(PS9-C56) Moderating Role of Interpersonal Hopelessness on Transitions to Suicidal Thinking

Background: The integrated motivational-volitional (IMV; O’Connor & Kirtley, 2018) model states that feelings of entrapment contribute to the development of suicidal ideation but only occur when motivational moderators such as perceived burdensomeness and thwarted belongingness are present. This idea is also proposed by the interpersonal theory of suicide (IPTS; Joiner, 2005), emphasizing that feelings of hopelessness about interpersonal experiences of burdensomeness and belonging (ie., interpersonal hopelessness) motivate suicidal intent. While numerous studies support a relationship between burdensomeness, thwarted belonging, and suicidal ideation (Chu et al., 2017; Ma et al., 2016), some do not (Forkmann & Teismann, 2017; Roeder et al., 2019). There are very few studies of interpersonal hopelessness on suicidal thinking, and all have been cross-sectional (Mandracchia et al., 2021; Tucker et al., 2018). To refine theoretical models and better understand risk, there is a need to test whether interpersonal hopelessness affects the transition to suicidal intent over time. The current study aims to do this by evaluating the hypothesis that interpersonal hopelessness at baseline (T1) would moderate the relationship between baseline (T1) entrapment and suicidal ideation/intent one month later (T2).

Methods: Participants (M age = 35.57, SD = 4.36; 96% white; 13.8% Veteran; 58.6% female) were recruited from an outpatient clinic (n=30) who had a score of 1 or higher on the PHQ suicide item. As part of a larger study, participants completed the interpersonal hopelessness scale, brief defeat and entrapment scale, and suicidal ideation items from the SITBI at baseline and one month later (n = 24).

Results:  A moderated linear regression using the PROCESS macro for SPSS with 5,000 bias-corrected bootstrapped samples was run. The full model was significant, F (3, 20) = 3.46, p < .04, accounting for 34.2% of the variance in suicidal intent at time 2. The interaction between entrapment and interpersonal hopelessness was significant (t = 2.80, p < .02, 95% CI: 0.004; 0.029). Entrapment was associated with higher levels of suicidal intent at one month only at average and high levels of interpersonal hopelessness. When interpersonal hopelessness was low, entrapment was not significantly related to suicidal intent one-month later (conditional effect = 0.032, t = 0.35, p = 0.73).

Discussion: These results suggest that higher levels of interpersonal hopelessness may facilitate transitions from feelings of entrapment to suicidal intent across one month, supporting the IMV and IPTS theories of suicide risk. CBT interventions that focus on reducing negative cognitions and self-perceptions of burdensomeness/belongingness have the potential to reduce the severity of suicidal thinking.