Validation of a Scale Measuring Perceived Burdensomeness and Thwarted Belongingness in Adolescents


August 2021


Frazee, Laura Alexandra

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Death by suicide is of growing concern for youth ages 14 to 24. In 2019, it was the second leading cause of death for this age group (CDC, 2019). To better understand why suicide rates have been on the rise over the last decade, various theoretical models were created. One of those theories, The Interpersonal Psychological Theory of Suicide (IPTS), was created by Thomas Joiner and has received significant empirical support across the world (Chu et al., 2017; Joiner, 2005). This theory includes two constructs, perceived burdensomeness and thwarted belongingness, to facilitate the understanding of the origin of suicidal ideation. Perceived burdensomeness is a construct reflecting the perception one's mere existence is a burden on others, and one's life is worthless. Thwarted belongingness describes the perception that one lacks reciprocally loving or caring relationships. These two constructs are hypothesized to be the final pathways by which suicidal ideation occurs. The most widely used assessment tool to measure perceived burdensomeness and thwarted belongingness is the Interpersonal Needs Questionnaire (INQ), which was initially designed for adults. This study addresses the measurement of these constructs by creating and validating a new scale specifically for the adolescent population using concrete scenarios and developmentally appropriate language. The scenario-based items were designed to reflect various contexts during which adolescents likely experience perceived burdensomeness and thwarted belongingness via qualitative interviews and review of the literature. A factor analysis of the new scale resulted in two subscales reflecting perceived burdensomeness, including worthlessness, and thwarted belongingness. The scale also demonstrated strong reliability and validity when compared to the INQ. It also was moderately correlated with concurrent measures of depression and suicidal ideation, and weakly correlated with fearlessness about death reflecting adequate convergent and discriminant validity. In both the new scale, and the INQ, perceived burdensomeness and thwarted belongingness were highly correlated. This suggests these cognitive-affective states might arise together, particularly in real-life situations and in clinical samples. In examination of the IPTS model, the interaction of perceived burdensomeness and thwarted belongingness, when measured both by the new scale and the INQ, did not contribute any significant variance to concurrent suicidal ideation when controlling for depressive symptoms. In this sample, depression was the only significant contributor in the model. This contradicts the IPTS and suggests an important area of consideration in future investigations of the model. The scale addressed gaps in the literature regarding measurement of perceived burdensomeness and thwarted belongingness across varying relational contexts (i.e., family versus friends) in a developmentally appropriate way. Exploratory analyses using the scale also provided evidence supporting a difference in the extent to which perceived burdensomeness and thwarted belongingness are elicited across domains and roles for clinically depressed adolescents. This has the opportunity to provide clinically relevant information when trying to target these cognitive-affective states in treatment. Future research can use this scale to continue testing the relationship between the IPTS variables across contexts and suicidal ideation in both clinical and community samples.

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