Lack of Emotional Awareness is Associated with Thwarted Belongingness and Acquired Capability for Suicide in a Military Psychiatric Inpatient Sample.
Journal
Suicide & life-threatening behavior
ISSN: 1943-278X
Titre abrégé: Suicide Life Threat Behav
Pays: England
ID NLM: 7608054
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
02
04
2018
accepted:
17
09
2018
pubmed:
21
11
2018
medline:
9
4
2020
entrez:
21
11
2018
Statut:
ppublish
Résumé
To examine potential links between facets of impulsivity and emotion dysregulation to components of the Interpersonal-Psychological Theory of Suicide (thwarted belongingness, perceived burdensomeness, and acquired capability) among U.S. military personnel. The current study performed secondary data analysis from a randomized control trial testing the efficacy of a cognitive therapy for 134 service members (71.64% male, 68.66% Caucasian; mean age: 30.14) admitted to a psychiatric inpatient unit for a suicide-related crisis. We utilized the Difficulties in Emotion Regulation Scale, the Barratt Impulsivity Scale, the Acquired Capability for Suicide Scale, and the Interpersonal Needs Questionnaire. All emotion dysregulation dimensions and one impulsivity facet (attentional) were positively correlated with perceived burdensomeness and thwarted belongingness. Lack of emotional awareness was positively associated with acquired capability. After controlling for depression, hopelessness, and demographic covariates, lack of emotional awareness was significantly associated with both thwarted belongingness and acquired capability, but not perceived burdensomeness, and impulsivity dimensions did not link to any variable of interest. Findings imply that individuals with reduced emotional awareness may have difficulty cultivating interpersonal bonds and be more vulnerable to elevated acquired capability. Lack of emotional awareness may be a potential contributor to both suicidal desire and capability.
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1395-1411Informations de copyright
© 2018 The American Association of Suicidology.
Références
Abbasi, M., Bagyan, M. J., & Dehghan, H. (2014). Cognitive failure and alexithymia and predicting high-risk behaviors of students with learning disabilities. International Journal of High Risk Behaviors & Addiction, 3, e16948.
Ammerman, B. A., Kleiman, E. M., Uyeji, L. L., Knorr, A. C., & McCloskey, M. S. (2015). Suicidal and violent behavior: The role of anger, emotion dysregulation, and impulsivity. Personality and Individual Differences, 79, 57-62.
Anestis, M. D., Bagge, C. L., Tull, M. T., & Joiner, T. E. (2011). Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample. Journal of Psychiatric Research, 45, 603-611.
Anestis, M. D., Fink, E. L., Bender, T. W., Selby, E. A., Smith, A. R., Witte, T. K., et al. (2012). Re-considering the association between negative urgency and suicidality. Personality and Mental Health, 6, 138-146.
Anestis, M. D., & Joiner, T. E. (2011). Examining the role of emotion in suicidality: Negative urgency as an amplifier of the relationship between components of the interpersonal-psychological theory of suicidal behavior and lifetime number of suicide attempts. Journal of Affective Disorders, 129, 261-269.
Anestis, M. D., Khazem, L. R., Mohn, R. S., & Green, B. A. (2015). Testing the main hypotheses of the interpersonal-psychological theory of suicidal behavior in a large diverse sample of United States military personnel. Comprehensive Psychiatry, 60, 78-85.
Anestis, M. D., Kleiman, E., Lavender, J., Tull, M., & Gratz, K. (2014). The pursuit of death versus escape from negative affect: An examination of the nature of the relationship between emotion dysregulation and both suicidal behavior and non-suicidal self-injury. Comprehensive Psychiatry, 55, 1820-1830.
Anestis, M. D., Soberay, K. A., Gutierrez, P. M., Hernández, T. D., & Joiner, T. E. (2014). Reconsidering the link between impulsivity and suicidal behavior. Personality and Social Psychology Review, 18, 366-386.
