Childhood Trauma Associations With the Interpersonal Psychological Theory of Suicide and Social Cognitive Biases in Psychotic Disorders

Abstract

Childhood trauma (CT) is associated with suicidal ideation and behaviors (SI/SB) in people with psychosis. The interpersonal psychological theory of suicide (IPTS) suggests that there are four factors that increase suicide risk: thwarted belongingness, perceived burdensomeness, acquired capacity for suicide, and hopelessness. The IPTS constructs and social cognitive biases are associated with SI/SB in psychotic disorders. However, the role of CT in IPTS constructs and social cognitive biases has not been examined in psychosis. In an outpatient community sample of persons with psychotic disorders (N = 96) assessed with the Childhood Trauma Questionnaire, the aims of this study were to a) evaluate rates of CT in this sample, b) determine the relationship between CT types and lifetime SI/SB, and c) explore the relationship between CT types, IPTS constructs, and social cognitive biases. All participants reported experiencing CT. Emotional abuse was associated with greater SI severity and higher rates of lifetime suicide attempts, as well as with greater perceived burdensomeness and more severe negative social cognitive biases. Other CT types were minimally associated with SI/SB or IPST constructs; hopelessness was not associated. Overall, negative interpersonal beliefs and social cognitive biases may explain how CT increases suicide risk in psychosis.

Systematic Review of the Link Between Social Cognition and Suicidal Ideation and Behavior in People With Serious Mental Illness

“…Two studies used the Ambiguous Intention Hostility Questionnaire (AIHQ). 40 , 55 While 1 study found that participants with SI had greater attributions of blame in ambiguous situations compared to those without SI, 40 the other included study found no relationship between the AIHQ blame subscale and lifetime SI. 55 It is possible that this discrepancy in findings is present as the study led by Depp et al assessed for current, not lifetime, SI.…”

“…The primary objective of 10 of the studies examined the relationship between some aspect of social cognition and SI or behavior, 40–45 , 50–54 whereas 5 of the studies did not have a primary objective of examining this relationship and reported statistics examining the relationship. 33 , 39 , 46 , 47 , 55 Nine studies included purely cross-sectional analysis of social cognitive variables, 33 , 43–47 , 53–55 5 studies were longitudinal with follow-up intervals ranging from 2 weeks to 20 years, 39–41 , 51 , 52 and 2 studies were cross-sectional case-control designs. 42 , 50 One included study is a Letter to the Editor that contains empirical data not published elsewhere, but is not a peer-reviewed journal article.…”

“…Nine studies included a measure of SI. 33 , 40 , 41 , 43 , 46 , 47 , 50 , 53 , 55 Twelve studies collected data relating to SB, specifically suicide attempts. 33 , 39 , 41 , 42 , 44–47 , 51 , 52 , 54 , 55 For SI and behavior, studies varied in the method of assessment (interviewer-rated vs self- or informant-report) and depth (scale vs single item) in characterizing this construct.…”

“… 33 , 40 , 41 , 43 , 46 , 47 , 50 , 53 , 55 Twelve studies collected data relating to SB, specifically suicide attempts. 33 , 39 , 41 , 42 , 44–47 , 51 , 52 , 54 , 55 For SI and behavior, studies varied in the method of assessment (interviewer-rated vs self- or informant-report) and depth (scale vs single item) in characterizing this construct. Importantly, no studies separately analyzed data on types of SB other than actual suicidal attempts (ie, preparatory behaviors, aborted attempts, and interrupted attempts), and only 1 study 55 examined suicide attempt lethality.…”

“… 33 , 39 , 41 , 42 , 44–47 , 51 , 52 , 54 , 55 For SI and behavior, studies varied in the method of assessment (interviewer-rated vs self- or informant-report) and depth (scale vs single item) in characterizing this construct. Importantly, no studies separately analyzed data on types of SB other than actual suicidal attempts (ie, preparatory behaviors, aborted attempts, and interrupted attempts), and only 1 study 55 examined suicide attempt lethality. One study combined ideation and behavior in their analyses, reporting on characteristics of participants who had made a suicide attempt and/or had SI.…”