Ryan M. Hill

The identification of theoretically and empirically supported correlates of suicide ideation is important to improve treatment approaches to suicide. This study sought to examine the association between interpersonal trust (theoretically conceptualized as a distal risk marker) and suicide ideation in adolescence. Specifically, it was hypothesized that interpersonal trust would be negatively associated with suicide ideation via perceived burdensomeness and thwarted belongingness (conceptualized as more proximal risk markers). Data were drawn from a cross‐sectional sample of 387 adolescent inpatients between the ages of 12 and 17 years (M = 14.72, SD = 1.49). The sample was 63.6% female, 37.5% Hispanic, 26.9% African American/Black, and 25.8% Caucasian. Adolescents completed a series of self‐report measures to assess thwarted belongingness, perceived burdensomeness, interpersonal trust, depressive symptoms, and suicide ideation. A structural equation model was fit to the data, and results demonstrated a significant indirect path from interpersonal trust to suicide ideation via perceived burdensomeness, but not thwarted belongingness. Results suggest that interpersonal trust may be a distal risk marker for suicide ideation and that interventions to increase interpersonal trust may help prevent the development of thwarted belongingness, perceived burdensomeness, and suicide ideation.

A relationship between anxiety disorders and suicide-related behaviors has been demonstrated in adolescents, with a paucity of research examining mediators of this association. The present study hypothesized that anxiety would be associated with suicidal ideation via a serial mediation pathway through depressive symptoms and perceived burdensomeness and/or thwarted belongingness. A sample of 80 adolescents (68.8% female, 65.8% Hispanic), 13–19 years of age (mean = 16.93, SD = 1.66), completed 3 interviews as part of a randomized controlled trial. Results indicated a significant serial mediation from anxiety to suicidal ideation via depressive symptoms and perceived burdensomeness, but not thwarted belongingness. Clinicians and mental health service providers working with adolescents experiencing elevated anxiety should regularly assess for perceived burdensomeness and suicidal ideation.

Five versions of the Interpersonal Needs Questionnaire (INQ), a self‐report measure of perceived burdensomeness and thwarted belongingness, have been used in recent studies (including 10‐, 12‐, 15‐, 18‐, and 25‐items). Findings regarding the associations between perceived burdensomeness, thwarted belongingness, and suicidal ideation using different versions have been mixed, potentially due to differences in measurement scales. This study evaluated factor structure, internal consistency, and concurrent predictive validity of these five versions in three samples. Samples 1 and 2 were comprised of 449 and 218 undergraduates, respectively; Sample 3 included 114 adolescent psychiatric inpatients. All versions demonstrated acceptable internal consistency. The 10‐item version and 15‐item version demonstrated the best, most consistent model fit in confirmatory factor analyses. Both perceived burdensomeness and thwarted belongingness consistently predicted concurrent suicidal ideation on the 10‐item INQ only. Future research should consider using the 15‐item or 10‐item versions.

Context: The interpersonal‐psychological theory of suicide identifies perceived burdensomeness as a primary component of suicidal desire and a possible point of intervention for suicide prevention. A growing literature has explored the relationship between perceived burdensomeness and suicide‐related behaviors.Objective: The aim of this review is to integrate the evidence, identify critical gaps in the evidence‐base, and explore implications for translation to prevention and intervention science.Methods: Papers published that reported on the association between perceived burdensomeness and suicide‐related behaviors were included.Results: The literature indicates (a) significant cross‐sectional associations between perceived burdensomeness and suicidal ideation and suicide attempts and (b) that perceived burdensomeness acts as either a moderator or a mediator of the association between risk and protective factors and suicide‐related behaviors.Conclusion: Research is needed to examine the longitudinal association between perceived burdensomeness and suicide‐related behaviors, develop additional measurement approaches, generalize findings to other samples, and begin translating findings to prevention and intervention science.