We aimed to demonstrate the utility of an item-level network analysis approach to suicide risk by testing the interpersonal psychological theory of suicide (IPTS) among 402 psychiatric inpatients. We hypothesized that specific thwarted belongingness (TB) or perceived burdensomeness (PB; Interpersonal Needs Questionnaire items) facets would positively relate to passive or active suicide ideation and that these facets would positively relate to each other and form distinct clusters. We also tested TB and PB facets central to the networks as predictors of suicide ideation compared with the full TB and PB subscales. Face-valid items congruent with latent constructs proposed by the IPTS (i.e., feelings of burden on society, feeling that one does not belong) were the only two facets uniquely predictive of passive and active suicide ideation. Facets of TB and PB did not form distinct clusters. Item-level network analysis may have important conceptual, assessment, predictive, and clinical implications for understanding suicide risk.
BeckA. T.BrownG. K.SteerR. A. (1997). Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. Behaviour Research and Therapy, 35, 1039–1046. https://doi.org/10.1016/S0005-7967(97)00073-9
BringmannL. F.LemmensL. H.HuibersM. J.BorsboomD.TuerlinckxF. (2015). Revealing the dynamic network structure of the Beck Depression Inventory-II. Psychological Medicine, 45, 747–757. https://doi.org/10.1017/S0033291714001809
6.
CeroI.ZuromskiK. L.WitteT. K.RibeiroJ. D.JoinerT. E. (2015). Perceived burdensomeness, thwarted belongingness, and suicide ideation: Re-examination of the interpersonal-psychological theory in two samples. Psychiatry Research, 228, 544–550. https://doi.org/10.1016/j.psychres.2015.05.055
7.
ChuC.Buchman-SchmittJ. M.StanleyI. H.HomM. A.TuckerR. P.HaganC. R.RogersM. L.PodlogarM. C.ChiurlizaB.RingerF. B.MichaelsM. S.PatrosC.JoinerT. E. (2017). The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143, 1313–1345. https://doi.org/10.1037/bul0000123
8.
CramerA. O.Van Der SluisS.NoordhofA.WichersM.GeschwindN.AggenS. H.KendlerK. S.BorsboomD. (2012). Measurable like temperature or mereological like flocking? On the nature of personality traits. European Journal of Personality, 26, 451–459. https://doi.org/10.1002/per.1879
DavidS. J.MarshallA. J.EvanovichE. K.MummaG. H. (2018). Intraindividual dynamic network analysis—New directions in clinical assessment. Journal of Psychopathology and Behavioral Assessment, 40, 235–248. https://doi.org/10.1007/s10862-017-9632-8
11.
de BeursD. P.FriedE. I.WetherallK.CleareS.O’ConnorD. B.FergusenE.O’CarrollR. E.O’ConnorR. C. (2019). Exploring the psychology of suicidal ideation: A theory driven network analysis. Behaviour Research and Therapy, 120, Article 103419. https://doi.org/10.1016/j.brat.2019.103419
12.
de BeursD. P.van BorkuloC. D.O’ConnorR. C. (2017). Association between suicidal symptoms and repeat suicidal behaviour within a sample of hospital-treated suicide attempters. British Journal of Psychiatry Open, 3, 120–126.
13.
EpskampS.BorsboomD.FriedE. I. (2018). Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods, 50, 195–212. https://doi.org/10.3758/s13428-017-0862-1
14.
EpskampS.CramerA. O.WaldorpL. J.SchmittmannV. D.BorsboomD. (2012). qgraph: Network visualizations of relationships in psychometric data. Journal of Statistical Software, 48, 1–18. https://doi.org/10.18637/jss.v048.i04
15.
FranklinJ. C.RibeiroJ. D.FoxK. R.BentleyK. H.KleimanE. M.HuangX.MusacchioK. M.JaroszewskiA. C.ChangB. P.NockM. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187–232. https://doi.org/10.1037/bul0000084
16.
FrewenP. A.SchmittmannV. D.BringmannL. F.BorsboomD. (2013). Perceived causal relations between anxiety, posttraumatic stress and depression: Extension to moderation, mediation, and network analysis. European Journal of Psychotraumatology, 4(1), Article 20656. https://doi.org/10.3402/ejpt.v4i0.20656
GrollA.TutzG. (2014). A variable selection approach for generalized linear mixed models by L1-penalized estimation. Statistics and Computing, 24, 137–154. https://doi.org/10.1007/s11222-012-9359-z
19.