Armed Forces Health Surveillance Center. (2014). Surveillance snapshot: Manner and cause of death, active component, U.S. Armed Forces, 1998-2013. Medical Surveillance Monthly Report, 21, 21. Retrieved from https://www.afhsc.mil/documents/pubs/msmrs/2014/v21_n10.pdf
Assavedo, B. L., & Anestis, M. D. (2016). The relationship between non-suicidal self-injury and both perceived burdensomeness and thwarted belongingness. Journal of Psychopathology and Behavioral Assessment, 38, 251-257.
Baer, M., LaCroix, J. M., Browne, J., Hassen, H., Grammer, G., Weaver, J., et al. (in press). Feeling out of control while distressed: A facet of emotion dysregulation links to non-suicidal self-injury in a psychiatric inpatient sample. Manuscript under review for publication.
Baer, M., LaCroix, J. M., Browne, J., Hassen, H., Perera, K., Weaver, J., et al. (2018). Non-suicidal self-injury elevates suicide risk among United States military personnel with lifetime attempted suicide. Archives of Suicide Research, 22, 453-464.
Bardeen, J. R., Fergus, T. A., & Orcutt, H. K. (2012). An examination of the latent structure of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 34, 382-392.
Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97, 90-113.
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42, 861-865.
Bender, T. W., Gordon, K. H., Bresin, K., & Joiner, T. E. (2011). Impulsivity and suicidality: The mediating role of painful and provocative experiences. Journal of Affective Disorders, 129, 301-307.
Bossarte, R. M., Knox, K. L., Piegari, R., Altieri, J., Kemp, J., & Katz, I. R. (2012). Prevalence and characteristics of suicide ideation and attempts among active military and veteran participants in a national health survey. American Journal of Public Health, 102, S38-S40.
Brodsky, B., Oquendo, M., Ellis, S., Haas, G., Malone, K., & Mann, J. (2001). The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression. American Journal of Psychiatry, 158, 1871-1877.
Bryan, C., & Anestis, M. (2011). Re-experiencing symptoms and the interpersonal-psychological theory of suicidal behavior among deployed service members evaluated for traumatic brain injury. Journal of Clinical Psychology, 67, 856-865.
Bryan, C. J., & Cukrowicz, K. C. (2011). Associations between types of combat violence and the acquired capability for suicide. Suicide and Life-Threatening Behavior, 41, 126-135.
Bryan, C. J., Cukrowicz, K. C., West, C. L., & Morrow, C. E. (2010). Combat exposure and the acquired capability for suicide. Clinical Psychology, 66, 1044-1056.
Bryan, C. J., Morrow, C. E., Anestis, M. D., & Joiner, T. E. (2010). A preliminary test of the interpersonal-psychological theory of suicidal behavior in a military sample. Personality and Individual Differences, 48, 347-350.
Bulik, C. M., Thornton, L., Pinheiro, A. P., Plotnicov, K., Klump, K. L., Brandt, H., et al. (2008). Suicide attempts in anorexia nervosa. Psychosomatic Medicine, 70, 378-383.
Carli, V., Jovanović, N., Podlesek, A., Roy, A., Rihmer, Z., Maggi, S., et al. (2010). The role of impulsivity in self-mutilators, suicide ideators and suicide attempters-A study of 1265 male incarcerated individuals. Journal of Affective Disorders, 123, 116-122.
Cazenave, N., Le Scanff, C., & Woodman, T. (2007). Psychological profiles and emotional regulation characteristics of women engaged in risk-taking sports. Anxiety Stress and Coping, 20, 421-435.
Cho, Y., & Hong, S. (2013). The new factor structure of the Korean version of the difficulties in emotion regulation scale (K-DERS) incorporating method factor. Measurement and Evaluation in Counseling and Development, 46, 192-201.
Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R., Hagan, C. R., et al. (2017). The Interpersonal Theory of Suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychological Bulletin, 143, 1313-1345.
Colborn, V., LaCroix, J. M., Neely, L., Tucker, J., Perera, K., Daruwala, S., et al. (2017). Motor impulsivity differentiates between psychiatric inpatients with multiple versus single lifetime suicide attempts. Psychiatry Research, 253, 18-21.
