The Interpersonal Theory of Suicide

Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA.
Psychological Review (Impact Factor: 7.72). 04/2010; 117(2):575-600. DOI: 10.1037/a0018697
Source: PubMed

ABSTRACT Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses.

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Available from: Kimberly Van Orden, Sep 04, 2015
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    • "and post-traumatic stress disorder (PTSD; Carey et al., 2011; Corneil et al., 1999; Murphy et al., 1999). Among the general population , these conditions confer increased risk for suicidal ideation and both nonfatal and fatal suicide attempts (Nock et al., 2009, 2008a; Van Orden et al., 2010); yet, there are scant data among firefighters in particular. Musk et al. (1978) found that, among firefighters serving in Boston, rates of suicide fatalities were actually lower than those identified in the general population. "
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    ABSTRACT: Background: Firefighters experience high-risk occupational hazards that may confer increased risk for suicide; however, prevalence rates of suicidal thoughts and behaviors among firefighters are unknown. The purpose of this study is to describe the career prevalence of suicide ideation, plans, attempts, and non-suicidal self-injury among firefighters, in addition to sociodemographic, physical health, and occupational correlates. Methods: Data were obtained from a cross-sectional convenience sample of 1027 current and retired firefighters who completed a nationwide web-based survey on mental health (mean age=38.49, SD=11.70; 91.2% male; 87.3% White). Sociodemographic, physical health, and occupational correlates were assessed via a structured questionnaire. Suicidal thoughts and behaviors were assessed using a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF). Results: The career prevalence estimates of suicide ideation, plans, attempts, and non-suicidal self-injury were found to be 46.8%, 19.2%, 15.5%, and 16.4%, respectively. Key factors associated with increased risk for reporting suicidal thoughts and behaviors included lower firefighter rank, fewer years of firefighter service, membership in an all-volunteer department, a history of professionally responding to a suicide attempt or death, and active duty military status. Limitations: The current study utilized a cross-sectional convenience sample of firefighters. Conclusions: Firefighters report an alarmingly high career prevalence of suicidal thoughts and behaviors. Our preliminary data are compelling, indicating the need for additional research as well as increased prevention and treatment efforts among firefighters to decrease suicide risk.
    Journal of Affective Disorders 09/2015; 187:163-171. DOI:10.1016/j.jad.2015.08.007 · 3.71 Impact Factor
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    • "Email: with suicide (Shneidman, 1996; Troister & Holden, 2010) and 'hopelessness'-referring to negative or pessimistic expectancies regarding one's future (Beck, 1963; Beck, Weissman, Lester, & Trexler, 1974; Brown, Beck, Steer, & Grisham, 2000; McMillan, Gilbody, Beresford, & Neilly, 2007). More recent theory and research have expanded this etiologic focus to incorporate interpersonal difficulties, including perceived absence of social support or integration and of burdening others (Joiner, 2005; Van Orden et al., 2010) and personality traits and/or disorders (e.g., Clark, 1993; Duberstein & Conwell, 1997). "
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    ABSTRACT: Objectives: To investigate the roles of Reasons for Living (RFL) and Meaning in Life (MIL) in potentially promoting mental health and well-being and protecting against suicide ideation among community-residing older adults and to investigate the psychometric properties of the Reasons for Living Scale-Older Adult Version (RFL-OA). Method: Of 173 older adults initially recruited into a longitudinal study on late-life suicide ideation, 109 completed the RFL-OA and measures of cognitive and physical functioning and positive and negative psychological factors at a two-year follow-up assessment. We tested a model in which RFL and MIL protect against suicide ideation, controlling for demographic and clinical factors. We also assessed the psychometric properties of the RFL-OA in community-residing older adults, investigating its internal consistency and its convergent (MIL, perceived social support, and life satisfaction), divergent (loneliness, depressive symptom severity, and suicide ideation), and discriminant validity (cognitive and physical functioning). Results: RFL-OA scores explained significant variance in suicide ideation, controlling for age, sex, depressive symptom severity, and loneliness. MIL explained significant unique variance in suicide ideation, controlling for these factors and RFL, and MIL significantly mediated the association between RFL and suicide ideation. Psychometric analyses indicated strong internal consistency (α=.94), convergent, divergent, and discriminant validity for the RFL-OA relative to positive and negative psychological factors and cognitive and physical functioning. Conclusion: These findings add to a growing body of literature suggesting merit in investigating positive psychological factors together with negative factors when assessing suicide risk and planning psychological services for older adults.
    Aging and Mental Health 08/2015; DOI:10.1080/13607863.2015.1078279 · 1.75 Impact Factor
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    • "These findings lead us to consider that firearm access and familiarity may be better conceptualized as a distal risk factor or vulnerability that, when coupled with distress associated with PTSD, is more likely to result in suicide. This interpretation parallels the distinction between suicidal desire and the capability for suicide espoused by the interpersonal theory of suicide (Smith and Cukrowicz, 2010; Van Orden et al., 2010). Whereas PTSD may influence veterans' desire for death by suicide, it is their familiarity with firearms that enables them to make a lethal suicide attempt. "
    Psychiatry Research 08/2015; 229:220-224. · 2.68 Impact Factor
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