Suicide Ideation and Thwarted Interpersonal Needs among Psychiatric Inpatients: A Network Approach.
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SUBMITTER: Brown SL
PROVIDER: S-EPMC8782252 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionIdentifying various interacting risk factors for suicidality is important to develop preventive measures. The Interpersonal-Psychological Theory of Suicidal Behavior (IPTS) postulates suicidal ideation resulting from the occurrence of Perceived Burdensomeness (PB) and Thwarted Belongingness (TB). Suicidal behavior ultimately occurs if people have a Capability for Suicide. In past studies, the validity of TB was often not empirically confirmed, questioning which of the aspects of TB are central and related to suicidal ideation and whether applied measurement methods adequately capture the construct.MethodUsing a sample of 3,404 individuals from different clinical and nonclinical settings, 30% (1,023) of whom reported suicidal ideation, two network analyses were conducted on the Interpersonal Needs Questionnaire (INQ) and a variable mapping suicidal ideation.ResultsAnalyses revealed that some items of the INQ were not related to suicidal ideation and the most central items did not have the strongest associations to suicidal ideation.ConclusionBased on these results, a shortened version of the INQ with the four items that showed the strongest associations with suicidal ideation in the network analyses was suggested.
| S-EPMC10642825 | biostudies-literature
Project description:The present study examined the psychometric properties and construct validity of scores derived from the Interpersonal Needs Questionnaire (INQ) using latent variable modeling with 5 independent samples varying in age and level of psychopathology. The INQ was derived from the interpersonal theory of suicide and was developed to measure thwarted belongingness and perceived burdensomeness-both proximal causes of desire for suicide. Results support that thwarted belongingness and perceived burdensomeness are distinct but related constructs and that they can be reliably measured. Further, multiple-group analyses were consistent with invariance for young versus older adults and nonclinical versus clinical populations, thereby supporting the relevance of these constructs to diverse populations. Finally, both constructs demonstrated convergent associations with related interpersonal constructs-including loneliness and social support for belongingness and social worth and death ideation for burdensomeness--as well as prospective associations with suicidal ideation.
| S-EPMC3377972 | biostudies-literature
Project description:Childhood abuse and/or neglect adversely influences development of neurocognitive systems that regulate affect and behavior. Poor inhibitory control over emotional reactions is thus one potential pathway from maltreatment to suicide. Adult psychiatric inpatients completed the Childhood Trauma Questionnaire and an emotional stop-signal task indexing negative emotional action termination (NEAT): the ability to inhibit ongoing motor reactions to aversive stimuli triggered by negative affect. Clinical interviews assessed suicidal thoughts and behaviors during hospitalization (n = 131) and at follow-up assessments 6 months later (n = 87). Our primary aim was to examine whether maltreatment history and NEAT explain overlapping variance in suicidal behaviors (1) retrospectively and (2) 6 months following hospital discharge. Contrary to prediction, childhood maltreatment was unrelated to history of suicidal behaviors. However, NEAT was consistently associated with prior suicidal acts, even controlling for suicidal ideation and demographic covariates. NEAT similarly contributed to the prediction of post-discharge suicidal behaviors, whereas we found no effect of maltreatment history. The present study suggests that NEAT captures suicide risk independently of childhood maltreatment. Results implicated NEAT impairment specifically, rather than broader response inhibition deficits (e.g., to positive stimuli), in past and future suicidal behaviors. These findings provide preliminary support for NEAT as a behavioral vulnerability marker for suicide, with implications for understanding links between maltreatment history and suicidal acts.
