The Interpersonal Theory of Suicide among Adolescents: Examining the Theory over the Course of Treatment

Suicide is a one of the leading causes of death among young adults and adolescents. Adolescence is the period where suicidal phenomena typically develop and may offer an important window for understanding suicidal behavior. There are many known risk factors for suicide, but it has been difficult to integrate findings in a meaningful way that increases overall understanding of various risk factors for suicide. The Interpersonal Psychological Theory of Suicide (IPTS; Joiner, 2005) offers an organizing framework for understanding risk factors. The IPTS posits that an individual has to have the desire for suicide, as indicated by perceived burdensomeness and thwarted belongingness as well as the acquired capability to do so. There are few multiwave studies that indicate how IPTS variables change over time and also few studies that control for or compare against well-established variables associated with suicidality, specifically depressive symptoms. We aimed to address these shortcomings by examining how the IPTS variables change with treatment, and simultaneously including a measure of depressive symptoms to investigate the dynamic nature of the model and its relationship with suicidal ideation relative to depressive symptoms. Participants were 56 adolescents engaged in an intensive outpatient treatment program, who completed measures of key IPTS constructs, depressive symptoms, and suicidal ideation at entrance and discharge. Results demonstrated that the interpersonal constructs of perceived burdensomeness and thwarted belongingness decreased significantly over the course of treatment while acquired capability remained stable. Change in interpersonal constructs and change in depressive symptoms were associated with change in suicidal ideation when tested in separate models. When change in depressive symptoms and change in interpersonal constructs were examined together, change in the interpersonal constructs contribution to prediction of variance in change in suicidal ideation persisted. This finding supports the unique contribution of IPTS variables to changes in suicidal ideation in a dynamic framework.