The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes
Relationships have been previously established between trauma exposure and suicide, particularly when the trauma exposure occurs during childhood, and when the event results in symptoms of Posttraumatic Stress Disorder (PTSD). Interpersonal types of trauma (i.e., trauma within a human relationship)...
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Psychology Clinical psychology Counseling psychology |
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Psychology Clinical psychology Counseling psychology The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
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Relationships have been previously established between trauma exposure and suicide, particularly when the trauma exposure occurs during childhood, and when the event results in symptoms of Posttraumatic Stress Disorder (PTSD). Interpersonal types of trauma (i.e., trauma within a human relationship) have been found to exhibit stronger relationships with both suicidal ideation (SI) and suicide attempts (SA) than noninterpersonal trauma (e.g., natural disaster). More specifically, interpersonal events that are physically assaultive exhibit stronger relationships with suicide-related outcomes than other types of trauma. Existing research has compared individual trauma events; however, there is a need to understand the differences between overarching types of trauma, and to explore the relationships between interpersonal trauma, age at time of exposure, PTSD, and suicide-related outcomes. The Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005) theorizes that death by suicide occurs when an individual possesses perceived burdensomeness (PB), thwarted belongingness (TB), and acquired capability for suicide (AC). Empirical evidence for IPTS is emerging, and relationships have been established between PB, TB, and AC with suicide-related outcomes. While interpersonal trauma exposure has been speculated to increase risk for PB, TB, and AC, there is a need to examine these relationships further, and to identify the interactions between trauma type and IPTS constructs. The first aim of the present study was to explore the relationships between trauma type (i.e., interpersonal assaultive, interpersonal non-assaultive, and noninterpersonal), age at time of trauma exposure, PTSD symptomology, and suicide-related outcomes (i.e., SI, SA, and severity of suicide-related outcomes (SSRO; a single variable that encompasses both SI and SA)). Given the existing relationships noted in literature, it was hypothesized that all variables would be significantly related to all suicide-related outcomes, and predictive of SSRO. Specifically, it was hypothesized that interpersonal assaultive trauma would demonstrate a stronger relationship with SSRO than the other trauma types. The second goal of the present study was to explore the relationships between trauma type and the IPTS constructs of PB, TB, and AC (Joiner, 2005) with suicide-related outcomes, as well as to explore interactions between IPTS constructs and trauma type. It was hypothesized that each IPTS construct would be significantly related to all suicide-related outcomes, and predictive of SSRO. Based on the conceptual understanding that assaultive trauma events increase habituation to painful experiences (Joiner, 2005), it was further hypothesized that interactions would be found between interpersonal assaultive trauma and AC. The current sample included 515 individuals. Of this sample, 426 individuals (82.7%) endorsed a traumatic event that met the minimum threshold of stressfulness to be included in the primary analyses. Participants completed an online survey that included a Demographic Questionnaire, the Trauma Experience Questionnaire (TEQ), a Worst Event Sampling Questionnaire, an Event Stressfulness Rating item, the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers, Litz, Keane, Palmieri, Marx & Schnurr, 2013), a questionnaire regarding history of SI and SA, an abbreviated form of the Interpersonal Needs Questionnaire (INQ; Van Orden, Witte, Gordon, Bender, & Joiner, 2008), and finally, an abbreviated form of the Acquired Capability for Suicide Scale (ACSS; Van Orden et al., 2008). Participants’ qualitative reports of their “worst traumatic experience” were coded by a trauma-focused research team into one of the three trauma types: interpersonal assaultive, interpersonal non-assaultive, and noninterpersonal. Statistical analyses included bivariate correlational analyses and a series of hierarchical regression analyses. Regression analyses examined the relationships between trauma type, age at time of trauma exposure, PTSD symptomology, PB, TB, and AC with SSRO, as well as the interactions between trauma type and IPTS constructs. Results indicated that age at time of trauma exposure and PTSD symptomology were both significant predictors of SSRO, but that trauma type did not predict SSRO when the aforementioned variables were controlled for. In regard to IPTS constructs (Joiner, 2005), PB was determined to be a positive predictor of SSRO after controlling for age at time of exposure and PTSD, when interaction effects were also included in the model. However, TB and AC were both found to have significant interactions with interpersonal assaultive trauma. Implications of this study include the clinical focus on elevated PTSD symptomology, younger age at time of trauma exposure, and feelings of burdensomeness in the assessment and treatment of individuals with history of trauma exposure. Limitations include the cross-sectional nature of this research as well as limited generalizability due to characteristics of the participants. This study further contributes to empirical evidence for IPTS by supporting the relationship between constructs and suicide-related outcomes, and by being the first known study to explore the interactions between IPTS constructs and trauma type. === A Dissertation submitted to the Department of Educational Psychology and Learning Systems in partial fulfillment of the requirements for the degree of Doctor of Philosophy. === Summer Semester 2018. === June 8, 2018. === Interpersonal Trauma, IPTS, Posttraumatic Stress Disorder, PTSD, Suicide, Trauma === Includes bibliographical references. === Angela I. Canto, Professor Directing Dissertation; Stephen J. Tripodi, University Representative; Martin A. Swanbrow Becker, Committee Member; Debra S. Osborn, Committee Member. |
