The interpersonal-psychological theory of suicide (IPTS;Joiner, 2005) is a relatively new model for understanding and conceptualizing suicide that posits two necessary conditions for an individual to engage in lethal or nearlethal suicidal behaviors: suicidal desire and capability. In terms of suicidal desire (i.e., who wants to die by suicide), the IPTS proposes two key psychological states: first, the perception that one is a burden to others (referred to as perceived burdensomeness) and, second, the perception that one is isolated from others or is not important to others (referred to as thwarted belongingness). According to the IPTS, active suicide ideation emerges from the combined experience of perceived burdensomeness and thwarted belongingness (Van Orden et al., 2010). In terms of suicidal capability (i.e., who is able to die by suicide), the IPTS hypothesizes that individuals with lowered fear of death and higher levels of pain tolerance have greater capacity for engaging in intentional self-inflicted injury (Van Orden et al., 2010). According to this model of suicide, it is the combination of suicidal desire and suicidal capability that leads to lethal or near-lethal suicidal behavior; possessing only one of these two dimensions is not sufficient. The IPTS thereby provides a model for understanding why some individuals who think about suicide do not go on to make a suicide attempt or die by suicide (i.e., they possess desire but not capability).Although the IPTS has been the focus of considerable empirical investigation over the past decade, the majority of this research has focused on suicidal desire. For example, studies have consistently found that perceived burdensomeness is associated with suicide ideation and suicide attempts in settings and populations including mental health outpatients AbstractThe interpersonal-psychological theory of suicide has been the focus of considerable empirical investigation over the past decade. However, little research has focused on the theory's proposition that the capability for suicide is "acquired" as a consequence of exposure to painful and provocative experiences such as violence, aggression, and trauma. To determine if capability for suicide is "acquired" over time, we conducted a prospective study of 168 military personnel deployed to Iraq. Capability scores remained stable over the course of 2 years from pre-to postdeployment, even among military personnel reporting high combat exposure. Significant positive correlations among capability and combat exposure were comparable both before and after deployment. These findings suggest that capability for suicide was not "acquired" following combat exposure in this sample of military personnel. Capability was, instead, a stable construct.

Rates of psychological disorders and suicide have increased dramatically among military personnel since the onset of combat operations in Iraq and Afghanistan. To date, few studies have identified psychological factors that insulate service members from emotional distress and suicide risk following combat. The current study investigates the protective effects of psychological flexibility on emotional distress and suicidal ideation in 168 active duty Air Force convoy operators. Self-report data were collected before deployment and at 1, 3, 6, and 12 months postdeployment. Robust generalized estimating equations with repeated measurements indicated that, over time, service members with greater psychological flexibility reported less severe posttraumatic stress (B =-.039, SE = .011, p = .001) and depression (B =-.053, SE = .009, p < .001) than subjects with less psychological flexibility. Greater psychological flexibility was also associated with decreased suicide risk (B =-.035, SE = .010, p < .001), significantly moderating the effects of depression on suicidal ideation over time (B = .115, SE = .044, p = .008). Results suggest that psychological flexibility guards against emotional distress among service members and buffers the effects of depression on suicide risk. Psychological flexibility in military 3 Since the onset of combat operations in Afghanistan (Operation Enduring Freedom, OEF) and Iraq (Operation Iraqi Freedom, OIF), much attention has been paid to the psychological well-being of the United States' Armed Forces. Of particular note is the steadily rising suicide rate; military suicides have doubled in the past decade and suicide is now the second leading cause of death among service members (Department of the Army, 2011). Accordingly, mental health promotion and resiliency enhancement have become major topics of both clinical and research interest. To date, however, most studies have focused primarily on identifying and confirming risk factors for suicide, typically seeking an answer to the question, "Why do some military personnel become suicidal?" In contrast, few studies have explored protective factors associated with resilience and low suicide risk; such studies are aimed at answering the question, "Why do most military personnel not become suicidal?" A greater understanding of factors that increase resilience and lessen suicide risk could ultimately improve military suicide prevention and intervention programs. Resilience has been described as "an ability, perception, or set of beliefs which buffer individuals from the development of suicidality in the face of risk factors or stressors" (p. 964; Johnson, Wood, Gooding, Taylor, & Tarrier, 2011) Cognitive style and behavioral response processes may partly explain why, given similar stressors and life experiences, some service members experience emotional distress and others do not. Beck's cognitive theory suggests that suicidal individuals become stuck in a "negative loop," rigidly viewing themselves, the world, and the future as unchangeable, une...

Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk.

A sense of belongingness may protect service members from depression at all stages of the deployment cycle, from predeployment preparations through deployment and postdeployment adjustment.

This study sought to identify factors contributing to symptoms of depression and posttraumatic stress disorder (PTSD) in recently deployed combat veterans. A sample of 168 active duty military personnel completed measures of combat exposure, deployment-related daily hassles, depression symptoms, and PTSD symptoms at six time points across their deployment: predeployment and 1, 3, 6, and 12 months postdeployment. Mixed-effects linear modeling with repeated measures was used to identify factors associated with depression and PTSD severity over time. Postdeployment depression severity did not change over time, but PTSD severity decreased slightly over time after returning home. Postdeployment depression severity was predicted by past (but not recent) combat exposure, daily hassles, and concurrent PTSD symptoms. Postdeployment PTSD severity was predicted by past and recent combat exposure, concurrent depression symptoms, and male sex. Depression severity mediated the relationship between daily hassles and postdeployment PTSD severity.