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According to the interpersonal-psychological theory of attempted and completed suicide (Joiner, 2005) suicide-related behavior is contingent upon three factors: acquired ability, burdensomeness, and failed belongingness. Qualitative research methodology was employed to explore these concepts among a group of returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) combat veterans. A sample of 16 individuals participated in interviews. Themes emerged regarding combat as a context for exposure to pain, subsequent coping strategies, and perceptions of burdensomeness, failed belongingness, and increased pain tolerance. Suicidal behavior was also articulated as a means of coping with risk factors outlined by Joiner. These results highlight the potential utility of this theory for OEF/OIF veterans. Interventions aimed at decreasing emotional dysregulation, and lessening perceptions of burdensomeness and failed belongingness may reduce risk for suicidal behavior.

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Physicians and medical trainees (medical students and residents) are at increased risk for suicidal ideation. Yet few conceptual models have attempted to explain the elevated rates of suicide among physicians, and very little is known about what factors contribute to medical trainees' suicidal ideation and behaviors. In this paper, Joiner's (2005) interpersonal-psychological theory of suicidality will be explored as it applies to suicidal ideation and behavior among physicians and medical trainees. Literature addressing each component of the theory will be reviewed. Drawing upon extant data, each dimension of the theory (burden, thwarted belongingness, and acquired ability) will be examined in depth in terms of its applicability to suicidal thinking and behavior among physicians and physicians-in-training. Findings from the literature provide support for the interpersonal-psychological theory of suicidality as applied to this population.