The Role of Self and Interpersonal Functioning in Suicidal Ideation: An Integrated Model of Suicidal Ideation

Abstract

The interpersonal Theory of Suicide has been widely adopted in studying suicide. However, inconsistent findings were found in the relationship between Thwarted Belongingness, Perceived Burdensomeness, and Suicidal Ideation or Suicide Attempt. Thwarted Belongingness focuses on the feelings of loneliness and the absence of reciprocal caring relationships but neglects the relationship between the presence of belongingness and suicidal ideation. Based on this argument, I developed a new construct named Destructive Connectedness (DC) to examine the presence of belongingness (Malfunctioning Relationship) and absence of belongingness (Thwarted Belongingness) in predicting suicidal ideation. Moreover, I also developed a new construct named “Distorted Self-meaning” (DS) to capture self-concept impairment and maladaptive schema. Distorted Self-meaning consists of perceived burdensomeness and self-dysfunction. These two new latent factors are assumed to assess self and interpersonal malfunctioning.

Furthermore, a new construct named Availability was developed by integrating perceived behavioural control from the Theory of Planned Behaviour with acquired capability. Thus, a new modified model of the Interpersonal Theory of Suicide was proposed in this thesis. The main objective of this thesis model is to verify this new model, namely, the Self and Interpersonal Model of Suicidal Ideation (SIMMSI). The second objective of this thesis is to explore the moderating effect of the protective and risk factors on suicidal ideation.

Adopting a cross-sectional survey design method, a total of 205 self-administered questionnaires based on snowball and convenience sampling (male= 57, female= 148) through online platforms were collected. The average age of the participants was 21.73 (SD = 4.14). The mediation models, sequential, path, latent, and moderated mediation models, were tested in the present study. The result of the regression analysis indicated that the three new constructs explained a 56.2% variance in suicidal ideation, which demonstrated that they are more robust indicators of suicidal ideation than the Interpersonal Theory of Suicide. In the moderated mediation model, the result revealed that self-efficacy, self-esteem, positive emotion, relationship, meaning, accomplishment, and physical health have conditional moderated mediating effects on the relationship between acquired capability and suicidal ideation. Moreover, mixed model methods were adopted in the current study to test the latent moderated mediation models. Results indicated that avoidance motivation moderated the relationship between Destructive Connectedness and Distorted Self-meaning, which indirectly increases the chance of suicidal ideation. These moderated mediation models not only support the new modified theory but also enriches the existing suicide and suicidal ideation theory.

Based on the result of the Self and Interpersonal Malfunctioning Model of Suicidal Ideation, I have further integrated the Theory of Escape from Self and The Integrated Motivational-Volitional (IMV) Model of Suicidal Behaviour into the thesis model. Moreover, I also developed a new hypothesis of suicidal ideation, named the Suicidal-Self Hypothesis, in explaining the aetiology of suicide and suicidal ideation. The assumption of the Suicidal-Self Hypothesis has been discussed in this thesis. In sum, the new modified model of Self and Interpersonal Malfunctioning Model of Suicidal Ideation and the new hypothesis Suicidal-Self Hypothesis showed the importance of the presence of belongingness, self-schema, psychological and physical readiness, and the expectancy of the future in explaining suicide and suicidal ideation. The current study and Suicidal-Self Hypothesis would impact current and future research.

Date of Award	15 Nov 2022
Original language	English
Awarding Institution	City University of Hong Kong
Supervisor	Yuk Ching Sylvia KWOK LAI (Supervisor)