Year of Award

2022

Document Type

Professional Paper

Degree Type

Master of Arts (MA)

Degree Name

Clinical Psychology

Department or School/College

Psychology

Committee Chair

Duncan G. Campbell

Commitee Members

Duncan G. Campbell, Greg Machek, John Sommers-Flanagan

Keywords

psychosis, suicide, belonging, burdensomeness

Subject Categories

Clinical Psychology

Abstract

Psychotic disorders confer high risk for suicidality. Previous research has found the symptom clusters of psychosis to have differential relationships with risk for suicidal ideation and behavior. Despite evidence for unique determinants of suicide among people with disorders on the psychosis spectrum, little research has examined theoretical models of suicide that aim to explore the transition from suicidal thoughts to behavior in this population. The Interpersonal-Psychological Theory of Suicide (IPTS) may be particularly useful in delineating this transition, as the constructs underlying the IPTS overlap with symptoms and experiences salient in people with psychosis. We examined baseline data from an ongoing longitudinal, multi-site study of 200 adults with psychosis (30% schizophrenia; 35% schizoaffective disorder; 33% bipolar disorder I or II with psychotic features; 2% major depressive disorder with psychotic features) to: a) replicate previous findings regarding relationships among thwarted belongingness, perceived burdensomeness, and suicidal ideation in a broader sample; b) expand on previous research by examining the relationship of suicidal desire and acquired capability for suicide in predicting suicidal ideation severity; and c) explore relationships among positive and negative symptoms of psychosis and the IPTS constructs. In regression analyses, perceived burdensomeness emerged as a significant predictor of suicidal ideation independent of thwarted belongingness; in contrast with expectations, thwarted belongingness was not significant. The interaction of acquired capability and perceived burdensomeness was also associated with current ideation severity. Contrary to expectations, a history of suicide attempts was not associated with acquired capability for suicide. Among symptoms, suspiciousness/persecution and emotional withdrawal were associated with higher scores of perceived burdensomeness and thwarted belongingness. Overall, the present findings provide further support for maladaptive beliefs as salient processes involved in increased suicidal ideation in psychosis and warrant further examination of acquired capability as a contributor to suicide risk. The IPTS may identify modifiable targets for improving suicide risk assessment and therapeutic targets in treatment for individuals who experience psychosis.

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© Copyright 2022 Jennifer Villa