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.

Acknowledgments

The authors gratefully acknowledge the clinical and administrative staff in the Child and Adolescent Psychiatric Inpatient Program at the University of Michigan for their invaluable support. The authors are also grateful for the support of research staff of the University of Michigan’s Youth Depression and Suicide Prevention Program. We also thank the youth and families who participated in this study.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Supplementary Material

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2022.2051525.

Notes

¹ Fixed effect sizes were calculated using partR2 package (Stoffel et al., 2021) based on simplified models without random slopes or autoregressive covariance structure, as these are not supported by the package. lme4 (Bates et al., 2015) was used to obtain multilevel models as required by partR2.

Additional information

Funding

This research was funded by [NIMH K23MH113776] (Czyz, E. K.). The National Institute of Mental Health [K23MH113776-01].