Thwarted Interpersonal Needs and Suicide Ideation Distress Among Psychiatric Inpatients: The Moderating Role of Criminal Associates

Mitchell, Sean M.; Cukrowicz, Kelly C.; Roush, Jared F.; Brown, Sarah; Alquist, Jessica L.; Bolaños, Angelea D.; Morgan, Robert D.; Poindexter, Erin K.

doi:10.1177/0306624x19842027

Cited by 3 publications

(6 citation statements)

References 31 publications

(62 reference statements)

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“…Additionally, even average levels of belonging buffer against the negative effects of stress related to CJ involvement. Our findings are congruent with previous findings that CJ‐involved individuals with a suicide attempt history are more likely to have relationship problems (Hakansson et al, 2010), and psychiatric inpatients who reported elevated TB and more time spent with criminals were most likely to also report “extreme” suicide ideation distress (Mitchell et al, 2019).…”

Section: Discussionsupporting

confidence: 91%

“…This figure was created using the coefficients from mean-centered predictors, including the mean-centered AUDIT scores; however, the non-mean-centered AUDIT scores are presented on the x-axis against the negative effects of stress related to CJ involvement. Our findings are congruent with previous findings that CJ-involved individuals with a suicide attempt history are more likely to have relationship problems (Hakansson et al, 2010), and psychiatric inpatients who reported elevated TB and more time spent with criminals were most likely to also report "extreme" suicide ideation distress (Mitchell et al, 2019). Further, we found a significant interaction between alcohol-related severity and TB predicting a lifetime suicide attempt history; however, the nature of this interaction was contrary to our hypotheses.…”

Section: Discussionsupporting

confidence: 83%

“…However, it may be crucial to consider the context in which social relationships are beneficial or potentially harmful in order to guide clinical intervention. For example, the literature indicates greater amounts of time spent with criminals when one has elevated TB may actually increase the risk of suicide ideation distress (Mitchell et al, 2019); thus, promoting prosocial and healthy relationships and connections with others is likely key. Additionally, system-level programs may be especially helpful to CJ-involved individuals.…”

Section: Discussionmentioning

confidence: 99%

“…In sum, existing literature indicates that substance use severity and CJ involvement are commonly experienced in combination (e.g., Bennett et al, 2008) and therefore are relevant risk factors for suicidal thoughts and behaviors among residential substance use patients (e.g., Hakansson et al, 2010; Yuodelis & Ries, 2015). TB may be particularly relevant for residential substance use patients with high substance use severity and who have CJ involvement (e.g., Mitchell et al, 2019; Yuodelis & Ries, 2015). However, research has not examined the unique and synergistic effects of these risk factors in relation to suicidal thoughts and behaviors.…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, individuals involved in the CJ system with a suicide attempt history are more likely to have relationship problems and associates who participate in substance use (Hakansson et al, 2010). Similarly, psychiatric inpatients who reported elevated TB and more time spent with criminal associates most likely reported "extreme" suicide ideation distress (Mitchell et al, 2019). Thus, TB may interact with substance use severity and current CJ involvement, and produce synergistic risk for suicidal thoughts and behaviors among residential substance use patients.…”

mentioning

confidence: 99%

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Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging

Mitchell

Brown

Görgülü

et al. 2021

Suicide & Life Threat Behav

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Objective Criminal justice involvement, substance use, and suicide pose significant public health concerns; however, the unique and synergistic effects of these experiences among high‐risk individuals remain understudied. We hypothesized positive main effects for alcohol‐related severity, drug‐related severity, current criminal justice involvement, and thwarted belonging (TB) on suicide ideation history (SIH) and suicide attempt history (SAH) and that TB would moderate these associations. Method We report on cross‐sectional analyses of self‐report assessments completed by 824 adult residential substance use patients. Results Multinomial logistic regression analyses indicated that as alcohol‐ and drug‐related severity increases, the probability of SIH and SAH increases; however, TB was only associated with a higher SIH probability. Significant two‐way interactions (current criminal justice involvement*TB; alcohol‐related severity*TB) indicated that (1) those high in TB with current criminal justice involvement were more likely to report a SIH than those without current criminal justice involvement; and (2) those low in TB and alcohol‐related severity had the lowest SAH probability, whereas those low in TB and high in alcohol‐related severity had the highest SAH probability. Conclusion The unique and combined effects of interpersonal and contextual risk factors may improve suicide risk conceptualization and assessment, and allow for tailored treatments for this high‐risk population.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging

Mitchell

Brown

Görgülü

et al. 2021

Suicide & Life Threat Behav

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A comparison of criminogenic risk factors and psychiatric symptomatology between psychiatric inpatients with and without criminal justice involvement.

