Patterns of Suicidal Risk and Its Relationship with Suicidal Ideation and Attempt: Practice and Policy Implications

Abstract

Despite efforts to prevent suicide, suicide mortality rate has been increasing since 2000. This dissertation examined distinct patterns of suicidal risk based on the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005), and the most critical patterns of suicidal ideation and suicide attempt were explored using latent class analysis. A nationally representative sample of White, Black, Latinx, and Asian adults from the Collaborative Psychiatric Epidemiology Surveys (Alegria et al., 2016) was used. For White adults, five latent classes were identified, and respondents in the All Three with Alcohol/Drug Dependence, All Three without Alcohol/Drug Dependence, and Thwarted Belongingness + Perceived Burdensomeness classes were more likely to demonstrate suicidal ideation and suicide attempt than those in the Only Acquired Capability for Suicide class. For Black adults, six latent classes were identified, and respondents in the All Three with Alcohol/Drug Dependence and All Three without Alcohol/Drug Dependence classes were significantly more likely to attempt suicide than those in the Low Risk class. For Latinx respondents, four latent classes were identified, and respondents in the Thwarted Belongingness + Acquired Capability for Suicide class were significantly more likely to attempt suicide than respondents in the Low Risk class. For Asian respondents, three latent classes were identified, and respondents in Thwarted Belongingness + (Active) Acquired Capability for Suicide class had a significantly higher risk for suicidal ideation and suicide attempt than those in the Low Risk class. Findings of this dissertation supported the major tenets of the IPTS that individuals are at the greatest risk for suicide attempt when thwarted belongingness, perceived burdensomeness, and acquired capability for suicide coexist. In addition, this dissertation found some variations across the four racial/ethnic groups. Findings suggested that clinicians working with people with higher risk for suicide should explore multiple dimensions of suicidal risk, especially clients’ capability for suicide (e.g., past exposure to trauma and pain- and fear-reducing experiences). Suicide-prevention campaigns and trainings need to include exploration of past exposure to trauma, physical violence, and risk-taking behaviors as well as access to means in training sessions so that trainees can better detect people with higher risk of suicide attempt.