An Examination of the Interpersonal Psychological Theory of Suicidal Behavior in Physicians

Abstract

Physicians are commonly reported to die by suicide more frequently than individuals in the general population. Thus far, few reasons for this elevated suicide risk have been empirically investigated. Although the interpersonal psychological theory of suicidal behavior (IPTS) has been suggested as a fruitful means of explaining physician suicidality, it has yet to be examined quantitatively. Four hundred nineteen Pennsylvania physicians were assessed on a number of demographics, as well as all components of the IPTS. Findings indicated that physician scores on IPTS components are comparable to other groups displaying increased suicidality (e.g., military populations, prior attempters). Perceived burdensomeness was a significant predictor of suicidal ideation, while thwarted belongingness predicted prior suicide attempts. Acquired capability did not distinguish between prior attempters and nonattempters. Preliminary findings indicate the IPTS may be a useful framework for understanding and predicting physician suicidality.

Relationships between anhedonia, suicidal ideation and suicide attempts in a large sample of physicians

“…Comparatively to the results of Fink-Miller [ 24 ] which showed that perceived burdensomeness was a significant predictor of suicidal ideation and that thwarted belongingness predicted prior suicide attempt in physicians, the present study showed that perceived burdensomeness and thwarted belongingness were predictors of suicidal ideations (lifetime or recent) whereas thwarted belongingness was a predictor of life-time suicide attempts.…”

“…One study [ 18 ] suggested, firstly, that recent loss of interest in people could potentially be associated with thwarted belongingness and, secondly, that recent loss of interest in people may lead to social isolation which constitutes a risk factor for suicidal ideation. Other studies in physicians [ 24 ] have reported that perceived burdensomeness leads to suicidal ideation whereas thwarted belongingness leads to suicide attempt. Moreover, one study [ 26 ] in 167 individuals aged 55 or over reported significant correlations between the SLIPS and rating scales that measure perceived burdensomeness and thwarted belongingness.…”

“…Two recent studies have tested the IPT in physicians. In the first study [ 24 ] Fink-Miller had four aims. The first aim was to compare physicians’ scores on IPT components with those reported in other populations.…”

“…Taking into account Winer et al’s suggestion [ 18 ] and the results of the Fink-Miller and Golding et al studies [ 24 – 26 ], the relationships between anhedonia, perceived burdensomeness, thwarted belongingness, suicidal ideations and suicide attempts must be explored and clarified, especially in physicians.…”

The Life Span Model of Suicide and Its Neurobiological Foundation

“…Joiner claims that even in suicidal individuals, who have already acquired a certain level of capability, it really is a conflict between these two contrasting factors. This sort of capability can be acquired by experiencing repetitive trauma and violence, which can take a wide range of forms, from being a combat fighter (Selby et al, 2010a ; Silva et al, 2016 ) or experiencing proxy-violence and death (as physicians do on a regular basis; Fink-Miller, 2015a , b ) or the experience of having attempted suicide or self-harming behavior in eating disorders (Holm-Denoma et al, 2008 ; Selby et al, 2010b ) to being responsible for animal euthanasia (Platt et al, 2010 , 2012 ). Also personality traits such as impulsivity are thought to contribute to the individual's capability.…”