Bolaños¹,

Mitchell²,

Morgan³

et al. 2020

Law and Human Behavior

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Objective: Research suggests distinct criminal risk factors, not mental illness, are more strongly associated with most criminal behaviors. This notion has been supported among inpatient persons with mental illness (PMI) when examining antisocial cognitions; however, other key criminogenic risk factors (the Big Four and Central Eight risk factors) have not been examined among psychiatric inpatient PMI. Hypotheses: We hypothesized that criminal justice (CJ)-involved PMI would endorse significantly greater criminogenic risk compared to non-CJ-involved PMI and that these risk factors would significantly and accurately identify whether PMI had CJ involvement. Additionally, we hypothesized that PMI with and without a history of CJ involvement would not significantly differ on their reported psychiatric symptomatology. Method: We examined all Central Eight criminal risk factors and psychiatric symptomatology among psychiatric inpatient PMI (N ϭ 142) with (n ϭ 74) and without (n ϭ 68) CJ involvement histories. Results: Multivariate analysis of variance and discriminant function analysis indicated significant differences between the Big Four and Central Eight criminal risk factors when classifying CJ and non-CJ groups. The Big Four risk factors correctly classified 85.9% of participants, and the Central Eight correctly classified 99.3% of participants into CJ and non-CJ groups; however, psychiatric symptoms only correctly classified 57.7% of participants into CJ and non-CJ groups. Conclusions: Criminal risk factors appear to be more strongly associated with CJ involvement among PMI than psychiatric symptomatology; therefore, psychotherapeutic intervention on criminal risk factors, not only mental illness, may decrease criminal recidivism among CJ-involved PMI. Public Significance StatementPeople have often assumed persons with mental illness become criminal justice involved because of symptoms associated with their illness or lack of mental health treatment; however, criminal risk factors (the Big Four and Central Eight), not severity of psychiatric symptomatology, most accurately classified psychiatric inpatients with and without a history of criminal justice involvement. Thus, psychotherapeutic interventions should target criminal risk factors, such as antisocial personality, attitudes toward criminal associates, and job-seeking behavior. In other words, to be most successful, when treating criminal justice-involved persons with mental illness, practitioners should assess and treat not only symptoms associated with their mental illness but their criminal risk as well.

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Assessing the clinical utility of MMPI‐2‐RF interpersonal theory of suicide proxy indices in psychiatric hospitalization setting

Khazem

Anestis

Rufino

2022

Suicide & Life Threat Behav

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Introduction:The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF Ben-Porath & Tellegen, 2008 has been applied to suicide risk assessment through derived proxy indices of perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide (Anestis et al., 2018, Joiner, 2005. However, limited research has examined the clinical utility of these proxy indices outside the outpatient setting. This study examined the performance of these proxy indices in identifying past-month suicide ideation intensity and attempts upon admission to a psychiatric inpatient program and changes in suicidal ideation intensity at discharge. We expected these indices and their interaction would be associated with suicide ideation intensity and attempts at baseline and with a lack of significant improvement in suicide ideation intensity at discharge, including when controlling for MMPI-2-RF Suicide/Death Ideation (SUI) scale scores.Method: Participants were 1007 patients in a private inpatient psychiatric hospital in the southwestern United States, 968 of whom completed study measures at admission and discharge. Participants were administered the C-SSRS and MMPI-2-RF upon admission, while the C-SSRS was administered again prior to discharge. A series of moderation analyses were conducted to examine the main and interaction effects of the MMPI-2-RF derived proxy indices on suicidal ideation intensity and suicide attempts at admission. Logistic regression analyses were conducted to examine whether MMPI-2-RF proxy index scores at admission were associated with changes in suicidal ideation intensity at discharge. Results:Neither the proxy indices nor their interaction was associated with all study outcomes. The acquired capability for suicide proxy index and its interaction with other indices were not associated with suicide attempt status at admission. However, high thwarted belongingness proxy index scores were associated with greater suicidal ideation intensity at admission; high perceived burdensomeness proxy index scores were indicative of a lack of significant change in suicide ideation intensity at discharge.

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Thwarted Interpersonal Needs and Suicide Ideation Distress Among Psychiatric Inpatients: The Moderating Role of Criminal Associates

Cited by 3 publications

References 31 publications

Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging

Substance use, current criminal justice involvement, and lifetime suicidal thoughts and behaviors history: The moderating role of thwarted belonging

A comparison of criminogenic risk factors and psychiatric symptomatology between psychiatric inpatients with and without criminal justice involvement.

Assessing the clinical utility of MMPI‐2‐RF interpersonal theory of suicide proxy indices in psychiatric hospitalization setting

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