Testing the interpersonal-psychological theory of suicidal behaviour (ipts) in the South African context.

Abstract

In spite of suicidality being a global mental health care problem, there has been relatively little empirical advancement in the conceptualization of suicide in recent years. Joiner’s (2005) Interpersonal-Psychological theory of suicidal behaviour (IPTS) attempts to answer the question of why people die by suicide. Joiner contends that people die by suicide because they can and because they want to. He proposes that the confluence of the interpersonal states of perceived burdensomeness and thwarted belongingness is the condition under which death ideation transforms into suicidal ideation, and in the presence of a third construct, an acquired capability for suicide, leads to a lethal suicide attempt. The theory has been lauded as an empirical advancement in our understanding of suicidality, as it provides testable hypotheses that translate into practical interventions. However, tests of the theory have provided inconsistent support for its hypotheses. Using a sample of 239 psychiatric outpatients from nine sites, the main hypotheses of Joiner’s theory were tested in the present study. Study findings provide unqualified support for all key IPTS hypotheses: Perceived burdensomeness and thwarted belongingness independently predicted death ideation; the confluence of these interpersonal states, in the presence of hopelessness regarding these states, predicted suicidal ideation and finally, the joint presence of acquired capability for suicide and suicidal ideation was associated with moderate to high risk for a suicide attempt. In addition, two new measures were developed for the present study: (a) the Death Inurement Scale and (b) the Interpersonal Hopelessness Scale, to address the limitations of available measures. Demographic and mental health predictors of IPTS constructs were also explored using regression analyses. The study findings suggest that the IPTS is a valid theory for understanding suicidal behaviour in the South African context. The findings are discussed with respect to their implications for theory, practice, and future research.