(PS2-A11) The Association Between Perceived Social Support and Suicide Ideation Distress Among Psychiatric Inpatients: The Role of Thwarted Interpersonal Needs

Psychiatric inpatients are at increased risk for death by suicide, and suicide ideation and attempts are common reasons for admission to psychiatric hospitals. Further, low perceived social support (i.e., PSS) has been linked to increased suicide ideation among psychiatric inpatients. The interpersonal theory of suicide may provide a framework for understanding this link. This theory suggests that thwarted belonging (TB; i.e., loneliness and a lack of reciprocal caring relationships) and perceived burden (PB; i.e., feelings of self-hate and liability to the extent that one believes they are a burden on others) are proximal risk factors for suicide ideation. TB and PB have been shown to predict suicide ideation among psychiatric inpatients, and cross-sectionally mediate the relation other risk factors and suicide ideation among psychiatric inpatients in prior research. Thus, it is possible that PSS is indirectly related to suicide through TB and PB. 

This study tested the mediating role of TB and PB in the relation between types of PSS (i.e., support from family, friends, a significant other, and total), and suicide ideation distress (i.e., SID) among psychiatric inpatients utilizing the ITS framework. We hypothesized that TB and PB, in parallel, would cross-sectionally mediate the relation between types of PSS and SID (a significant total indirect effect). Specifically, we hypothesized there would be a significant total indirect effect of TB and PB, in parallel, in the relation between types of PSS and SID, demonstrating that as PSS decreases, TB and PB increase, and SID increases. Participants (i.e., short-term psychiatric inpatients; N = 139) were administered assessments cross-sectionally, which included self-report measures of TB and PB, PSS, and current psychiatric symptomology.

Nonparametric, parallel mediation procedures were used to test the hypotheses, where 95% bias-corrected confidence intervals based on 10,000 bootstrap samples containing zero were nonsignificant. Results indicated TB and PB, in parallel, significantly mediated the relation between PSS from family and SID (total indirect effect 95% CI = -.68, -.01). Furthermore, TB and PB, in parallel, significantly mediated the relation between PSS from friends and SID (total indirect effect 95% CI = -.70, -.16). TB and PB, in parallel, also significantly mediated the relation between PSS from a significant other and SID (total indirect effect 95% CI = -.75, -.05). Lastly, TB and PB, in parallel, significantly mediated the relation between total PSS from and SID (total indirect effect 95% CI = -.84, -.05).

These findings indicate TB and PB, in parallel, may serve as proximal risk factors for SID among psychiatric inpatients with lower PSS from family, friends, a significant other, and overall social support. These findings are congruent with the interpersonal theory of suicide’s propositions that the combination of TB and PB increases risk for thoughts of suicide. Clinicians may consider using interventions that target increasing PSS (i.e., cognitive restructuring and social skills training) and decreasing TB and PB (i.e., cognitive behavioral therapy) for this population.