Corruble, E., Benyamina, A., Bayle, F., Falissard, B., & Hardy, P. (2003). Understanding impulsivity in severe depression? A psychometrical contribution. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 27, 829-833.
Derks, Y. P., Westerhof, G. J., & Bohlmeijer, E. T. (2016). A meta-analysis on the association between emotional awareness and borderline personality pathology. Journal of Personality Disorders, 31, 362-384.
Dixon-Gordon, K. L., Weiss, N. H., Tull, M. T., DiLillo, D., Messman-Moore, T., & Gratz, K. L. (2015). Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence. Comprehensive Psychiatry, 62, 187-203.
Dougherty, D., Mathias, C., Marsh, D., Papageorgiou, T., Swann, A., & Moeller, F. (2004). Laboratory measured behavioral impulsivity relates to suicide attempt history. Suicide and Life-Threatening Behavior, 34, 374-385.
Evren, C., & Evren, B. (2005). Self-mutilation in substance-dependent patients and relationship with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality. Drug and Alcohol Dependence, 80, 15-22.
Fowler, J. C., Charak, R., Elhai, J. D., Allen, J. G., Frueh, B. C., & Oldham, J. M. (2014). Construct validity and factor structure of the difficulties in emotion regulation scale among adults with severe mental illness. Journal of Psychiatric Research, 58, 175-180.
Franklin, J. C., Aaron, R. V., Arthur, M. S., Shorkey, S. P., & Prinstein, M. J. (2012). Nonsuicidal self-injury and diminished pain perception: The role of emotion dysregulation. Comprehensive Psychiatry, 53, 691-700.
Frewen, P. A., Dozois, D. J., Neufeld, R. W., & Lanius, R. A. (2008). Meta-analysis of alexithymia in posttraumatic stress disorder. Journal of Traumatic Stress, 21, 243-246.
Frewen, P. A., Dozois, D. J., Neufeld, R. W., & Lanius, R. A. (2012). Disturbances of emotional awareness and expression in posttraumatic stress disorder: Meta-mood, emotion regulation, mindfulness, and interference of emotional expressiveness. Psychological Trauma Theory Research Practice and Policy, 4, 152-161.
Ghahramanlou-Holloway, M., Cox, D., & Greene, F. (2012). Post-Admission Cognitive Therapy: A brief intervention for psychiatric inpatients admitted after a suicide attempt. Cognitive and Behavioral Practice, 19, 233-244.
Giromini, L., Velotti, P., Campora, G., Bonalume, L., & Zavattini, G. C. (2012). Cultural adaptation of the difficulties in emotion regulation scale: Reliability and validity of an Italian version. Journal of Clinical Psychology, 68, 989-1007.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54.
Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26, 1-26.
Grynberg, D., Luminet, O., Corneille, O., Grèzes, J., & Berthoz, S. (2010). Alexithymia in the interpersonal domain: A general deficit of empathy? Personality and Individual Differences, 49, 845-850.
Gutierrez, P. M., Pease, J., Matarazzo, B. B., Monteith, L. L., Hernandez, T., & Osman, A. (2016). Evaluating the psychometric properties of the Interpersonal Needs Questionnaire and the Acquired Capability for Suicide Scale in military veterans. Psychological Assessment, 28, 1684-1694.
Helmers, K. F., & Mente, A. (1999). Alexithymia and health behaviors in healthy male volunteers. Journal of Psychosomatic Research, 47, 635-645.
Hintikka, J., Honkalampi, K., Koivumaa-Honkanen, H., Antikainen, R., Tanskanen, A., Haatainen, K., et al. (2004). Alexithymia and suicidal ideation: A 12-month follow-up study in a general population. Comprehensive Psychiatry, 45, 340-345.
Jacob, G. A., Gutz, L., Bader, K., Lieb, K., Tüscher, O., & Stahl, C. (2010). Impulsivity in borderline personality disorder: Impairment in self-report measures, but not behavioral inhibition. Psychopathology, 43, 180-188.
