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Suicidal Desire in Adolescents: An Examination of the Interpersonal Psychological Theory Using Daily Diaries
Journal of Clinical Child & Adolescent Psychology  (IF5.077),  Pub Date : 2022-04-27, DOI: 10.1080/15374416.2022.2051525
Nadia Al-Dajani, Ewa K. Czyz

ABSTRACT

Objective

Despite decades of research, relatively little is known about short-term predictors of suicidal thoughts and behavior. Intensive longitudinal methods are increasingly applied to investigate near-term risk factors of suicidal thoughts in daily life. The aim of this study was to examine short-term predictors of daily-level suicidal thoughts in a high-risk adolescent sample using the interpersonal-psychological theory of suicidal behavior (IPTS) as a guiding framework; the theory proposes that interpersonal experiences of thwarted belongingness in combination with perceived burdensomeness lead to suicidal desire.

Methods

Seventy-eight adolescents hospitalized due to suicide risk responded to one survey/day for 28 days after discharge (n = 1621 unique observations). Multilevel models examined IPTS-informed predictors of same- and next-day suicidal urge intensity.

Results

Partial and time-dependent support for the theory was found. The hypothesized two-way interaction between burdensomeness and thwarted belongingness (either family or peer) was significantly associated with increasing same-day, but not next-day, suicidal ideation; specifically, greater belongingness attenuated adverse impact of burdensomeness. The only significant predictor of next-day ideation was higher previous-day burdensomeness. Baseline burdensomeness also emerged as a predictor of day-to-day suicidal ideation.

Conclusion

Using a theoretically informed model, this study offers an in-depth examination of short-term predictors of suicidal ideation among high-risk adolescents. Findings underscore the importance of fostering peer and family relationships in reducing suicidal thoughts in the post-discharge period. Results additionally suggest that both state- and trait-level burdensomeness have lasting influence on suicidal thoughts during this high-risk period. These findings could inform intervention efforts for high-risk youth.