = 12-18 years, M = 15.38, SD = 1.43) consecutively admitted to a psychiatric partial hospitalization program. Data were collected with paper and pen cil surveys upon intake into the program (Time 1 [T1]) and discharge from the program (Time 2 [T2]). Youth SI was assessed with the Suicidal Ideation Questionnaire and depression (diagnosis and symptom severity) with the Youth Inventory-4. Youth also completed the Interpersonal Needs Questionnaire, which assesses for perceptions of burdensomeness and thwarted belongingness. Results of cross-sectional analyses showed an independent association of perceived burdensomeness on T1 SI, after controlling for depression diagnosis and sex. There was no main effect of thwarted belongingness and no significant interaction between the two interpersonal states. In a short-term prospective moderation model, neither interpersonal state predicted T2 SI after controlling for covariates. In a third mediation model, thwarted belongingness, but not perceived burdensomeness, had a significant indirect effect on T2 SI via T2 depressive symptom severity after controlling for T1 SI and sex. Results suggest that: 1) perceptions of burdensomeness may contribute to concurrent risk for SI; and 2) thwarted belongingness affects depression symptom severity over time, which indirectly predicts SI over a short follow-up time frame. These results only partially replicate findings with adults in prior tests of the interpersonal-psychological theory of suicide. Though results are preliminary, these data suggest that perceptions of burdensomeness and thwarted belongingness may function differently in adolescent relative to adult clinical samples.
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Keywords
Clinical psychology, Perceived burdensomeness, Social support, Suicidal behavior, Suicidal thoughts, Thwarted belongingness