| S-EPMC8531534 | biostudies-literature
Project description:AimsSeveral authors claimed that expression of suicidal ideation is one of the most important predictors of completed suicide. However, the strength of the association between suicidal ideation and subsequent completed suicide has not been firmly established in different populations. Furthermore, the absolute suicide risk after expression of suicidal ideation is unknown. In this meta-analysis, we examined whether the expression of suicidal ideation predicted subsequent completed suicide in various populations, including both psychiatric and non-psychiatric populations.MethodsA meta-analysis of cohort and case-control studies that assessed suicidal ideation as determinant for completed suicide in adults. Two independent reviewers screened 5726 articles for eligibility and extracted data of the 81 included studies. Pooled risk ratios were estimated in a random effects model stratified for different populations. Meta-regression analysis was used to determine suicide risk during the first year of follow-up.ResultsThe risk for completed suicide was clearly higher in people who had expressed suicidal ideation compared with people who had not, with substantial variation between the different populations: risk ratio ranging from 2.35 (95% confidence interval (CI) 1.43-3.87) in affective disorder populations to 8.00 (95% CI 5.46-11.7) in non-psychiatric populations. In contrast, the suicide risk after expression of suicidal ideation in the first year of follow-up was higher in psychiatric patients (risk 1.40%, 95% CI 0.74-2.64) than in non-psychiatric participants (risk 0.23%, 95% CI 0.10-0.54). Past suicide attempt-adjusted risk ratios were not pooled due to large underreporting.ConclusionsAssessment of suicidal ideation is of priority in psychiatric patients. Expression of suicidal ideation in psychiatric patients should prompt secondary prevention strategies to reduce their substantial increased risk of suicide.
| S-EPMC6998965 | biostudies-literature
Project description:BackgroundWomen seeking shelter from intimate partner violence (IPV) experience heightened risk for suicide ideation and attempts compared to abused and non-abused women in the general population. However, few theory-guided studies have examined what cognitive-emotional symptoms might underlie this increased risk.MethodsGuided by fluid vulnerability theory, this cross-sectional, survey study tested whether depressive symptoms, PTSD symptoms, and hopelessness mediate the association between IPV (coercive control and physical violence) and suicide ideation and whether suicide attempt history facilitated these mediated relations in 134 women seeking shelter from IPV.ResultsDepressive symptoms, but not PTSD symptoms or hopelessness, mediated the relation between coercive control and suicide ideation, and suicide attempt history facilitated this association. No variables mediated the association between physical violence and suicide ideation.LimitationsThe small sample size may have limited statistical power. The cross-sectional design precludes temporal conclusions from being drawn.ConclusionsShelter-seeking women subjected to coercive control who experience associated depressive symptoms may be at risk of suicide ideation, with history of a suicide attempt increasing this risk. Fluid vulnerability theory may help guide suicide risk assessment and intervention efforts among women seeking shelter from IPV.
| S-EPMC5647881 | biostudies-literature
Project description:ObjectiveInpatient suicide comprises a proportionately small but clinically important fraction of suicide. This study is intended as a qualitative analysis of the comprehensive English literature, highlighting what is known and what can be done to prevent inpatient suicide.MethodA systematic search was conducted on the Cochrane Library, PubMed, Embase, Web of Knowledge, and a personal database for articles on cohort series, preferably controlled, of inpatient suicide (not deliberate self-harm or attempted suicide, unless they also dealt specifically with suicide data).ResultsA qualitative discussion is presented, based on the findings of the literature searched.ConclusionsThe bulk of inpatient suicides actually occur not on the ward but off premises, when the patient was on leave or had absconded. Peaks occur shortly after admission and discharge. It is possible to reduce suicide risk on the ward by having a safe environment, optimizing patient visibility, supervising patients appropriately, careful assessment, awareness of and respect for suicide risk, good teamwork and communication, and adequate clinical treatment.
| S-EPMC4079240 | biostudies-literature
Project description:Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual's likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems.
