The Interpersonal–Psychological Theory of Suicide in Medical Students: Comparisons of Individuals without Suicidality, Ideators, and Planners

The aim of this study was to explore the interpersonal–psychological theory of suicide (IPTS) in medical students. Higher levels of thwarted belongingness and perceived burdensomeness were expected in medical students with suicidality compared with medical students without suicidality, and a high level of acquired capability was expected in planners compared with ideators. Recruited for the study were 178 undergraduate medical students at the Université Libre de Bruxelles (ULB): 95 subjects without suicidality, 24 subjects with lifetime suicidality, 28 subjects with recent suicidal ideation, and 26 planners. An ad hoc questionnaire evaluated the risk of suicide as well as the “Suicidal thoughts and wishes” item of the BDI-II. The Interpersonal Needs Questionnaire (INS) measured thwarted belongingness (TB) and perceived burdensomeness (PB). The Acquired Capability for Suicide Scale (ACSS) measured notably fearlessness of death or pain tolerance and depression was rated using the revised version of the Beck Depression Inventory (BDI). Cognitive–affective symptoms of depression (CA-BDI) were assessed using six items of the BDI. Analyses of variance showed significant differences between groups for TB and PB but not for ACSS. Analyses of covariance, controlling for the CA-BDI scores, confirmed the significance of differences in TB and PB. Post hoc tests showed that (1) high levels of TB were characteristic of subjects with recent suicidal ideation and planners compared with subjects without suicidality; and (2) high levels of PB were characteristic of planners compared with the three other groups. Among the three characteristics of the IPTS, PB could be a strong predictor of severe suicide risk in medical students.

The Interpersonal-Psychological Theory of Suicide to Explain Suicidal Risk in Eating Disorders: A Mini-Review

Suicide is a major cause of death in Eating Disorders (EDs) and particularly in anorexia nervosa (AN). The aim of the present mini-review was to summarize the literature focusing on the interpersonal-psychological theory of suicide (IPTS) by Thomas E. Joiner, as applied to explain suicidal risk in EDs. PubMed database was used to search articles focused on IPTS in EDs; 10 studies were eventually included. The majority of the included studies reported data from the same sample, even though the hypotheses and analyses for each study were unique. The investigated suicidal outcomes were suicidal ideation (SI) (40%), non-suicidal self-injury (10%), suicide attempt (40%) and suicide (10%). In ED patients Perceived Burdensomeness (PB) may play an important role, especially regarding SI risk. ED patients may feel like a burden to their close ones, and actually some of the ED symptoms may be an expression of anger and hate against the self. Overall, currently available research has supported some IPTS derived predictions (i.e., ED symptoms may increase PB and thereby SI), but not others (i.e., the elevated suicide rate in AN may be due to higher acquired capability for suicide). Further research on IPTS tenets as well as on other theoretical perspectives and constructs (e.g., interoceptive awareness), hopefully with a longitudinal design and adequate follow-up duration, might allow a more thorough understanding of the complex topic of suicidal behavior in ED patients.

Suicide Ideation and Thwarted Interpersonal Needs Among Psychiatric Inpatients: A Network Approach

We aimed to demonstrate the utility of an item-level network analysis approach to suicide risk by testing the interpersonal psychological theory of suicide (IPTS) among 402 psychiatric inpatients. We hypothesized that specific thwarted belongingness (TB) or perceived burdensomeness (PB; Interpersonal Needs Questionnaire items) facets would positively relate to passive or active suicide ideation and that these facets would positively relate to each other and form distinct clusters. We also tested TB and PB facets central to the networks as predictors of suicide ideation compared with the full TB and PB subscales. Face-valid items congruent with latent constructs proposed by the IPTS (i.e., feelings of burden on society, feeling that one does not belong) were the only two facets uniquely predictive of passive and active suicide ideation. Facets of TB and PB did not form distinct clusters. Item-level network analysis may have important conceptual, assessment, predictive, and clinical implications for understanding suicide risk.

The Relationship of Specific Demographic Variables to Perceived Burdensomeness, Thwarted Belongingness, and Acquired Suicide Capability in K–12 Students

This study explores the relationship between specific demographic variables and the three Interpersonal-Psychological Theory (IPT) variables known to influence suicidal ideation and acts. The population was a large sample of K–12 students. Current research regarding demographic variables and the IPT variables in youth has been largely unexplored, leaving many assumptions and untested hypotheses. To address this gap, an archival cross-sectional design employing three multiple regression analyses was completed. For each analysis, the three demographic variables (age, gender, and race/ethnicity) were regressed on one of the IPT variables (perceived burdensomeness, thwarted belongingness, and acquired suicide capability). The overall model for each of the research questions was significant, with R2 ranging from .06 to .07. Reasons for the obtained results as well as implications for researchers and clinicians are discussed.

An Exploration of the Relationship between Interpersonal Needs and Nonsuicidal Self-Injury in Adolescents

Nonsuicidal self-injury has become a worrying phenomenon among adolescents worldwide, emphasising the need for increasing public health awareness and exploration of the factors associated with this behaviour. This study was framed using Joiner’s Interpersonal–Psychological Theory of Suicide and Nock and Prinstein’s four-function model of nonsuicidal self-injury. The aim of this study was to explore the relationship between the interpersonal needs constructs of Joiner’s theory and nonsuicidal self-injury and is motivated by the need to explore the contagion of self-injury. A cross-sectional convenience sampling method was used to obtain a sample of 216 adolescents, who were recruited from four schools in the greater Durban area, South Africa. Regression analyses were performed to establish whether a relationship exists between the interpersonal needs constructs and nonsuicidal self-injury. The results indicated a positive relationship between perceived burdensomeness and the occurrence of nonsuicidal self-injury in this sample, thereby illuminating thwarted interpersonal needs as a contributor to the occurrence of nonsuicidal self-injury in adolescents.