JahnD. R.CukrowiczK. C.MitchellS. M.PoindexterE. K.GuidryE. T. (2015). The mediating role of perceived burdensomeness in relations between domains of cognitive functioning and indicators of suicide risk. Journal of Clinical Psychology, 71, 908–919. https://doi.org/10.1002/jclp.22190
20.
JoinerT. (2005). Why people die by suicide. Harvard University Press.
21.
KlineT. J. (2005). Psychological testing: A practical approach to design and evaluation. SAGE.
22.
MaJ.BatterhamP. J.CalearA. L.HanJ. (2016). A systematic review of the predictions of the interpersonal–psychological theory of suicidal behavior. Clinical Psychology Review, 46, 34–45. https://doi.org/10.1016/j.cpr.2016.04.008
23.
McNallyR. J.RobinaughD. J.WuG. W.WangL.DesernoM. K.BorsboomD. (2015). Mental disorders as causal systems a network approach to posttraumatic stress disorder. Clinical Psychological Science, 3, 836–849. https://doi.org/10.1177/2167702614553230
24.
MitchellS. M.BrownS. L.RoushJ. F.BolañosA. D.LittlefieldA. K.MarshallA. J.JahnD. R.MorganR. D.CukrowiczK. C. (2017). The clinical application of suicide risk assessment: A theory-driven approach. Clinical Psychology & Psychotherapy, 24(6), 1406–1420. https://doi.org/10.1002/cpp.2086
25.
MitchellS. M.BrownS. L.RoushJ. F.TuckerR. P.CukrowiczK. C.JoinerT. E. (2019). The Interpersonal Needs Questionnaire: Statistical considerations for improved clinical application. Assessment, 27(3), 621–637. https://doi.org/10.1177/1073191118824660
26.
MonteithL. L.MenefeeD. S.PettitJ. W.LeopoulosW. L.VincentJ. P. (2013). Examining the interpersonal-psychological theory of suicide in an inpatient veteran sample. Suicide and Life-Threatening Behavior, 43, 418–428. https://doi.org/10.1111/sltb.12027
27.
NeunerT.SchmidR.WolfersdorfM.SpiesslH. (2008). Predicting inpatient suicides and suicide attempts by using clinical routine data?General Hospital Psychiatry, 30, 324–330. https://doi.org/10.1016/j.genhosppsych.2008.03.003
28.
OpsahlT.AgneessensF.SkvoretzJ. (2010). Node centrality in weighted networks: Generalizing degree and shortest paths. Social Networks, 32, 245–251. https://doi.org/10.1016/j.socnet.2010.03.006
29.
PaternosterR.BrameR.MazerolleP.PiqueroA. (1998). Using the correct statistical test for the equality of regression coefficients. Criminology, 36, 859–866.
30.
R Core Team. (2020). R: A language and environment for statistical computing (Version 3.6.1) [Computer software]. R Foundation for Statistical Computing. http://www.R-project.org
RobinaughD. J.LeBlancN. J.VuletichH. A.McNallyR. J. (2014). Network analysis of persistent complex bereavement disorder in conjugally bereaved adults. Journal of Abnormal Psychology, 123, 510–522. https://doi.org/10.1037/abn0000002
33.
RoushJ. F.CukrowiczK. C.MitchellS. M.BrownS. L.SeymourN. E. (2018). Valued living, life fulfillment, and suicide ideation among psychiatric inpatients: The mediating role of thwarted interpersonal needs. Journal of Contextual Behavioral Science, 7, 8–14. https://doi.org/10.1016/j.jcbs.2017.11.001
34.
RuzzanoL.BorsboomD.GeurtsH. M. (2015). Repetitive behaviors in autism and obsessive-compulsive disorder: New perspectives from a network analysis. Journal of Autism and Developmental Disorders, 45, 192–202. https://doi.org/10.1007/s10803-014-2204-9
van BorkuloC.BoschlooL.BorsboomD.PenninxB. H.WaldorpL. J.SchoeversR. A. (2015). Association of symptom network structure with the course of longitudinal depression. JAMA Psychiatry, 72, 1219–1226. https://doi.org/10.1001/jamapsychiatry.2015.2079
38.
Van OrdenK. A.CukrowiczK. C.WitteT. K.JoinerT. E.Jr. (2012). Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychological Assessment, 24, 197–215. https://doi.org/10.1037/a0025358
39.
Van OrdenK. A.WitteT. K.CukrowiczK. C.BraithwaiteS. R.SelbyE. A.JoinerT. E.Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117, 575–600. https://doi.org/10.1037/a0018697
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