Klonsky, E. D., & May, A. M. (2010). Rethinking impulsivity in suicide. Suicide Life-Threatening Behavior, 40, 612-619.
Klonsky, E. D., & May, A. M. (2014). Differentiating suicide attempters from suicide ideators: A critical frontier for suicidology research. Suicide Life-Threatening Behavior, 44, 1-5.
Klonsky, E. D., & May, A. M. (2015). Impulsivity and suicide risk: Review and clinical implications. Psychiatric Times, 32, 13-21.
Lavender, J., Wonderlich, S., Engel, S., Gordon, K., Kaye, W., & Mitchell, J. (2015). Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 40, 111-122.
Law, K. C., Khazem, L. R., & Anestis, M. D. (2015). The role of emotion dysregulation in suicide as considered through the ideation to action framework. Current Opinion in Psychology, 3, 30-35.
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., et al. (2011). Pain and emotion: A biopsychosocial review of recent research. Journal of Clinical Psychology, 67, 942-968.
Maloney, E., Degenhardt, L., Darke, S., & Nelson, E. C. (2009). Impulsivity and borderline personality as risk factors for suicide attempts among opioid-dependent individuals. Psychiatry Research, 169, 16-21.
Mathias, C., Dougherty, D., James, L., Richard, D., Dawes, M., Acheson, A., et al. (2011). Intolerance to delayed reward in girls with multiple suicide attempts. Suicide and Life-Threatening Behavior, 41, 277-286.
Meganck, R., Vanheule, S., Inslegers, R., & Desmet, M. (2009). Alexithymia and interpersonal problems: A study of natural language use. Personality and Individual Differences, 47, 990-995.
Michaelis, B., Goldberg, J., Davis, G., Singer, T., Garno, J., & Wenze, S. (2004). Dimensions of impulsivity and aggression associated with suicide attempts among bipolar patients: A preliminary study. Suicide and Life-Threatening Behavior, 34, 172-176.
Miranda, R., Tsypes, A., Gallagher, M., & Rajappa, K. (2013). Rumination and hopelessness as mediators of the relation between perceived emotion dysregulation and suicidal ideation. Cognitive Therapy and Research, 37, 786-795.
Monteith, L. L., Menefee, D. S., Pettit, J. W., Leopoulos, W. L., & Vincent, J. P. (2013). Examining the Interpersonal-Psychological theory of suicide in an inpatient veteran sample. Suicide and Life-Threatening Behavior, 43, 418-428.
Morie, K. P., Yip, S. W., Nich, C., Hunkele, K., Carroll, K. M., & Potenza, M. N. (2016). Alexithymia and addiction: A review and preliminary data suggesting neurobiological links to reward/loss processing. Current Addiction Reports, 3, 239-248.
Neacsiu, A. D., Fang, C. M., Rodriguez, M., & Rosenthal, M. Z. (2018). Suicidal behavior and problems with emotion regulation. Suicide and Life-Threatening Behavior, 48, 52-74.
Oquendo, M. A., Waternaux, C., Brodsky, B., Parsons, B., Haas, G. L., Malone, K. M., et al. (2000). Suicidal behavior in bipolar mood disorder: Clinical characteristics of attempters and nonattempters. Journal of Affective Disorders, 59, 107-117.
Parker, J. D., Wood, L. M., Bond, B. J., & Shaughnessy, P. (2005). Alexithymia in young adulthood: A risk factor for pathological gambling. Psychotherapy and Psychosomatics, 74, 51-55.
Patton, J., Stanford, M., & Barratt, E. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51, 768-774.
Perez, J., Venta, A., Garnaat, S., & Sharp, C. (2012). The difficulties in emotion regulation scale: Factor structure and association with non-suicidal self-injury in adolescent inpatients. Journal of Psychopathology and Behavioral Assessment, 34, 393-404.
Pisani, A. R., Wyman, P. A., Petrova, M., Schmeelk-Cone, K., Goldston, D. B., Xia, Y., et al. (2013). Emotion regulation difficulties, youth-adult relationships, and suicide attempts among high school students in underserved communities. Journal of Youth and Adolescents, 42, 807-820.
