Symposia
Schizophrenia / Psychotic Disorders
Daisy Lopez, M.S.
Graduate Student
University of Miami
Miami Beach, Florida
Amy G. Weisman de Mamani, Ph.D.
Professor
University of Miami
Coral Gables, Florida
Individuals with psychotic disorders are 12 times more likely to die by suicide than individuals without a psychotic disorder (Dutta et al., 2010). The interpersonal-psychological theory (Joiner, 2005) and the Integrated Motivational-Volitional model (O’Connor, 2011) are prominent theories of suicide risk supported by a growing body of empirical evidence. Although these theories are not specific to psychosis, research has found key risk factors from these theories, such as perceived burdensomeness (BP), thwarted belonging (TB), defeat (D), and entrapment (E), to be associated with suicidal ideation among individuals with schizophrenia spectrum disorders (Villa et al., 2018; Wastler et al., 2020; Taylor et al., 2010). Moreover, researchers have found that greater psychotic symptoms are associated with PB, TB, D and E (Taylor et al., 2010; Parrish et al., 2021). Greater psychotic symptomatology may increase these risk factors, leading to greater suicidality. However, it is unclear how early in the development of psychotic disorders these associations are present. Therefore, identifying suicide risk and underlying mechanisms involved before the onset of a psychotic disorder is paramount for primary and secondary prevention efforts given the severity of psychotic disorders and suicide outcomes.
The current study examined associations between TB, PB, D, E, subclinical symptoms of psychosis (SSP), and suicidal ideation (SI) among a non-clinical population of 55 adults (age: M=19.13; Male=40%, White=50.9%) using the Interpersonal Needs Questionnaire (Van Orden et al., 2012), Defeat and Entrapment Scale (Gilbert & Allan, 1998), Community Assessment of Psychic Experiences questionnaire (Konings et al., 2006), and the Suicidal Ideation Attributes Scale (van Spiiker et al., 2014).
As hypothesized, after controlling for gender and race, greater SSP were associated with TB, (b=.11, SE=.02), B (b=.06, SE=.01), D (b=.05, SE=.01), and E (b=.03, SE=.01). A significant total effect was found in the mediation model from SSP through these factors to SI (b=.05, SE=.01). When including SSP and all mediators, only TB and B were associated with greater SI.
Results extend suicide theories to SSP and indicate that greater SSP may increase key interpersonal risk factors, contributing to raised suicide probability. Study findings have implications for early prevention and intervention research. Results also have clinical implications, suggesting that TB, PB, D, E, and suicide risk be assessed and targeted when treating individuals with SSP.