| S-EPMC7215778 | biostudies-literature
Project description:BackgroundSexually transmitted infections (STIs) are a serious public health problem worldwide. Patients with STIs have a high rate of psychosocial problems and may perceive unmet interpersonal needs, which is considered a proximal and sufficient cause of suicidal thoughts and behaviors. The present study examined the construct validity and psychometric properties of the 15-item Interpersonal Needs Questionnaire among patients with STIs in Shanghai, China.MethodsWe recruited 910 patients with STIs (438 males and 472 females; mean age = 38.72, standard deviation [SD] = 13.034) from the Shanghai Skin Disease Hospital using accidental sampling. Baseline descriptive statistics were calculated using R 4.0.0, and a latent variable model was developed using Mplus 7.4.ResultsThe construct validity results supported a latent variable measurement model with three distinct but related constructs (thwarted belongingness, perceived burdensomeness, and social exclusion) (p < 0.001, χ2/df = 2.475, root mean square error of approximation = 0.057, comparative fit index = 0.931, Tucker-Lewis index = 0.916, standardized root mean residual = 0.044). The Cronbach's α and McDonald's ω values were 0.849 and 0.767 for the total scale, 0.888 and 0.889 for perceived burdensomeness, 0.764 and 0.777 for social exclusion, and 0.892 and 0.893 for thwarted belongingness. Interpersonal needs were significantly associated with low self-esteem (r = 0.539), loneliness (r = 0.573), depression (r = 0.338), entrapment (r = 0.420), defeat (r = 0.579), and low perceived social support (r = 0.424).ConclusionsThis was the first study to highlight social exclusion as a distinct but related dimension of interpersonal needs. This finding indicates that patients with STIs perceive high social exclusion. Therefore, health providers should consider the psychological status of these patients and implement strategies to support their integration into society.
| S-EPMC8842558 | biostudies-literature
Project description:BackgroundThe interpersonal theory of suicide (IPTS) is one of the most intensively researched contemporary theories on the development of suicidal ideation and behaviour. However, there is a lack of carefully conducted prospective studies.AimsTo evaluate the main predictions of the IPTS regarding the importance of perceived burdensomeness, thwarted belongingness and capability for suicide in predicting future suicide attempts in a prospective design.MethodPsychiatric in-patients (n = 308; 53.6% (n = 165) female; mean age 36.82 years, s.d. = 14.30, range 18-81) admitted for severe suicidal ideation (n = 145, 47.1%) or a suicide attempt completed self-report measures of thwarted belongingness, perceived burdensomeness, capability for suicide, hopelessness, depression and suicidal ideation as well as interviews on suicide intent and suicide attempts and were followed up for 12 months. Logistic regression and receiver operating characteristics (ROC) analysis were conducted.ResultsThe interaction of perceived burdensomeness, thwarted belongingness and capability for suicide was not predictive of future suicide attempts, but perceived burdensomeness showed a significant main effect (z = 3.49, P < 0.01; OR = 2.34, 95% CI 1.59-3.58) and moderate performance in screening for future suicide attempts (area under the curve AUC = 0.729, P < 0.01).ConclusionsThe results challenge the theoretical validity of the IPTS and its clinical utility - at least within the methodological limitations of the current study. Yet, findings underscore the importance of perceived burdensomeness in understanding suicidal ideation and behaviour.
| S-EPMC7576651 | biostudies-literature
Project description:Epidemiological studies have recognized a genetic diathesis for suicidal behavior, which is independent of other psychiatric disorders. Genome-wide association studies (GWAS) on suicide attempt (SA) and ideation have failed to identify specific genetic variants. Here, we conduct further GWAS and for the first time, use polygenic score analysis in cohorts of patients with mood disorders, to test for common genetic variants for mood disorders and suicide phenotypes. Genome-wide studies for SA were conducted in the RADIANT and GSK-Munich recurrent depression samples and London Bipolar Affective Disorder Case-Control Study (BACCs) then meta-analysis was performed. A GWAS on suicidal ideation during antidepressant treatment had previously been conducted in the Genome Based Therapeutic Drugs for Depression (GENDEP) study. We derived polygenic scores from each sample and tested their ability to predict SA in the mood disorder cohorts or ideation status in the GENDEP study. Polygenic scores for major depressive disorder, bipolar disorder and schizophrenia from the Psychiatric Genomics Consortium were used to investigate pleiotropy between psychiatric disorders and suicide phenotypes. No significant evidence for association was detected at any SNP in GWAS or meta-analysis. Polygenic scores for major depressive disorder significantly predicted suicidal ideation in the GENDEP pharmacogenetics study and also predicted SA in a combined validation dataset. Polygenic scores for SA showed no predictive ability for suicidal ideation. Polygenic score analysis suggests pleiotropy between psychiatric disorders and suicidal ideation whereas the tendency to act on such thoughts may have a partially independent genetic diathesis.
| S-EPMC4309466 | biostudies-literature