Abstract
Introduction
Individuals with schizophrenia are at increased risk for suicide, and the Demoralization Hypothesis states that non-delusional awareness of one’s social, cognitive, or occupational deterioration elicits depression and hopelessness. Both depression and hopelessness are established risk factors for suicide and are features of schizophrenia. The present study investigated whether insight into one’s schizophrenia yields suicidal ideation, specifically by way of thwarted belongingness and perceived burdensomeness, which are constructs related to demoralization and measured by the Interpersonal Needs Questionnaire (INQ).
Methods
Three separate models explored the mediating role of INQ scores on suicidal ideation in 99 participants with schizophrenia. With suicidal ideation entered as the dependent variable and INQ scores entered as the mediator, the first model included insight as the independent variable, the second included cognitive functioning, and the third included cognitive deterioration post-illness-onset.
Results
Consistent with our hypothesis, INQ scores related to suicidal ideation (B = .03, SE = .01, p < .001). However, neither insight, cognitive functioning, nor cognitive deterioration predicted INQ scores or suicidal ideation. Additionally, INQ scores did not mediate relationships with suicidal, ideation.
Conclusion
Although INQ scores led to increased suicidal ideation, neither insight into illness, current cognitive functioning, nor shift in functioning led to increased INQ scores. Implications are discussed, and future directions are proposed.
Correction Statement
This article has been corrected with minor changes. These changes do not impact the academic content of the article.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
AUTHOR CONTRIBUTIONS
Amy Lieberman: Conceptualization; formal analysis; methodology; project administration; writing- original draft
Emma M. Parrish: Data curation; writing- review & editing
Colin A. Depp: Conceptualization; data curation; supervision; writing- review & editing
Phillip D. Harvey: Data curation
Amy E. Pinkham: Data curation
Thomas E. Joiner: Conceptualization; supervision; writing- review & editing
Notes
1 Incidentally, meta-analytic results from 37 studies comprising 1,961 participants with schizophrenia and 1,444 controls found that the digit symbol coding task, alone, can expose an information processing inefficiency that is a central feature of the cognitive deficit in schizophrenia (Dickinson et al., Citation2007).
2 Post-hoc, exploratory analyses sought to investigate the effects of controlling for race in addition to age and gender. Our initial results remained.
3 Post-hoc analyses sought to investigate the effects of splitting TB and PB in the mediation analyses. All confidence intervals passed through zero, corroborating our original analyses.
Additional information
Funding
Notes on contributors
Amy Lieberman
Amy Lieberman, MS, Department of Psychology, Florida State University, Tallahassee, Florida, USA;
Emma M. Parrish
Emma M. Parrish, MS, Clinical Psychology, San Diego State University/University of California, San Diego, California, USA;
Colin A. Depp
Colin A. Depp, PhD, Department of Psychiatry, University of California-San Diego, San Diego, California, USA;
Phillip D. Harvey
Phillip D. Harvey, PhD, University of Miami Health System, Miami, Florida, USA;
Amy E. Pinkham
Amy E. Pinkham, PhD, Dallas School of Behavioral and Brain Sciences, University of Texas, Richardson, Texas, USA;
Thomas E. Joiner
Thomas E. Joiner, PhD, Department of Psychology, Florida State University, Tallahassee, Florida, USA