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Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM.
Methods
Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up.
Results
424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09–1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11–1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81–0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82–0.98). Perceived burdensomeness partially mediated these prospective associations.
Conclusion
To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.
The Interpersonal Needs Questionnaire (INQ-15) and the Acquired Capability for Suicide Scale - Fearlessness About Death (ACSS-FAD) have been introduced to evaluate the theoretical constructs posit by Joiner’s Interpersonal Psychological Theory of Suicide (IPTS).
Objectives
The present study aimed to evaluate the psychometric properties of the INQ-15 (which measures Thwarted Belongingness, TB, and Perceived Burdensomeness, PB) and the ACSS-FAD (measurement of Fearlessness About Death, FAD, dimension of the acquired capability) in a population of Italian university students.
Methods
Since there was no Italian version of the ACSS-FAD, we have translated it through an accurate multistage procedure. ACSS-FAD and INQ-15 have been administered to a sample of 1,665 Italian university students. We analyzed the factorial structure of the INQ-15 and the ACSS-FAD, their reliability, criterion, convergent and discriminant validity.
Results
Principal Component Analysis confirmed a two-dimensional structure for INQ-15 and a one-factor structure for ACSS-FAD. Internal consistency reliability of the scales was good, respectively TB: α = .85; PB: α = .90; and FAD: α = .85. The INQ-15 demonstrated concurrent associations with suicidal ideation, while the ACSS-FAD with a history of suicidal planning/suicide attempt. Convergent and discriminant validity were also in line with previous studies.
Conclusions
Both INQ-15 and ACSS-FAD appropriately capture the respective constructs, proving to be valid measures for the assessment of suicide risk factors among Italian university students according to the IPTS. The valuable psychometric properties of the two scales established with this study in the Italian context encourages their use to advance the clinical understanding and prevention of suicide.
Poor adherence with recommendations during pandemic is wide-spread and increases populational risk of being infected (Smith et al., 2020, Webster et al., 2020, Freeman et al., 2020). Revealing psychological factors of low adherence in adolescents is important for interventions planning. This study tests the role of perceived social support and belongingness in COVID-related anxiety and adherence.
Objectives
The aim was to reveal relationships between COVID-related anxiety, monitoring of information about pandemic, adherence to recommendations and interpersonal needs in female adolescents.
Methods
183 female adolescents (13-21 years old) filled Anxiety Regarding Pandemic Scale, Information Monitoring and Adherence To COVID-related Recommendations Scales (Tkhostov, Rasskazova, 2020), Interpersonal Needs Questionnaire (Van Orden et al., 2012).
Results
Female adolescents moderately (m±sd=3.32±1.40 of 1–6-point scale) worried about negative consequences of pandemic on their life and lowly worried about risk of being infected (m±sd=2.53±1.15). Their adherence to recommendations was upper medium (m±sd=3.42±1.18). Neither worries nor adherence were related to age. Perceived burdensomeness was unrelated to COVID-related anxiety and adherence while thwarted belongingness was related to lower anxiety of being infected (r=-.23, p<.01) and poorer adherence to recommendations (r=-.19, p<.05).
Conclusions
In female adolescents thwarted belongingness is a risk factor of poor adherence to COVID-related recommendations because of lower anxiety of being infected. Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.
Disclosure
Research is supported by the Russian Foundation for Basic Research, project No. 20-04-60072.
The Interpersonal Theory of Suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) are proximal causes of current suicidal desire, while the acquired capability predicts suicide attempts (Joiner, 2005).
Objectives
This study examined the psychometric properties of the Interpersonal Needs Questionnaire (INQ-15-I), as a measure of the two constructs, on a sample of 458 Italian university students.
Methods
After examining the socio-demographic, clinical and psychosocial characteristics of the sample, we tested the differences in current suicidal ideation and lifetime suicide risk among students. We conducted a confirmatory factor analyses to identify the latent structure of the INQ-15-I and we tested the reliability, criterion concurrent validity and convergent/discriminant validity.
Results
The socio-demographic, clinical and psychosocial features of the sample are in line with the literature on the topic. A two-factor related model with 15 item, showed a good fit to the data and subscales showed excellent internal consistencies (α ≥ 0.84). TB, but mostly PB, were mainly correlated with concurrent suicidal ideation and less with suicidal risk. Divergent validity has emerged with the constructs of the acquired capability. Convergent validity is supported for similar constructs such as depression, low reasons for living, anxiety, interoceptive awareness, psychological pain, loneliness, absence of social support and low self-esteem.
