Interpersonal Theory Of Suicide
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The interpersonal theory of suicide attempts to explain why individuals engage in
suicidal behavior Suicide is the act of intentionally causing one's own death. Risk factors for suicide include mental disorders, physical disorders, and substance abuse. Some suicides are impulsive acts driven by stress (such as from financial or acad ...
and to identify individuals who are at risk. It was developed by
Thomas Joiner Thomas Joiner is an American academic psychologist and leading expert on suicide. He is the Robert O. Lawton Professor of Psychology at Florida State University, where he operates his Laboratory for the Study of the Psychology and Neurobiology ...
and is outlined in ''Why People Die By Suicide''.Joiner, T. E. (2005). ''Why People Die By Suicide''. Cambridge, MA: Harvard University Press The theory consists of three components that together lead to suicide attempts. According to the theory, the simultaneous presence of thwarted
belongingness Belongingness is the human emotional need to be an accepted member of a group. Whether it is family, friends, co-workers, a religion, or something else, some people tend to have an 'inherent' desire to belong and be an important part of somethi ...
and perceived burdensomeness produce the desire for suicide. While the desire for suicide is necessary, it alone will not result in death by suicide. Rather, Joiner asserts that one must also have acquired capability (that is, the acquired ability) to overcome one's natural fear of death. A number of
risk factor In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection. Due to a lack of harmonization across disciplines, determinant, in its more widely accepted scientific meaning, is often use ...
s have been linked to suicidal behavior, and there are many theories of suicide that integrate these established risk factors, but few are capable of explaining all of the phenomena associated with suicidal behavior as the interpersonal theory of suicide does. Another strength of this theory lies in its ability to be tested empirically. It is constructed in a way that allows for falsifiability. A number of studies have found at least partial support for the interpersonal theory of suicide. Specifically, a systematic review of 66 studies using the interpersonal theory of suicide found that the effect of perceived burdensomeness on suicide ideation was the most tested and supported relationship. The theory’s other predictions, particularly in terms of critical interaction effects, are less strongly supported.


Desire for suicide


Thwarted belongingness

Belongingness—feeling accepted by others—is believed to be a fundamental need, something that is essential for an individual's psychological health and well-being. Increased social connectedness—a construct related to belongingness—has been shown to lower risk for suicide. More specifically, being married, having children, and having more friends are associated with a lower risk of suicidal behavior. Additionally, "pulling together" (e.g., gathering for sporting events, celebrations) with others has been shown to have a preventive effect.Joiner, Jr., T.E., Hollar, D., & Van Orden, K.A. (2007). "On Buckeyes, Gators, Super Bowl Sunday, and the Miracle on Ice: 'Pulling together' is associated with lower suicide rates". ''Journal of Social and Clinical Psychology'', 25, 180–196 For example, suicide rates have been lower on
Super Bowl Sunday Super Bowl Sunday is the day on which the Super Bowl, the National Football League (NFL)'s annual championship game, is played. It was the first Sunday in February from Super Bowl XXXVIII in 2004 until Super Bowl LV in 2021, but is now the seco ...
s than other Sundays, and it is believed that the social connectedness that occurs from being a fan of a sport's team increases one's feeling of belongingness. In contrast,
social isolation Social isolation is a state of complete or near-complete lack of contact between an individual and society. It differs from loneliness, which reflects temporary and involuntary lack of contact with other humans in the world. Social isolation c ...
is frequently reported by those who die by suicide prior to death.


Perceived burdensomeness

Perceived is the extent to which an individual perceives themselves as a burden on others or society. Joiner describes perceived burdensomeness as the belief that "my death is worth more than my life".
Unemployment Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is the proportion of people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work du ...
, medical or health problems, and incarceration are examples of situations in which a person may feel like they are a burden to others. It is important to note that the burdensomeness is "perceived", and is often a false belief. According to the theory, thwarted belongingness and perceived burdensomeness together, when perceived as stable and unchanging (one is experiencing hopelessness regarding these states), is enough to give rise to active suicidal desire.


Acquired capability

Joiner terms this "acquired" capability because it is not an ability with which humans are born. Rather, this ability to engage in suicidal behaviors is only acquired through life experiences. Fear of death is a natural and powerful instinct. According to the theory, one's fear of death is weakened when one is exposed to physical
pain Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...
or provocative life experiences as these experiences often lead to fearlessness and pain insensitivity. These experiences could include
childhood trauma Childhood trauma is often described as serious adverse childhood experiences. Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and phys ...
, witnessing a traumatic event, suffering from a severe illness, or engaging in
self-harm Self-harm refers to intentional behaviors that cause harm to oneself. This is most commonly regarded as direct injury of one's own skin tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and s ...
behaviors. These behaviors are thought to result in the desensitization to painful stimuli and to increase one's ability to engage in suicidal behaviors. This component is important in identifying individuals who are likely to attempt or die by suicide. For example, certain professions (e.g., soldiers, surgeons, and police officers) are exposed to physical pain or provocative experiences. More specifically, soldiers with a history of combat have likely been exposed to grave injuries, witnessing the death of others, and are habituated to fear of painful experiences. This is consistent with data indicating an increased rate of suicide in soldiers. Additionally, past attempts of suicide has been found to be the number one predictor of future attempts. This is consistent with Joiner's theory; individuals who attempt suicide will habituate to the fear of death, and this weakened fear will make an individual more likely to make a subsequent attempt.


Implications

A survey study of a large population-based cohort provides support for the interpersonal theory in that the interaction between thwarted belongingness and perceived burdensomeness predicted suicidal ideation, and suicidal ideation and ability predicted plans to attempt suicide and actual attempts. The interpersonal theory of suicide identifies factors clinicians should assess for increased suicide risk and factors that should be targeted in prevention and treatment.Stellrecht, N. E., Gordon, K. H., Van Orden, K., Witte, T. K., Wingate, L. R., Cukrowicz, K. C., ... & Fitzpatrick, K. K. (2006). "Clinical applications of the interpersonal‐psychological theory of attempted and completed suicide". ''
Journal of Clinical Psychology The ''Journal of Clinical Psychology'' is a monthly peer-reviewed medical journal covering psychological research, assessment, and practice. It was established in 1945. It covers research on psychopathology, psychodiagnostics, psychotherapy, psych ...
'', 62(2), 211-222
Furthermore, the theory provides avenues of future research for scientists.


See also

*
Anomie In sociology, anomie or anomy () is a social condition defined by an uprooting or breakdown of any moral values, standards or guidance for individuals to follow. Anomie is believed to possibly evolve from conflict of belief systems and causes b ...
* Workism


References

{{Suicide navbox Interpersonal conflict Suicide