Examining Real-Time Variations in Interpersonal Hopelessness and Suicidal Ideation Using Ecological Momentary Assessment

Abstract

The Interpersonal Theory of Suicide (ITS; Van Orden et al., 2010) hypothesizes that suicidal ideation (SI) arises from the simultaneous presence of thwarted belongingness (TB) and perceived burdensomeness (PB). For SI to intensify to suicidal desire, hopelessness about the changes in TB and PB must be present (Van Orden et al, 2010). Recent research on the ITS has moved away from a general measure of hopelessness, instead focusing on hopelessness specific to the interpersonal constructs of TB and PB (Tucker et al., 2018). This construct, referred to as interpersonal hopelessness (IH), is further broken down into two correlated but distinct constructs; hopelessness about one’s belongingness being thwarted (IH-TB) and about one’s perception that they are a burden (IH-PB; Mitchell et al., 2023). Few studies have explored IH, and none to date have explored the temporal stability of IH and its prospective prediction of suicidal ideation (SI) severity. Undergraduates (N = 43) selectively recruited for past-two-week SI completed five ecological momentary assessment surveys per day for 10-days. Intraclass correlations, root mean square of successive differences, and multi-level models were used to examine the data and explore relationships among predictor variables. Results indicated that IH-TB and IH-PB demonstrated greater temporal stability than general hopelessness across assessments. IH-TB, IH-PB, and their interaction were significant predictors of SI severity concurrently and prospectively. However, IH-PB was no longer significantly predictive of SI severity at the next time point when adjusting for general hopelessness. Results show that targeting IH specific to TB and PB may reduce subsequent SI. Targeting IH may require different strategies than targeting general conceptions of hopelessness due to its more stable nature. Future research should replicate these results in larger and more diverse samples and consider the use of shorter ambulatory assessment intervals.