Tests of the Interpersonal Psychological Theory of Suicide among Adolescents
Horton, Sarah Elizabeth
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Self-injurious behaviors tend to first manifest during adolescence, marking this developmental period as an important context for suicide research. The lack of theory-driven research in this area has made it difficult to integrate scattered findings in a way that increases understanding of suicidal behaviors. The Interpersonal Psychological Theory of Suicide (IPTS; Joiner, 2005) aims to remedy this issue by offering an organizing framework that has many conceptual and practical merits. Although this theory has a growing base of evidence among adults, it has yet to be tested in adolescents using direct measures of its central constructs. The current study offers preliminary examinations of 1) psychometric properties of scales to assess key constructs in the IPTS: perceived burdensomeness and thwarted belongingness assessed by the Interpersonal Needs Questionnaire (INQ), and acquired capability for suicide measured by the Acquired Capability for Suicide Scale-Fearlessness About Death (ACSS-FAD) and 2) hypotheses guided by the IPTS in an adolescent clinical sample. Participants were 147 adolescents on an inpatient psychiatric unit, who completed measures of key IPTS constructs, depression severity, hopelessness, severity of suicidal symptoms, and various constructs relevant to convergent and discriminant validity. Factor analyses and evidence for construct validity of the 15-item INQ and 7-item ACSS-FAD provided preliminary support for utilization of these scales in this population (Study 1). Study 2 findings were largely consistent with hypotheses derived from the IPTS: perceived burdensomeness, and at a marginal level, thwarted belongingness, were independently associated with current suicidal ideation. The thwarted belongingness by perceived burdensomeness interaction distinguished between adolescents with passive and active suicidal ideation. Acquired capability for suicide was associated with recent suicidal intent. IPTS constructs and their interactions were associated with suicidal symptom severity. This study offers strong, albeit preliminary, support of the IPTS in a clinical adolescent sample. Assessment of IPTS constructs may be useful in determining persistent risk for suicide attempts. Prospective tests of the theory, and extensions to intervention and prevention should be considered in future IPTS research.