Abstract
ABSTRACTBackground: Self-perceived burden and perceived burdensomeness are two apparently related constructs that have arisen independently from research in physical and mental health, respectively. Although both are associated with suicidal ideation in individuals with chronic pain, they have yet to be examined concurrently in the same group of patients.Aims: The aim of this study was to investigate the relationship between the two constructs and their differential prediction of suicidal ideation.Methods: Participants were 260 outpatients of an interdisciplinary chronic pain treatment program. Each participant completed the Self-Perceived Burden Scale (SPBS), the Interpersonal Needs Questionnaire Perceived Burdensomeness Scale (INQPBS), the Beck Scale for Suicide Ideation, and the thoughts of self-harm item of the Patient Health Questionnaire-9.Results: The SPBS and the INQPBS were both unifactorial measures with good internal consistency. They correlated significantly with one another (r = 0.50, P < 0.001), as well as with scores on the two measures of suicidal ideation (rs ranging from 0.29 to 0.62, Ps < 0.001). However, the INQPBS correlated more highly with suicidal ideation than did the SPBS. In regression analyses, the INQPBS predicted unique variance in suicidal ideation after adjusting for the SPBS. Conversely, the SPBS did not contribute uniquely when the INQPBS was entered first.Conclusions: Patients with chronic pain who believe that they have become “a burden to others” are at increased risk for suicidal ideation. The conceptual similarities and differences between the constructs of self-perceived burden and perceived burdensomeness are reviewed to explain why perceived burdensomeness is the stronger predictor of this increased risk.
Highlights
Two areas of research have shown that people who feel that they have become a “burden to others” are at increased risk for suicidal ideation (SI)
We examined the psychometric characteristics of the Self-Perceived Burden Scale (SPBS) and Interpersonal Needs Questionnaire Perceived Burdensomeness Scale (INQPBS); the extent of their intercorrelation; their associations with measures of pain, mood, and function; and their differential prediction of SI
The rate of noncompletion was significantly higher for the SPBS than for the INQPBS (McNemar’s χ2 = 33.62, P < 0.001)
Summary
Two areas of research have shown that people who feel that they have become a “burden to others” are at increased risk for suicidal ideation (SI). The first area of research has focused on medical patients with physical disabilities, some of whom develop the belief that their functional limitations cause undue difficulty for caregivers and significant others This belief has been termed self-perceived burden, and it has been defined as “a multidimensional construct arising from care recipients’ feelings of dependence and the resulting frustration and worry, which lead to feelings of guilt at being responsible for the caregiver’s hardship” Self-perceived burden and perceived burdensomeness are two apparently related constructs that have arisen independently from research in physical and mental health, respectively Both are associated with suicidal ideation in individuals with chronic pain, they have yet to be examined concurrently in the same group of patients. The conceptual similarities and differences between the constructs of self-perceived burden and perceived burdensomeness are reviewed to explain why perceived burdensomeness is the stronger predictor of this increased risk
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