1. Physical disability and suicide risk: An examination of constructs of the Interpersonal-Psychological Theory of Suicide
Lauren R. Khazem, B.A.,a Danielle R. Jahn, Ph.D.,b Kelly C. Cukrowicz, Ph.D.,c & Michael D. Anestis, Ph.D.a
a The University of Southern Mississippi
b VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center; University of Maryland School of Medicine
c Texas Tech University
Presented at the Annual Meeting of the American Association of Suicidology, Atlanta, Georgia. (April, 2015).
INTRODUCTION
DIFFERENCES IN MEAN LEVELS OF IPTS CONSTRUCTS
DATA ANALYSIS
Physical disability is defined as a limitation in performing a normal activity (e.g., walking, driving), which may include difficulty with dexterity, movement, hearing, or vision (Rokach, Lechcier-Kimel, & Safarov, 2006)
Roughly 50 million Americans have some form of physical disability
(Brault, 2012).
Research has indicated an association between physical disability
and suicide (Kaplan, McFarland, Huguet, & Newsom, 2007; Russell, Turner, & Joiner, 2009)
Individuals with physical disabilities may be at risk for perceived
burdensomeness (Dempsey, Karver, Labouliere, Zesiewicz, & DeNadai, 2012).
The possibility of heightened thwarted belongingness and the acquired capability for suicide in those with physical disabilities has yet to be examined.
No research has examined differences in elevations of suicide-related outcomes between individuals with and without varying physical disabilities within the framework of the Interpersonal-Psychological Theory of Suicide (IPTS) IJoiner, 2005).
A series of ANCOVAs assessed for differences in IPTS constructs and suicidal ideation between individuals with and without physical disabilities.
Due to the presence of significant skew and kurtosis, perceived burdensomeness and suicidal ideation variables were rank transformed using Blom’s formula.
23.83
RESULTS
Individuals with physical disabilities endorsed significantly higher levels of perceived burdensomeness than those without physical disabilities, F(1, 156) = 4.89, p = 03, Cohen’s d = .35.
There was no significant difference in levels of thwarted belongingness between groups, F(1, 152) = 1.97, p = .16,
Cohen’s d = .23.
There was no significant difference in the acquired capability for suicide between groups, F(1, 154) = .66, p = .42, Cohen’s d = .13.
There was no significant difference in suicidal ideation between groups, F(1, 152) =.02, p = .89, Cohen’s d = .00.
OBJECTIVES AND HYPOTHESIS
The current study aimed to examine whether individuals with physical disabilities endorse higher levels of perceived burdensomeness, thwarted belongingness, the acquired capability for suicide, and suicidal ideation than those without physical disabilities.
Individuals with physical disabilities were expected to endorse higher levels of the IPTS constructs and suicidal ideation than individuals without physical disabilities.
Outcome VariablesTransformed Due to Significant Skew and Kurtosis
DISCUSSION
Participants
184 students from 2 universities
26 (15.76%) with suicidal ideation
Mage = 22.83, SD = 7.71
76.9% female
61.5% White; 29.8% African American
49 with physical disabilities
10 (22.73%) with suicidal ideation
Disabilities assessed through ADA guidelines (Americans with Disabilities Act, 1990)
mobility (n = 24, 49.0%)
hearing (n = 8, 16.3%)
vision (n = 8, 16.3%)
multiple physical disabilities (n = 6,12.2%)
sleep apnea (n = 1, 2.0%)
bowel and bladder control (n = 1, 2.0%)
pain (n = 1, 2.0%)
Measures
Interpersonal Needs Questionnaire (INQ-15; Van Orden, Cukrowicz, Witte, & Joiner, 2012)
Acquired Capability for Suicide Scale-Fearless About Death (ACSS-FAD; Ribeiro et al., 2014)
Positive and Negative Suicide Ideation Inventory (PANSI; Osman, Gutierrez, Kopper, barrios, & Chiros, 1998)
Demographic question assessing physical disability status
Demographic covariates: Age, race, sex, relationship status, self-reported presence of a mental disorder, and self-reported use of mental health services
Students with physical disabilities may be at heightened risk for perceived burdensomeness.
Certain factors (belonging to a university community, support groups, disability-related services) may protect against developing thwarted belongingness.
Individuals with physical disabilities may experience heightened levels of pain tolerance or comfort with bodily harm. However, only the fearlessness about death component of the acquired capability for suicide was assessed.
These results may assist university-based mental healthcare providers, campus staff, and administrators in better understanding cognitive states that may contribute to suicide risk in students with physical disabilities.
It may be beneficial for university-based mental health providers to screen for the presence of perceived burdensomeness in students with physical disabilities.
Future research should examine potential contributors to perceived burdensomeness and potential relationships between IPTS constructs and risk for suicide in a community-based sample of adults with physical disabilities.
METHOD
Values in parentheses reflect nontransformed means
Perceived Burdensomeness Suicidal Ideation
p= p=.89
d= d=.00
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REFERENCES
Americans with Disabilities Act of 1990, Pub. L. No , § 3, 104 Stat. 328 (1990).
Brault, M. W. (2012). Americans with disabilities 2010: Household economic studies. Current Population Reports, U.S. Census Bureau. Retrieved from prod/2012pubs/p pdf
Dempsey, L. E., Karver, M. S., Labouliere, C., Zesiewicz, T. A., & DeNadai, A. S. (2012). Self-perceived burden as a mediator of depression symptoms amongst individuals living with a movement disorder. Journal of Clinical Psychology, 68, doi: /jclp.21901
Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
Kaplan, M. S., Huguet, N., McFarland, B. H., & Newsom, J. T. (2007). Suicide among male veterans: A prospective population-based study. Journal of Epidemiology and Community Health, 61, doi: /jech
Osman, A., Gutierrez, P. M., Kopper, B. A., Barrios, F. X., & Chiros, C. E. (1998). The Positive and Negative Suicide Ideation Inventory: Development and validation. Psychological Reports, 82, doi: /pr
Ribeiro, J. D., Witte, T. K., Van Orden, K. A., Selby, E. A., Gordon, K. H., Bender, T. W., & Joiner, T. E., Jr. (2014). Fearlessness about death: The psychometric properties and construct validity of the revision to the Acquired Capability for Suicide Scale. Psychological Assessment, 26, doi: /a
Van Orden, K. A., Cukrowicz, K. C., Witte, T. K., & Joiner, T. E. (2012). Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychological Assessment, 24, doi: /a