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Evaluation ViewAttendees 6

Category: Suicide and Self-Injury

Symposium 29 - Using Real-Time, Objective, and Performance-Based Methods to Advance Understanding of Interpersonal Risk Factors for Suicidal Thoughts and Behaviors

Friday, November 17, 2023
12:30 PM – 2:00 PM PST
Location: Skykomish (604), Level 6
CE: 1.5

Keywords: Suicide, Social Relationships, Risk / Vulnerability Factors
Level of Familiarity: Basic to Moderate
Recommended Readings: Cheek, S. M., Goldston, D. B., Erkanli, A., Massing-Schaffer, M., & Liu, R. T. (2020). Social Rejection and Suicidal Ideation and Attempts among Adolescents Following Hospitalization: a Prospective Study. Journal of Abnormal Child Psychology, 48(1), 123–133.

Liu, R.T. & Spirito, A. (2019). Suicidal behavior and stress generation in adolescents. Clinical Psychological Science, 7(3), 488–501.,   Cheek, S. M., Reiter-Lavery, T., & Goldston, D. B. (2020). Social rejection, popularity, peer victimization, and self-injurious thoughts and behaviors among adolescents: A systematic review and meta-analysis. Clinical Psychology Review, 82, 101936. 

Liu, R.T. & Spirito, A. (2019). Suicidal behavior and stress generation in adolescents. Clinical Psychological Science, 7(3), 488–501.

Pollock, L. R., & Williams, J. M. (2004). Problem-solving in suicide attempters. Psychological Medicine, 34(1), 163–167. 

Spirito, A., Esposito-Smythers, C., Weismoore, J., Miller, A. (2012). Adolescent suicidal behavior. In P.C. Kendall (Ed.), Child and Adolescent Therapy: Cognitive-Behavioral Procedures (pp. 234–56). Guilford Press.

Williams, J. M., Barnhofer, T., Crane, C., & Beck, A. T. (2005). Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation. Journal of Abnormal Psychology, 114(3), 421–431. ,   Glenn, C. R., Kleiman, E. M., Kandlur, R., Esposito, E. C., & Liu, R. T. (2022). Thwarted Belongingness Mediates Interpersonal Stress and Suicidal Thoughts: An Intensive Longitudinal Study with High-risk Adolescents. Journal of Clinical Child and Adolescent Psychology, 51(3), 295–311. 

Kaurin, A., Dombrovski, A. Y., Hallquist, M. N., & Wright, A. G. C. (2022). Momentary interpersonal processes of suicidal surges in borderline personality disorder. Psychological Medicine, 52(13), 2702–2712. 

Uliaszek, A. A., Hamdullahpur, K., Amestoy, M. E., & Carnovale, M. (2023). Longitudinal pathways between suicidal ideation and life stress. Anxiety, Stress, and Coping, 1–13.,   Coppersmith, D. D. L., Kleiman, E. M., Glenn, C. R., Millner, A. J., & Nock, M. K. (2019). The dynamics of social support among suicide attempters: A smartphone-based daily diary study. Behaviour Research and Therapy, 120, 103348. 

Kleiman, E. M., & Liu, R. T. (2013). Social support as a protective factor in suicide: findings from two nationally representative samples. Journal of Affective Disorders, 150(2), 540–545.,   Xu, Z., Müller, M., Heekeren, K., Theodoridou, A., Metzler, S., Dvorsky, D., Oexle, N., Walitza, S., Rössler, W., & Rüsch, N. (2016). Pathways between stigma and suicidal ideation among people at risk of psychosis. Schizophrenia Research, 172(1-3), 184–188.

Interpersonal factors have long been cited as robust risk factors for suicidal thoughts and behavior (STBs), and relational factors—such as perceived burdensomeness and social disconnectedness—feature prominently in contemporary suicide theories (Beautrais et al., 1997; Van Orden et al., 2010). However, most suicide research has been limited by use of retrospective self-report measures of broad perceptions of relationships and interpersonal experiences. Now, with advances in research methodology such as ecological momentary assessment (EMA), contextual life stress interviews, and performance-based paradigms, it is possible to more intensively and robustly capture aspects of an individual’s interpersonal style and real-life social context to understand how interpersonal factors influence STB risk.

Rather than focus on singular, state-level factors that may confer distal risk for STBs, research in this symposium capitalizes on real-time, state-dependent, and/or performance-based methods to advance understanding of the social and psychological factors that are most relevant to STB risk across both in-person and online interactions and over granular, dynamic, and longitudinal timescales. Findings from community and clinical samples of both adolescents and adults are discussed.

First, Shayna Cheek and Olivia Pollak use contextual life stress interviews and performance-based measures of cognitive inflexibility and social problem-solving to examine how proximal, cognitive-behavioral responses to stressors impact future STB risk in contexts of chronic, real-life stress. Cheek assesses cognitive inflexibility and suicidal ideation using a neurocognitive task in a psychiatric adolescent sample, while Pollak uses a novel, performance-based measure of social problem-solving to examine how social stress-related changes in community adolescents’ in-vivo, problem-solving behaviors relate to future suicidal behavior risk. Next, Adam Horwitz and Taylor McGuire use EMA to examine near-term and bidirectional relations between both interpersonal risk (e.g., interpersonal conflict events, perceived burdensomeness) and protective (i.e., social connectedness) factors and STBs. Their data highlight the importance of examining dynamic, within-person associations of interpersonal risk and protective factors with STBs as they occur outside the lab and across shorter timescales (i.e., next day) than is typically examined. Elizabeth Thompson then examines social risk factors, and social media interactions in particular, in a unique sample of psychiatrically hospitalized youth. She explores how interpersonal exchanges occurring via new online modalities influence STB risk among teens, and how this may interact with comorbid clinical vulnerabilities (i.e., psychosis symptoms, deficits in social functioning) in acute clinical samples. 

Finally, we are thrilled to have Richard Liu as Discussant given his expertise in suicide, interpersonal life stress, and novel methodologies such as EMA. Collectively, talks reflect recent research from some of the most prolific labs studying suicide. Findings will be discussed in the context of direct implications for STB risk assessment, prevention, and treatment.

Learning Objectives:

At the end of the session, the learner will be able to:
  • Describe three recent methodological advances in research on suicidal thoughts and behaviors.
  • Explain two ways that recent empirical findings can improve evidence-based prevention and treatment of suicidal thoughts and behaviors.
  • Describe three interpersonal or social processes that may be altered, maladaptive, or show variability among suicidal or at-risk individuals.
  • Understand how interpersonal factors relate to suicide risk in community vs. clinical populations, including during or post-hospitalization.
  • Explain three clinical or scientific advantages of data collection methods that rely on real-time, objective, or performance-based assessment.