Longitudinal causal dynamics between perceived burdensomeness and suicidal ideation: Population-based cohort study

Better understanding of the determinants of suicidal distress may be critical to improving clinical approaches to suicide prevention. According to the Interpersonal-Psychological Theory of Suicide, perceived burdensomeness (PB) is one of the proximal, causal risk factors for the development of suicidal distress. Considerable cross-sectional data has supported this association, but limited longitudinal data has investigated whether short-term change in PB influences subsequent suicidal ideation (SI). This longitudinal study involved daily assessments of both PB and SI over a 7-day period in 791 Australian adults who reported recent or current SI. Eight different panel models, with and without covariates were fit to examine cross-lagged effects between PB and SI. In the final model, there was weak evidence for a lagged effect from PB on SI the next day (β = 0.175), although the contemporaneous effect of PB on SI was larger and more consistent (β = 0.948). There was little evidence for lagged effects of SI on PB (β = 0.008). Effects varied across age groups and living situations. Inconsistent with the theory, findings suggest limited value of PB in predicting later SI, after accounting for cross-sectional relationships. Greater consideration of other psychosocial and contextual risk factors may be important for theories of suicide risk and for supporting people who are at risk of suicidal behaviour.