Poindexter, E. K., Nazem, S., & Forster, J. E. (2017). Painful and provocative events scale and fearlessness about death among veterans: Exploratory factor analysis. Journal of Affective Disorders, 208, 528-534.
Preyde, M., Vanderkooy, J., Chevalier, P., Heintzman, J., Warne, A., & Barrick, K. (2014). The psychosocial characteristics associated with NSSI and suicide attempt of youth admitted to an in-patient psychiatric unit. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 23, 100-110.
Racine, S. E., & Wildes, J. E. (2013). Emotion dysregulation and symptoms of anorexia nervosa: The unique roles of lack of emotional awareness and impulse control difficulties when upset. International Journal of Eating Disorders, 46, 713-720.
Rajappa, K., Gallagher, M., & Miranda, R. (2012). Emotion dysregulation and vulnerability to suicidal ideation and attempts. Cognitive Therapy and Research, 36, 833-839.
Reid, R. C., Carpenter, B. N., Spackman, M., & Willes, D. L. (2008). Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior. Journal of Sex and Marital Therapy, 34, 133-149.
Selby, E. A., Anestis, M. D., Bender, T. W., Ribeiro, J. D., Nock, M. K., Rudd, M. D., et al. (2010). Overcoming the fear of lethal injury: Evaluating suicidal behavior in the military through the lens of the interpersonal-psychological theory of suicide. Clinical Psychology Review, 30, 298-307.
Silva, C., Hagan, C. R., Rogers, M. L., Chiurliza, B., Podlogar, M. C., Hom, M. A., et al. (2016). Evidence for the propositions of the interpersonal theory of suicide among a military sample. Journal of Clinical Psychology, 73, 669-680.
Svaldi, J., Griepenstroh, J., Tuschen-Caffier, B., & Ehring, T. (2012). Emotion regulation deficits in eating disorders: A marker of eating pathology or general psychopathology? Psychiatry Research, 197, 103-111.
Swann, A., Dougherty, D., Pazzaglia, P., Pham, M., Steinberg, J., & Moeller, F. (2005). Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. American Journal of Psychiatry, 162, 1680-1687.
Tull, M., & Aldao, A. (2015). New directions in the science of emotion regulation. Current Opinion in Psychology, 3, iv-x.
Tull, M. T., Barrett, H. M., McMillan, E. S., & Roemer, L. (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38, 303-313.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117, 575-600.
Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008). Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 76, 72-83.
Vanheule, S., Desmet, M., Meganck, R., & Bogaerts, S. (2007). Alexithymia and interpersonal problems. Journal of Clinical Psychology, 63, 109-117.
Vanheule, S., Vandenbergen, J., Verhaeghe, P., & Desmet, M. (2010). Interpersonal problems in alexithymia: A study in three primary care groups. Psychology and Psychotherapy, 83, 351-362.
Victor, S. E., & Klonsky, E. D. (2016). Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples. Journal of Psychopathology and Behavioral Assessment, 38, 284-296.
Weinberg, A., & Klonsky, E. D. (2009). Measurement of emotion dysregulation in adolescents. Psychological Assessment, 21, 616.
Weiss, N. H., Williams, D. C., & Connolly, K. M. (2015). A preliminary examination of negative affect, emotion dysregulation, and risky behaviors among military veterans in residential substance abuse treatment. Military Behavioral Health, 3, 212-218.
Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689.
Witte, T. K., Gordon, K. H., Smith, P. N., & Van Orden, K. A. (2012). Stoicism and sensation seeking: Male vulnerabilities for the acquired capability for suicide. Journal of Research in Personality, 46, 384-392.
Woodman, T., Hardy, L., Barlow, M., & Le Scanff, C. (2010). Motives for participation in prolonged engagement high-risk sports: An agentic emotion regulation perspective. Psychology of Sport & Exercise, 11, 345-352.
Woodman, T., Huggins, M., Le Scanff, C., & Cazenave, N. (2009). Alexithymia determines the anxiety experienced in skydiving. Journal of Affective Disorders, 116, 134-138.