Conclusions
INQ-15-I provides a valid measure of the interpersonal needs among Italian university students by indirectly investigating suicidal risk factors. It also suggest specific clinical intervention areas in suicide prevention. Thus it may be included in suicide risk assessment protocols in Italy.
Evidence-based theoretical models outlining the pathways to the development of suicidal ideation may inform treatment. The current research draws from the Interpersonal Theory of Suicide (IPT) and the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour and aims to test the interaction between perceived burdensomeness and thwarted belongingness as proposed by the IPT model, and the defeat-entrapment pathway as proposed by the IMV model, in the prediction of suicidal ideation at 12-month follow-up.
Methods
The Scottish Wellbeing Study is a nationally representative prospective study of young people aged 18–34 years (n = 3508) from across Scotland, who completed a baseline interview and a 12-month follow-up (n = 2420). The core factors from both the IPT (perceived burdensomeness and thwarted belongingness) and the IMV model (defeat, internal and external entrapment) were measured alongside demographics, depressive symptoms and suicidal ideation at baseline. At 12-month follow-up, suicidal ideation was assessed again.
Results
In multiple regression analysis perceived burdensomeness and internal entrapment, with baseline suicidal ideation, predicted 12-month suicidal ideation. No support for the interaction between perceived burdensomeness and thwarted belongingness in predicting 12-month suicidal ideation was found. However, there was evidence that internal, but not external, entrapment mediated the relationship between defeat and 12-month suicidal ideation, but no support was found for the moderation of burdensomeness and belongingness on the entrapment to suicidal ideation pathway.
Conclusions
The current findings highlight the importance of targeting perceived burdensomeness and internal entrapment to reduce the likelihood that suicidal ideation emerges in at risk individuals.
The interpersonal theory of suicide (IPTS) is one of the most intensively researched contemporary theories on the development of suicidal ideation and behaviour. However, there is a lack of carefully conducted prospective studies.
Aims
To evaluate the main predictions of the IPTS regarding the importance of perceived burdensomeness, thwarted belongingness and capability for suicide in predicting future suicide attempts in a prospective design.
Method
Psychiatric in-patients (n = 308; 53.6% (n = 165) female; mean age 36.82 years, s.d. = 14.30, range 18–81) admitted for severe suicidal ideation (n = 145, 47.1%) or a suicide attempt completed self-report measures of thwarted belongingness, perceived burdensomeness, capability for suicide, hopelessness, depression and suicidal ideation as well as interviews on suicide intent and suicide attempts and were followed up for 12 months. Logistic regression and receiver operating characteristics (ROC) analysis were conducted.
Results
The interaction of perceived burdensomeness, thwarted belongingness and capability for suicide was not predictive of future suicide attempts, but perceived burdensomeness showed a significant main effect (z = 3.49, P < 0.01; OR = 2.34, 95% CI 1.59–3.58) and moderate performance in screening for future suicide attempts (area under the curve AUC = 0.729, P < 0.01).
Conclusions
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 perceived burdensomeness in understanding suicidal ideation and behaviour.
Research is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel.
Methods
US military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality – i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up.
Results
Hopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator.
Conclusions
Hopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.
Personality disorder traits are relatively prevalent among older adults, and can be associated with complex and chronic difficulties, including suicide risk. However, there is a lack of research regarding personality disorders and suicide ideation in older adults. Depressive symptoms and hopelessness may be important to the relation between personality disorders and suicide risk. Additionally, variables from the interpersonal theory of suicide, perceived burdensomeness and thwarted belongingness, may be critical risk factors for suicide in this population. We hypothesized that perceived burdensomeness and thwarted belongingness, theory-based variables, would act as parallel mediators of the relation between personality disorder traits and suicide ideation, whereas depressive symptoms and hopelessness would not.
Methods:
The hypothesis was tested in a sample of 143 older adults recruited from a primary care setting. Participants completed self-report questionnaires of personality traits, suicide ideation, depressive symptoms, hopelessness, perceived burdensomeness, and thwarted belongingness.
Results:
Findings from a non-parametric bootstrapping procedure indicated that perceived burdensomeness, thwarted belongingness, and depressive symptoms mediated the relation between total personality disorder traits and suicide ideation. Hopelessness did not act as a mediator.
Conclusions:
These findings indicate that perceived burdensomeness, thwarted belongingness, and depressive symptoms are likely important risk factors for suicide ideation among older adults. Clinicians should be aware of these issues when assessing and treating suicide risk among older adults.
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