Exploring the psychology of suicidal ideation: A theory driven network analysis

D De Beurs,E.I Fried,K Wetherall,S Cleare,D.B O’ Connor,E Ferguson,R.E O'Carroll,R.C O’ Connor

doi:10.1016/j.brat.2019.103419

Abstract

Two leading theories within the field of suicide prevention are the interpersonal psychological theory of suicidal behaviour (IPT) and the integrated motivational-volitional (IMV) model. The IPT posits that suicidal thoughts emerge from high levels of perceived burdensomeness and thwarted belongingness. The IMV model is a multivariate framework that conceptualizes defeat and entrapment as key drivers of suicide ideation. We applied network analysis to cross-sectional data collected as part of the Scottish Wellbeing Study, in which a nationally representative sample of 3508 young adults (18–34 years) completed a battery of psychological measures. Network analysis can help us to understand how the different theoretical components interact and how they relate to suicide ideation. Within a network that included only the core factors from both models, internal entrapment and perceived burdensomeness were most strongly related to suicide ideation. The core constructs defeat, external entrapment and thwarted belonginess were mainly related to other factors than suicide ideation. Within the network of all available psychological factors, 12 of the 20 factors were uniquely related to suicide ideation, with perceived burdensomeness, internal entrapment, depressive symptoms and history of suicide ideation explaining the most variance. None of the factors was isolated, and we identified four larger clusters: mental wellbeing, interpersonal needs, personality, and suicide-related factors. Overall, the results suggest that relationships between suicide ideation and psychological risk factors are complex, with some factors contributing direct risk, and others having indirect impact.

Highlights

Suicide is a global health problem, with at least 800, 000 people dying by suicide each year (World Health Organization, 2014)
We set out to better understand how key psychological factors as determined by two leading theories in suicidology, the interpersonal psychological theory (IPT), and the integrated motivational-volitional (IMV) model, interact among each other, and how they relate to suicide ideation
Within the interpersonal psychological theory of suicidal behaviour (IPT), suicide ideation is hypothesized to be related to high levels of perceived burdensomeness and thwarted belongingness (Van Orden et al, 2010), whereas the IMV model proposes that entrapment is central in the development of suicide ideation (O'Connor, 2011; O'Connor & Kirtley, 2018)

Summary

Introduction

Suicide is a global health problem, with at least 800, 000 people dying by suicide each year (World Health Organization, 2014). Traditional attempts at understanding suicide risk have tended to focus on single risk factors for suicidal behaviour (e.g., escape: Baumeister, 1990), or have attended to a specific domain of risk such as cognition (Wenzel, Brown, & Beck, 2009). Such approaches have resulted in a better understanding of specific risk factors for suicidal behaviour, their narrow focus has not done justice to the complexity of the factors leading to suicidal ideation and behaviour (O'Connor, 2011; O'Connor & Kirtley, 2018; O'Connor & Nock, 2014).

Objectives

Methods

Results

Conclusion