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 This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct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 Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples.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

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

Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in...

Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population

Drawing on minority stress theory, the present study tested the relations of minority stressors (i.e., experiences of prejudice and discrimination, internalized antitrans attitudes, fear of antitrans stigma), social support (i.e., friend, family, and significant other support), and substance use (i.e., drug and alcohol use) with depression and suicide risk in a sample of trans individuals. Depression was examined as a mediator of the relations of minority stressors and social support with suicide risk; drug and alcohol use were examined as direct correlates of suicide risk. Participants were 335 trans-identified individuals, diverse in gender identities (e.g., trans men, trans women, nonbinary gender identities). They were recruited using online social networks and they completed the study survey online via Qualtrics. Structural equation modeling was used to test hypothesized relations. Depression fully mediated the relations of perceived experiences of discrimination, fear of antitrans stigma, and friend support with suicide risk, and partially mediated the relation of internalized antitrans attitudes with suicide. Drug use was positively associated with suicide risk, whereas alcohol use was not linked with suicide risk. Exploratory comparisons across gender subgroups suggested that the pattern of relations among study variables was consistent across trans men, trans women, and individuals with nonbinary gender identities. These findings point to minority stressors, friend support, and drug use as potentially fruitful targets of prevention and intervention efforts to reduce depression and suicide risk in trans populations. (PsycINFO Database Record

Suicide risk in trans populations: An application of minority stress theory.

Five versions of the Interpersonal Needs Questionnaire (INQ), a self-report measure of perceived burdensomeness and thwarted belongingness, have been used in recent studies (including 10-, 12-, 15-, 18-, and 25-items). Findings regarding the associations between perceived burdensomeness, thwarted belongingness, and suicidal ideation using different versions have been mixed, potentially due to differences in measurement scales. This study evaluated factor structure, internal consistency, and concurrent predictive validity of these five versions in three samples. Samples 1 and 2 were comprised of 449 and 218 undergraduates, respectively; Sample 3 included 114 adolescent psychiatric inpatients. All versions demonstrated acceptable internal consistency. The 10-item version and 15-item version demonstrated the best, most consistent model fit in confirmatory factor analyses. Both perceived burdensomeness and thwarted belongingness consistently predicted concurrent suicidal ideation on the 10-item INQ only. Future research should consider using the 15-item or 10-item versions.

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Evaluating the Interpersonal Needs Questionnaire: comparison of the reliability, factor structure, and predictive validity across five versions

Suicide in late life is an enormous public health problem that will likely increase in severity as adults of the baby boom generation age. Data from psychological autopsy studies supplemented with recent studies of suicidal ideation and attempts point to a consistent set of risk factors for the spectrum of suicidal behaviors in late life (suicide ideation, attempts, and deaths). Clinicians should be vigilant for psychiatric illness (especially depression), physical illness, pain, functional impairment, and social disconnectedness. Recent advances in late-life suicide prevention have in common collaborative, multifaceted intervention designs. We suggest that one mechanism shared by all preventive interventions shown to reduce the incidence of late-life suicide is the promotion of connectedness. For the clinician working with older adults, our recommendation is to not only consider risk factors, such as depression, and implement appropriate treatments but to enhance social connectedness as well.

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Suicides in late life.

Older adults have a disproportionally high rate of completed suicide as compared to the general population. Whereas a large literature has focused on risk factors related to elder suicide, limited research exists on relationships between coping strategies with protective factors against suicide and suicidal ideation in this population. Community-dwelling older adults (N = 108, mean age = 71.5 years, age range = 60-95 years) completed the Coping Orientations to Problems Experienced scale, Reasons for Living inventory, and Geriatric Suicide Ideation Scale (GSIS). Problem- and emotion-focused coping were associated positively with reasons for living and negatively with suicide ideation. Dysfunctional coping was associated positively with suicide ideation, but results did not support the hypothesized negative relationship with reasons for living. Thus, problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicidal ideation among community-dwelling older adults. Implications of the study are that some coping strategies may serve as protective factors against suicide and that coping strategies should be evaluated as part of a thorough assessment of suicidal risk among older adults. The results also provide some evidence of convergent validity for the recently developed GSIS.

Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults

Objectives. This study examined associations between diverse types of personality disorder (PD) features, personality traits, suicidal ideation, and protective factors against suicide among community-dwelling older adults. METHODS: Participants (N = 109, M age = 71.4 years, 61% female) completed the Coolidge Axis II Inventory, NEO Five-Factor Inventory, Geriatric Suicide Ideation Scale, and Reasons for Living Inventory. RESULTS: PD features had positive correlations with suicidal ideation and mixed relationships with aspects of reasons for living. Personality traits had negative correlations with suicidal ideation, with the exception of neuroticism, which had a positive relationship, and were mostly unrelated to reasons for living. In regression analyses, borderline and histrionic were the only PD features that contributed significant variance in suicidal ideation, whereas neuroticism was the only personality trait that contributed significant variance in suicidal ideation. No individual PD features or personality traits contributed significant variance in reasons for living. Discussion. The findings highlight the complexity of risk and protective factors for suicide and suggest that a thorough assessment of suicidal potential among older adults should include attention to their underlying personality traits. Language: en

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Personality, Suicidal Ideation, and Reasons for Living among Older Adults

Background The Geriatric Anxiety Scale (GAS; Segal et al. (Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Journal of Anxiety Disorders, 24, 709-714. doi:10.1016/j.janxdis.2010.05.002) is a self-report measure of anxiety that was designed to address unique issues associated with anxiety assessment in older adults. This study is the first to use item response theory (IRT) to examine the psychometric properties of a measure of anxiety in older adults. Method A large sample of older adults (n = 581; mean age = 72.32 years, SD = 7.64 years, range = 60 to 96 years; 64% women; 88% European American) completed the GAS. IRT properties were examined. The presence of differential item functioning (DIF) or measurement bias by age and sex was assessed, and a ten-item short form of the GAS (called the GAS-10) was created. Results All GAS items had discrimination parameters of 1.07 or greater. Items from the somatic subscale tended to have lower discrimination parameters than items on the cognitive or affective subscales. Two items were flagged for DIF, but the impact of the DIF was negligible. Women scored significantly higher than men on the GAS and its subscales. Participants in the young-old group (60 to 79 years old) scored significantly higher on the cognitive subscale than participants in the old-old group (80 years old and older). Conclusions Results from the IRT analyses indicated that the GAS and GAS-10 have strong psychometric properties among older adults. We conclude by discussing implications and future research directions.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1041610214000210

Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10).

OBJECTIVES: This study evaluated the structure and validity of the use of the 18-item Interpersonal Needs Questionnaire (INQ-18), a measure of thwarted belongingness (TB) and perceived burdensomeness (PB), among older adults. METHOD: Community-dwelling older adults (N = 284; mean age = 73 years; age range = 64-96 years; 56% women) anonymously completed a questionnaire packet. RESULTS: Principal axis factor analysis indicated that two factors should be retained. Items in the first factor reflected the concept of TB, whereas items in the second factor were consistent with the concept of PB. Both factors had medium-to-large positive correlations with hopelessness, depression, suicide ideation, and low meaning in life, providing evidence for convergent validity. CONCLUSIONS: Findings from this study support the use of the INQ-18 among community-dwelling older adults. Language: en

Analysis of the psychometric properties of the Interpersonal Needs Questionnaire (INQ) among community-dwelling older adults.

Objectives: Suicide among older adults is a major public health problem in the USA. In our recent study, we examined relationships between the 10 standard DSM-5 personality disorders (PDs) and suicidal ideation, and found that the PD dimensions explained a majority (55%) of the variance in suicidal ideation. To extend this line of research, the purpose of the present follow-up study was to explore relationships between the four PDs that previously were included in prior versions of the DSM (depressive, passive-aggressive, sadistic, and self-defeating) with suicidal ideation and reasons for living.Method: Community-dwelling older adults (N = 109; age range = 60–95 years; 61% women; 88% European-American) completed anonymously the Coolidge Axis II Inventory, the Reasons for Living Inventory (RFL), and the Geriatric Suicide Ideation Scale (GSIS).Results: Correlational analyses revealed that simple relationships between PD scales with GSIS subscales were generally stronger than with RFL subscales. Regarding G...

Relationships among depressive, passive-aggressive, sadistic and self-defeating personality disorder features with suicidal ideation and reasons for living among older adults

Meghan A. Marty

Papers

Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults

Personality, Suicidal Ideation, and Reasons for Living among Older Adults

Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10).

Analysis of the psychometric properties of the Interpersonal Needs Questionnaire (INQ) among community-dwelling older adults.

Relationships among depressive, passive-aggressive, sadistic and self-defeating personality disorder features with suicidal ideation and reasons for living among older adults