Abstract
The Interpersonal Psychological Theory of Suicide has a growing base of empirical support for use with adolescents. Of the two interpersonal constructs that make up the theory, perceived burdensomeness demonstrates a stronger relationship with suicidal ideation and appears more resistant to change over the course of treatment than thwarted belongingness. Despite this, there are few clinical interventions directly informed by theoretical models of suicide. Qualitative methodology is currently underutilized in better understanding the manifestation of theoretical constructs among suicidal youth and may shed light on how to harness this information during intervention development. Qualitative interviews about perceived burdensomeness were conducted with adolescents with a history of suicidality (n = 10), their parents (n = 10), and clinicians administering care to this population (n = 10). Perceived burdensomeness was widely recognized and described as relevant by all participants. Parents and clinicians expressed limited success when trying to directly address these cognitions with adolescents. Results from this exploratory study elucidated a close relationship with thwarted belongingness, especially in regard to how burden cognitions can lead to behaviors that damage social connectedness. An enhanced clinical model of perceived burdensomeness is proposed that identifies possible mechanisms of change when targeting this construct in a clinical setting. Potential interventions informed by these results are also outlined.
Highlights
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Cognitions of burdensomeness cause levels of thwarted belongingness to rise.
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Qualitative methods allow for a deeper understanding of theories of suicide.
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Interventions targeting cognitions of burdensomeness among youth are needed.
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Acknowledgements
We would like to thank the clinicians who generously donated their time to participate in the qualitative interviews for this study.
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This work was supported by the Jerry M. Lewis Mental Health Research Foundation.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. This study was approved by the UT Southwestern Medical Center Institutional Review board.
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Zullo, L., Mbroh, H., Moorehead, A. et al. Exploring the Construct of Perceived Burdensomeness Among Suicidal Adolescents: An Intervention Development Study. J Child Fam Stud 31, 1994–2004 (2022). https://doi.org/10.1007/s10826-022-02310-4
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DOI: https://doi.org/10.1007/s10826-022-02310-4