Suicidal Desire in Adolescents: An Examination of the Interpersonal Psychological Theory Using Daily Diaries

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.

Figure 1.. Two-Way Interaction Effect Between Burdensomeness and Peer Belongingness

Note. A binary burdensomeness variable was created for ease of interpretation. The sample of observations was split at the median such that observations in the low burdensomeness group had a score of burdensomeness below the median, while observations in the high burdensomeness group had a burdensomeness score at the median or above. SI = suicide ideation.

Figure 2.. Two-Way Interaction Effect Between Burdensomeness and Family Belongingness

Note. A binary burdensomeness variable was created for ease of interpretation. The sample of observations was split at the median such that observations in the low burdensomeness group had a score of burdensomeness below the median, while observations in the high burdensomeness group had a burdensomeness score at the median or above. SI = suicide ideation.