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The interpersonal theory of suicide and adolescent suicidal behavior.
J Affect Disord. 2015 Sep 01; 183:68-74.JA

Abstract

BACKGROUND

Joiner's interpersonal theory of suicide (IPTS) proposes that suicide results from the combination of a perception of burdening others, social alienation, and the capability for self-harm. The theory gained some empirical support, however the overall model has yet to be tested. This study aimed to test the main predictions of IPTS in a large community sample of Israeli adolescents.

METHOD

1196 Israeli Jewish and Arab high-school pupils participating in the SEYLE project completed a self-report questionnaire measuring perceived burdensomeness, thwarted belongingness, health risk behaviors, and non-suicidal self-injury (risk variables), and suicidal ideation and suicide attempts (outcome measures). The data were tested in cross-sectional regression models.

RESULTS

Consistent with IPTS, perceived burdensomeness was found to interact with thwarted belongingness, predicting suicidal ideation. Depression mediated most of the effect of thwarted belongingness and perceived burdensomeness on suicidal ideation. Acquired capability for self-harm, as measured by health risk behaviors and direct non-suicidal self-injurious behaviors, predicted suicide attempt. However, this mechanism operated independently from ideation rather than in interaction with it, at variance with IPTS-based predictions.

LIMITATIONS

The cross-sectional design precludes conclusions about causality and directionality. Proxy measures were used to test the interpersonal theory constructs.

CONCLUSION

The findings support some of the IPTS predictions but not all, and imply two separate pathways for suicidal behavior in adolescents: one related to internalizing psychopathology and the other to self-harm behaviors. This conceptualization has clinical implications for the differential identification of adolescents at risk for suicidal behavior and for the development of prevention strategies.

Authors+Show Affiliations

Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel. Electronic address: shirabarzilay@gmail.com.Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel.Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychology, Bar Ilan University, Ramat Gan, Israel.Feinberg Child Study Centre, Schneider Children's Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.National Center for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Health Sciences, University of Molise, Campobasso, Italy.Department of Health Sciences, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy "d'Annunzio University" Foundation, Chieti, Italy.National Center for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26001665

Citation

Barzilay, S, et al. "The Interpersonal Theory of Suicide and Adolescent Suicidal Behavior." Journal of Affective Disorders, vol. 183, 2015, pp. 68-74.
Barzilay S, Feldman D, Snir A, et al. The interpersonal theory of suicide and adolescent suicidal behavior. J Affect Disord. 2015;183:68-74.
Barzilay, S., Feldman, D., Snir, A., Apter, A., Carli, V., Hoven, C. W., Wasserman, C., Sarchiapone, M., & Wasserman, D. (2015). The interpersonal theory of suicide and adolescent suicidal behavior. Journal of Affective Disorders, 183, 68-74. https://doi.org/10.1016/j.jad.2015.04.047
Barzilay S, et al. The Interpersonal Theory of Suicide and Adolescent Suicidal Behavior. J Affect Disord. 2015 Sep 1;183:68-74. PubMed PMID: 26001665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The interpersonal theory of suicide and adolescent suicidal behavior. AU - Barzilay,S, AU - Feldman,D, AU - Snir,A, AU - Apter,A, AU - Carli,V, AU - Hoven,C W, AU - Wasserman,C, AU - Sarchiapone,M, AU - Wasserman,D, Y1 - 2015/05/07/ PY - 2015/01/15/received PY - 2015/04/25/revised PY - 2015/04/27/accepted PY - 2015/5/24/entrez PY - 2015/5/24/pubmed PY - 2016/1/7/medline KW - Depression KW - Interpersonal theory KW - Non suicidal self-injury KW - Self-harm KW - Suicide SP - 68 EP - 74 JF - Journal of affective disorders JO - J Affect Disord VL - 183 N2 - BACKGROUND: Joiner's interpersonal theory of suicide (IPTS) proposes that suicide results from the combination of a perception of burdening others, social alienation, and the capability for self-harm. The theory gained some empirical support, however the overall model has yet to be tested. This study aimed to test the main predictions of IPTS in a large community sample of Israeli adolescents. METHOD: 1196 Israeli Jewish and Arab high-school pupils participating in the SEYLE project completed a self-report questionnaire measuring perceived burdensomeness, thwarted belongingness, health risk behaviors, and non-suicidal self-injury (risk variables), and suicidal ideation and suicide attempts (outcome measures). The data were tested in cross-sectional regression models. RESULTS: Consistent with IPTS, perceived burdensomeness was found to interact with thwarted belongingness, predicting suicidal ideation. Depression mediated most of the effect of thwarted belongingness and perceived burdensomeness on suicidal ideation. Acquired capability for self-harm, as measured by health risk behaviors and direct non-suicidal self-injurious behaviors, predicted suicide attempt. However, this mechanism operated independently from ideation rather than in interaction with it, at variance with IPTS-based predictions. LIMITATIONS: The cross-sectional design precludes conclusions about causality and directionality. Proxy measures were used to test the interpersonal theory constructs. CONCLUSION: The findings support some of the IPTS predictions but not all, and imply two separate pathways for suicidal behavior in adolescents: one related to internalizing psychopathology and the other to self-harm behaviors. This conceptualization has clinical implications for the differential identification of adolescents at risk for suicidal behavior and for the development of prevention strategies. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/26001665/The_interpersonal_theory_of_suicide_and_adolescent_suicidal_behavior_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(15)00280-3 DB - PRIME DP - Unbound Medicine ER -