Examining suicidal desire through the lens of the three-step theory: A cross-sectional and longitudinal investigation in a community sample.

Abstract

Advancing evidence-based theories of suicide is critical to improving suicide prevention. The aim of the current study was to investigate suicidal desire through an emerging theory of suicide, the Three-Step Theory (3ST). Specifically, this study investigated the validity and predictive utility of Steps 1 and 2 of the 3ST in a Canadian community sample. Participants were 487 adults between the ages of 35 to 90 (M = 59; 64% female, 87% White) who completed self-report measures assessing suicidal ideation and attempt history, hopelessness, psychological pain, and 5 forms of social connectedness at baseline and 6 months later. In support of 3ST predictions, cross-sectional analyses showed (a) the combination of pain and hopelessness strongly correlated with suicidal desire, and (b) connectedness was protective of suicidal desire among those high in pain and hopelessness. Regarding predictive utility, longitudinal analyses showed that pain and hopelessness were strong predictors of future suicidal desire and that connectedness was protective against future suicidal desire. These relationships of pain, hopelessness, and connectedness remained when controlling for baseline suicidal desire. Results support the validity and predictive utility of 3ST hypotheses related to suicidal desire. Taken together with previous studies, findings suggest that Steps 1 and 2 are useful for conceptualizing suicide risk and prevention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).