Empirical evaluation of three 21st century suicide theories: interpersonal theory of suicide, cultural model of suicide, and the integrated motivational-volitional model

Abstract

Introduction

Suicide, suicide attempts, and suicidal ideation since the pandemic have been tied to both unemployment and being an essential worker. This study examined three suicide theories – the Interpersonal Theory, the Cultural Model of Suicide, and the Integrated Motivational-Volitional model - in this population.

Methods

Participants were recruited through Prolific in late 2020 if unemployed because of COVID-19 or an essential worker. Participants completed a baseline survey including measures of suicide theories as well as suicide risk. Those experiencing distress were invited to enroll in a randomized trial of mobile apps and the suicide theories' performance in predicting suicide risk was examined in this subsample (N = 843), adjusting for COVID-19 work status and history of suicide attempt.

Results

Cross-sectional analysis showed perceived burdensomeness but not thwarted belongingness predicted suicide risk. Cross-sectional analysis found idioms of distress and cultural sanctions predicting suicide risk while minority stress and social discord did not. In cross-sectional analysis, both defeat and entrapment predicted suicide risk with partial mediation of defeat through entrapment. In cross-lagged analysis, defeat predicted entrapment, but entrapment did not predict defeat.

Conclusion

There was partial support for the Interpersonal and Cultural theories of suicide and full support for the Integrated Motivational-Volitional model's primary pathway.