Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study

David Pagliaccio; Alma Bitran; Jaclyn S Kirshenbaum; Kira L Alqueza; Katherine Durham; Lauren S Chernick; Karla Joyce; Ranqing Lan; Giovanna Porta; David A Brent; Nicholas B Allen; Randy P Auerbach

doi:10.1111/jcpp.13868

Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study

J Child Psychol Psychiatry. 2024 May;65(5):668-679. doi: 10.1111/jcpp.13868. Epub 2023 Jul 20.

Authors

David Pagliaccio^{1

2}, Alma Bitran^{1

2}, Jaclyn S Kirshenbaum^{1

2}, Kira L Alqueza³, Katherine Durham^{1

2}, Lauren S Chernick⁴, Karla Joyce⁵, Ranqing Lan^{1

2}, Giovanna Porta⁶, David A Brent⁵, Nicholas B Allen⁷, Randy P Auerbach^{1

2

8}

Affiliations

¹ Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
² Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
³ School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL, USA.
⁴ Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA.
⁵ Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁶ UPMC Western Psychiatric Hospital, Pittsburgh, PA, USA.
⁷ Department of Psychology, University of Oregon, Eugene, OR, USA.
⁸ Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY, USA.

PMID: 37474206
PMCID: PMC10799188 (available on 2025-05-01)
DOI: 10.1111/jcpp.13868

Abstract

Background: Suicide is a major public health crisis among youth. Several prominent theories, including the Interpersonal Theory of Suicide (IPTS), aim to characterize the factors leading from suicide ideation to action. These theories are largely based on findings in adults and require testing and elaboration in adolescents.

Methods: Data were examined from high-risk 13-18-year-old adolescents (N = 167) participating in a multi-wave, longitudinal study; 63% of the sample exhibited current suicidal thoughts or recent behaviors (n = 105). The study included a 6-month follow-up period with clinical interviews and self-report measures at each of the four assessments as well as weekly smartphone-based assessments of suicidal thoughts and behaviors. Regression and structural equation models were used to probe hypotheses related to the core tenets of the IPTS.

Results: Feelings of perceived burdensomeness were associated with more severe self-reported suicidal ideation (b = 0.58, t(158) = 7.64, p < .001). Similarly, burdensomeness was associated with more frequent ideation based on weekly smartphone ratings (b = 0.11, t(1460) = 3.41, p < .001). Contrary to IPTS hypotheses, neither feelings of thwarted belongingness, nor interactions between burdensomeness and thwarted belongingness were significantly associated with ideation (ps > .05). Only elevated depression severity was associated with greater odds of suicide events (i.e., suicide attempts, psychiatric hospitalizations, and/or emergency department visits for suicide concerns) during the follow-up period (OR = 1.83, t(158) = 2.44, p = .01). No effect of acquired capability was found.

Conclusions: Perceptions of burdensomeness to others reflect a critical risk factor for suicidal ideation among high-risk adolescents. Null findings with other IPTS constructs may suggest a need to adopt more developmentally sensitive models or measures of interpersonal and acquired capability risk factors for youth. Refining methods and theoretical models of suicide risk may help improve the identification of high-risk cases and inform clinical intervention.

Keywords: Suicide; adolescence; longitudinal studies; risk factors; social factors.

MeSH terms

Adolescent
Adult
Humans
Interpersonal Relations*
Longitudinal Studies
Psychological Theory*
Risk Factors
Suicidal Ideation
Suicide, Attempted / psychology

Abstract

MeSH terms

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