Exposure to Nonfatal Suicidal Behavior: Examining Pathways to Suicide Risk Using the Interpersonal-Psychological Theory of Suicide (IPTS)

Abstract

Despite efforts to identify risk factors for suicide following exposure to completed suicide, research has paid less attention to the associations between exposure to nonfatal suicidal behavior (NFSB) and subsequent suicide risk among the exposed. Using path analysis, this study examined direct effects of NFSB exposure on suicide risk, as well as indirect effects via depression and anxiety symptom severity, perceived burdensomeness, and thwarted belongingness. Using a sample of 230 college students, a demographic group that is disproportionately exposed to NFSB, results indicated that NFSB exposure was directly associated with suicide risk and depressive symptomatology and indirectly associated with suicide risk through elevations in depressive symptomatology and perceived burdensomeness. These findings support the notion that exposure to NFSB serves as a risk factor for suicidality and that this association can be explained, at least in part, by heightened depressive symptomatology and perceived burdensomeness. Furthermore, these findings highlight the importance of enhancing provisions of support for those exposed to NFSB.

Keywords:

• Nonfatal suicidal behavior (NFSB)
• interpersonal psychological theory of suicide (IPTS)
• suicide propagation
• suicide suggestion
• suicide contagion
• college students
• suicide exposure

Note

Notes

1 For the purpose of this paper, NFSB is defined as suicidal ideation with or without suicide attempts, consistent with the definition put forth by Nock et al. (2008).

Additional information

Notes on contributors

Jamison S. Bottomley

Jamison S. Bottomley, MS, is a graduate student in the Department of Psychology at the University of Memphis. His research has largely focused on the experience of exposure to suicide, with a particular emphasis on how survivors of a suicide loss adjust and find meaning in the wake of a suicide death.

Seth Abrutyn

Seth Abrutyn is an assistant professor in the Department of Sociology at the University of British Columbia. As a theorist, Abrutyn examines the intersection of mesolevel structure and culture and the microlevel dynamics such as identity and emotions. His research on suicide provides a fundamental social phenomenon through which he can shed light on this theoretical puzzle. His work on suicide with Anna Mueller has won several awards for its contributions to knowledge and has been published in journals such as the American Sociological Review, Sociological Theory, and the Journal of Health and Social Behavior.

Melissa A. Smigelsky

Melissa A. Smigelsky is a psychologist in the Department of Veterans Affairs Mental Health and Chaplaincy Program, where she is engaged in research, educational, and clinical efforts related to the integration of mental health and chaplaincy. Her research focuses on the intersection of religion and spirituality with psychology in the context of individual and community experiences of trauma and loss, including moral injury, suicide bereavement, and complicated grief.

Robert A. Neimeyer

Robert A. Neimeyer is a professor of psychology, University of Memphis, where he also maintains an active clinical practice. Neimeyer has published 30 books, including Techniques of Grief Therapy: Creative Practices for Counseling the Bereaved, and serves as editor of the journal Death Studies. The author of nearly 500 articles and book chapters and a frequent workshop presenter, he is currently working to advance a more adequate theory of grieving as a meaning-making process.