Investigation of the interpersonal theory of suicide in the context of attention‐deficit/hyperactivity disorder symptomatology and suicide ideation

Abstract

Objective The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self‐reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. Method Participants were 217 college students with elevated depressive symptoms (Mage = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well‐being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). Results In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self‐reported ADHD symptoms and suicide ideation. Conclusion Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.

Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide

“…74 A single study in the general population examined this association in relation to the ITS, showing that the association between ADHD traits and suicide ideation was indeed mediated by higher scores in thwarted belongingness and perceived burdensomeness. 41 While the present study supports a mediating role for perceived burdensomeness, the apparent irrelevance of thwarted belongingness stands in contrast to these previous findings and those of Pelton et al, 32 who previously found associations between this constructs and both suicide ideation and attempts. Notedly, as those authors did not control for depression, the effect of thwarted belongingness they observed could have been confounded by depression.…”

“…Our first analyses focused on thwarted belongingness and perceived burdensomeness, which we hypothesised might occur at higher levels in autistic people with ADHD due to the deleterious academic, occupational, social and emotional correlates of co-occurring autism and ADHD. 46,63,64 In the general public, the association between these constructs and ADHD features mediated their association with suicide ideation, 41 consistent with the assertions of the ITS. We hypothesised a similar mediating role of these constructs between co-occurring ADHD and suicide ideation in our autistic sample, but given that thwarted belongingness and perceived burdensomeness may be relevant to suicide attempts in autistic people, 32 we also examined their role in the association between co-occurring ADHD and suicide attempts.…”

“…40 Financial distress, which is suggested by the ITS as a likely antecedent of perceived burdensomeness, 24 has actually been linked to psychological distress and suicide in this population, 19 While little research has explored ITS constructs as predictors of suicidality in ADHD, recent studies in the general population has indeed suggested a mediating role for perceived burdensomeness and thwarted belongingness in the association between ADHD traits and suicide ideation. 41 With both states (particularly perceived burdensomeness) associated with suicidality in autistic people, 32,33 it is possible that the higher risk of suicide ideation in autistic people with ADHD might also be mediated by greater likelihood of experiencing these states. As children and adolescents, these individuals tend to score more poorly than young people with either condition alone on standardised measures of adaptive and executive function, experience more mental health conditions, and struggle more with the social and academic pressures of school.…”

Nursing Students Facilitating the Transition from Suicidal Ideation to Action in the Rural: A Qualitative Study

“…Guilt appears to lead instantly to emotional excess and, over time, to a maladaptive self-scheme. 37 It appears that the burden of guilt causes youngsters to turn inside and reluctant to seek assistance from others. 38 Despair appears to be associated with a lack of purpose and a lack of a reason to live, both of which contribute to the belief that suicide is a reasonable option because life lasts longand will never improve.…”