Longitudinal causal dynamics between perceived burdensomeness and suicidal ideation: Population-based cohort study

Abstract

Better understanding of the determinants of suicidal distress may be critical to improving clinical approaches to suicide prevention. According to the Interpersonal-Psychological Theory of Suicide, perceived burdensomeness (PB) is one of the proximal, causal risk factors for the development of suicidal distress. Considerable cross-sectional data has supported this association, but limited longitudinal data has investigated whether short-term change in PB influences subsequent suicidal ideation (SI). This longitudinal study involved daily assessments of both PB and SI over a 7-day period in 791 Australian adults who reported recent or current SI. Eight different panel models, with and without covariates were fit to examine cross-lagged effects between PB and SI. In the final model, there was weak evidence for a lagged effect from PB on SI the next day (β = 0.175), although the contemporaneous effect of PB on SI was larger and more consistent (β = 0.948). There was little evidence for lagged effects of SI on PB (β = 0.008). Effects varied across age groups and living situations. Inconsistent with the theory, findings suggest limited value of PB in predicting later SI, after accounting for cross-sectional relationships. Greater consideration of other psychosocial and contextual risk factors may be important for theories of suicide risk and for supporting people who are at risk of suicidal behaviour.

Keywords: Causation; Interpersonal-psychological theory; Lagged effects; Perceived burdensomeness; Suicidal distress.