Social connections and suicidal thoughts and behavior.

Abstract

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness-1) living alone, 2) perceived social support, 3) interpersonal conflict, 4) belongingness. Participants (n = 814) were recruited from four residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. Keywordssuicide attempts; suicidal ideation; loneliness; thwarted belongingness; social support Substance dependence confers elevated risk for suicidal ideation (i.e., thoughts about killing oneself; Grant & Hasin, 1999) and suicide attempts (i.e., attempting suicide but surviving) (Kessler et al., 1999), as well as suicide (i.e., suicide attempts that result in death; Wilcox, Conner, & Caine, 2004). Reviews of the suicide literature have estimated that the risk for suicide among individuals with SUDs is five times or greater that of the general population (Wilcox, Conner, & Caine, 2004;Yoshimasu, Kiyohara, & Miyashita, 2008). The identification of psychological and social processes that elevate risk for suicidal thoughts and behaviors (i.e., ideation, attempts, or death) among individuals with substance use disorders (SUDs) represents one avenue for increased understanding of etiological mechanisms, as well as improved prevention efforts. (Shneidman, 1987) proposes that an unmet need for "affiliation" is one of several needs that contribute to suicide when unmet. The interpersonal theory of suicide (Joiner, 2005; Van Orden, Witte, Cukrowicz, Braithwaite, Selby, & Joiner Jr, in press) proposes that the need to belong to caring and supportive relationships (Baumeister & Leary, 1995) is so powerful that, when thwarted, contributes to a desire for suicide. Several studies specifically examining the relationship between belongingness-the degree to which individuals perceive that they are meaningfully connected to satisfying (and positive) relationships or social groups-and suicidal desire have supported the theory (Conner, Britton, Sworts, & Joiner, 2007;Joiner, Hollar, & Van Orden, 2006;Joiner, Van Orden, Witte, Selby, Ribeiro, Lewis, et al., 2009;Van Orden, Witte, Gordon, Bender, & Joiner, 2008;Van Orden, Witte, James, Castro, Gordon, Braithwaite, et al., 2008), although only one report used a substance dependent sample (Conner et al., 2007).Empirically, indices of social connectedness are related to ...

Psychosocial Factors as Risk Factor in Suicidal Poisoning: A Cross-Sectional Study

“…Agents of poisoning showed a similar trend in all age categories with a maximum consumption of household agents followed by drugs for DSH (Tables 1 and 3 Four main factors were interpersonal conflict, stress, dissatisfaction, and others. Interpersonal conflict was the chief reason and this is consistent with the literature that interpersonal conflict is among the top-stated reasons for suicide attempts, especially among young people [15][16][17]. The conflicts included fights and arguments with family members, friends, and even colleagues.…”

Associations of Emotional Abuse Types With Suicide Ideation Among Dating Couples

“…Restrictive engulfment involves such acts as attempting to keep one from seeing friends or family, complaining about them socializing, or asking friends/family members about their whereabouts. This implies that the victim has a social network—albeit one that the perpetrator is attempting to isolate them from—that buffers effects such control may have on suicidal ideation (You et al, 2011). Alternatively, individuals victimized by restrictive engulfment may employ coping strategies other than suicidal ideation such as placating perpetrator worries underlying restrictive engulfment.…”

“…Stable and healthy relationships, such as romantic relationships, are strong, targetable protective factors for suicidal ideation (Gunnell, Harbord, Singleton, Jenkins, & Lewis, 2004; Kleiman, Riskind, & Schaefer, 2014; Mazza & Reynolds, 1998; You, Van Orden, & Conner, 2011). Studies examining relationship factors associated with suicide risk have highlighted victimization by intimate partner violence (IPV), defined as physical, sexual, and/or emotional abuse within couples, as a correlate of suicidal ideation (see Golding, 1999 for a meta-analysis; Saltzman et al, 2002).…”

Recovery Resources and Psychiatric Severity Among Persons with Substance Use Disorders

“…It is possible that abstinence social support may not be enough to counter other social influences related to substance use such as perceptions of 12-step group cohesion and 12-step peers (Noordsy et al, 1996; Rice & Tonigan, 2012), some of whom may not extend a sense of belongingness necessary to counter pathological behavior (You, Van Orden, & Conner, 2011), especially among 12-step peers who view psychiatric medication use as drug-use behavior among persons with psychiatric comorbid substance use disorders (Laudet, 2000). However, these findings may be limited to clients receiving a total abstinence approach to recovery and they may not necessarily generalize among clients receiving drug replacement therapies who attend alternative 12-step groups for those on medications (e.g.…”