Main predictions of the interpersonal–psychological theory of suicidal behavior: Empirical tests in two samples of young adults.

Abstract

The interpersonal-psychological theory of suicidal behavior (Joiner, 2005) makes two overarching predictions: 1) that perceptions of burdening others and of social alienation combine to instill the desire for death; and 2) that individuals will not act on the desire for death unless they have developed the capability to do so -a capability that develops through exposure and thus habituation to painful and/or fearsome experiences, and which is posited by the theory to be necessary to overcome powerful self-preservation pressures. Two studies test these predictions. In Study 1, the interaction of (low) family social support (cf. social alienation or low belonging) and feeling like one does not matter (cf. perceived burdensomeness) predicted current suicidal ideation, beyond depression indices. In Study 2, the three-way interaction between a measure of low belonging, a measure of perceived burdensomeness, and lifetime number of suicide attempts (viewed as a strong predictor of the level of acquired capability for suicide) predicted current suicide attempt (vs. ideation) among a clinical sample of suicidal young adults, again beyond depression indices and other key covariates. Implications for the understanding, treatment, and prevention of suicidal behavior are discussed.Address correspondence to: Thomas E. Joiner, Jr., Florida State University, Tallahassee, Florida 32306-1270, joiner@psy.fsu.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/abn. NIH Public AccessAuthor Manuscript J Abnorm Psychol. Author manuscript; available in PMC 2010 August 1. Main Predictions of the Interpersonal-Psychological Theory of Suicidal Behavior: Empirical Tests in Two Samples of Young AdultsThe interpersonal-psychological theory of suicidal behavior (Joiner, 2005) proposes that an individual will not die by suicide unless s/he has both the desire to die by suicide as well as the ability to do so. What is the desire for suicide, and what are its component parts? What is the ability to die by suicide and in whom and how does it develop?In answer to the first question of who desires suicide, the theory asserts that when people hold two specific psychological states in their minds simultaneously, and when they do so for long enough, they develop the desire for death. The two psychological states are perceived burdensomeness and a sense of low belongingness or social alienation. In answer to the second question regarding capability for suicide, self-preservation is a powerful enough instinct that few can overcome it by force o...

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

“…Refers to the perception that one is is not an important member of a group, such as family and circle of friends or is alienated from others (123). Empirical research indicates that greater sense of low belongingness is associated with increased suicidal ideation (124).…”

Is Insomnia Lonely? Exploring Thwarted Belongingness as an Explanatory Link between Insomnia and Suicidal Ideation in a Sample of South Korean University Students

“…Considering the increasing body of support for the interpersonal theory, 21,22 this theory may provide a useful framework for understanding why insomnia appears to be a robust suicide risk factor. In considering this theory, one potential avenue through which insomnia may have an effect on suicidal desire is by elevating and exacerbating feelings of thwarted belongingness.…”

Open Trial and Pilot Randomized Controlled Trial of a Novel Program to Reduce Perceived Burdensomeness

“…In the case of perceived burdensomeness, the IPTS hypothesizes that perceived burdensomeness and thwarted belongingness interact to predict suicidal ideation. The interaction between perceived burdensomeness and thwarted belongingness has been tested in several empirical studies Bryan, Clemans, et al, 2012;Davidson, Wingate, Slish, & Rasmussen, 2010;Joiner, et al, 2009;Wong, et al, 2011). The interaction between perceived burdensomeness and the acquired capability to enact lethal self-injury has also been tested Bryan, Clemans, et al, 2012;Joiner, et al, 2009 Others have tested the relation between perceived burdensomeness and the acquired capability to enact lethal self-injury, or between all three components of the IPTS, which are hypothesized by the IPTS to predict serious suicide attempts.…”

“…The interaction between perceived burdensomeness and thwarted belongingness has been tested in several empirical studies Bryan, Clemans, et al, 2012;Davidson, Wingate, Slish, & Rasmussen, 2010;Joiner, et al, 2009;Wong, et al, 2011). The interaction between perceived burdensomeness and the acquired capability to enact lethal self-injury has also been tested Bryan, Clemans, et al, 2012;Joiner, et al, 2009 Others have tested the relation between perceived burdensomeness and the acquired capability to enact lethal self-injury, or between all three components of the IPTS, which are hypothesized by the IPTS to predict serious suicide attempts. Bryan and colleagues (Bryan, Clemans, et al, 2012) tested the interaction between perceived burdensomeness and the acquired capability to enact lethal self-injury in a study of two samples of military personnel -those seeking services for mild traumatic brain injury and those seeking outpatient mental health services.…”

“…Further evidence for the association between perceived burdensomeness and suicide-related behaviors has been reported in several studies. Since that time, correlations between perceived burdensomeness and suicidal ideation have been demonstrated among samples of young adults (Joiner et al, 2009), older adults Jahn, Cukrowicz, Linton, & Prabhu, 2011;Marty et al, 2012;Van Orden, Cukrowicz, Witte, & Joiner, 2012), college students of varying race and ethnicity Davidson et al, 2011;Davidson et al, 2009;Freedenthal et al, 2011;Lamis & Lester, 2012;Rasmussen, Slish, Wingate, Davidson, & Grant, 2012;Rasmussen & Wingate, 2011;Tucker et al, 2013;Van Orden, et al, 2012;Wong et al, 2011), American Indian/Alaskan Native adults (O'Keefe et al, 2014), military personnel (Bryan, Clemans, & Hernandez, 2012;Bryan, Cukrowics, et al, 2010;Bryan, Ray-Sannerud, et al, 2012), Spanish-speaking adult women (Garza & Pettit, 2010), and adolescents (Czyz et al, in press;Hill et al, in press;Merchant, 2010). Associations between perceived burdensomeness and a past suicide attempt have also been demonstrated in samples of military personnel (Bryan, Ray-Sannerud, et al, 2012;Monteith, Menefee, Pettit, Leopoulos, & Vincent, 2013) and clinical outpatients .…”