author2 |
Blankenship, Allison Paige (author) |
author_facet |
Blankenship, Allison Paige (author) |
title |
The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
title_short |
The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
title_full |
The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
title_fullStr |
The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
title_full_unstemmed |
The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes |
title_sort |
impact of interpersonal trauma exposure and posttraumatic stress disorder on suicide-related outcomes |
publisher |
Florida State University |
url |
http://purl.flvc.org/fsu/fd/2018_Su_Blankenship_fsu_0071E_14669_Comp |
_version_ |
1719218042168147968 |
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ndltd-fsu.edu-oai-fsu.digital.flvc.org-fsu_6502512019-07-01T05:19:35Z The Impact of Interpersonal Trauma Exposure and Posttraumatic Stress Disorder on Suicide-Related Outcomes Blankenship, Allison Paige (author) Canto, Angela I. (professor directing dissertation) Tripodi, Stephen J. (university representative) Becker, Martin Swanbrow (committee member) Osborn, Debra S., 1968- (committee member) Florida State University (degree granting institution) College of Education (degree granting college) Department of Educational Psychology and Learning Systems (degree granting departmentdgg) Text text doctoral thesis Florida State University English eng 1 online resource (192 pages) computer application/pdf Relationships have been previously established between trauma exposure and suicide, particularly when the trauma exposure occurs during childhood, and when the event results in symptoms of Posttraumatic Stress Disorder (PTSD). Interpersonal types of trauma (i.e., trauma within a human relationship) have been found to exhibit stronger relationships with both suicidal ideation (SI) and suicide attempts (SA) than noninterpersonal trauma (e.g., natural disaster). More specifically, interpersonal events that are physically assaultive exhibit stronger relationships with suicide-related outcomes than other types of trauma. Existing research has compared individual trauma events; however, there is a need to understand the differences between overarching types of trauma, and to explore the relationships between interpersonal trauma, age at time of exposure, PTSD, and suicide-related outcomes. The Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005) theorizes that death by suicide occurs when an individual possesses perceived burdensomeness (PB), thwarted belongingness (TB), and acquired capability for suicide (AC). Empirical evidence for IPTS is emerging, and relationships have been established between PB, TB, and AC with suicide-related outcomes. While interpersonal trauma exposure has been speculated to increase risk for PB, TB, and AC, there is a need to examine these relationships further, and to identify the interactions between trauma type and IPTS constructs. The first aim of the present study was to explore the relationships between trauma type (i.e., interpersonal assaultive, interpersonal non-assaultive, and noninterpersonal), age at time of trauma exposure, PTSD symptomology, and suicide-related outcomes (i.e., SI, SA, and severity of suicide-related outcomes (SSRO; a single variable that encompasses both SI and SA)). Given the existing relationships noted in literature, it was hypothesized that all variables would be significantly related to all suicide-related outcomes, and predictive of SSRO. Specifically, it was hypothesized that interpersonal assaultive trauma would demonstrate a stronger relationship with SSRO than the other trauma types. The second goal of the present study was to explore the relationships between trauma type and the IPTS constructs of PB, TB, and AC (Joiner, 2005) with suicide-related outcomes, as well as to explore interactions between IPTS constructs and trauma type. It was hypothesized that each IPTS construct would be significantly related to all suicide-related outcomes, and predictive of SSRO. Based on the conceptual understanding that assaultive trauma events increase habituation to painful experiences (Joiner, 2005), it was further hypothesized that interactions would be found between interpersonal assaultive trauma and AC. The current sample included 515 individuals. Of this sample, 426 individuals (82.7%) endorsed a traumatic event that met the minimum threshold of stressfulness to be included in the primary analyses. Participants completed an online survey that included a Demographic Questionnaire, the Trauma Experience Questionnaire (TEQ), a Worst Event Sampling Questionnaire, an Event Stressfulness Rating item, the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers, Litz, Keane, Palmieri, Marx & Schnurr, 2013), a questionnaire regarding history of SI and SA, an abbreviated form of the Interpersonal Needs Questionnaire (INQ; Van Orden, Witte, Gordon, Bender, & Joiner, 2008), and finally, an abbreviated form of the Acquired Capability for Suicide Scale (ACSS; Van Orden et al., 2008). Participants’ qualitative reports of their “worst traumatic experience” were coded by a trauma-focused research team into one of the three trauma types: interpersonal assaultive, interpersonal non-assaultive, and noninterpersonal. Statistical analyses included bivariate correlational analyses and a series of hierarchical regression analyses. Regression analyses examined the relationships between trauma type, age at time of trauma exposure, PTSD symptomology, PB, TB, and AC with SSRO, as well as the interactions between trauma type and IPTS constructs. Results indicated that age at time of trauma exposure and PTSD symptomology were both significant predictors of SSRO, but that trauma type did not predict SSRO when the aforementioned variables were controlled for. In regard to IPTS constructs (Joiner, 2005), PB was determined to be a positive predictor of SSRO after controlling for age at time of exposure and PTSD, when interaction effects were also included in the model. However, TB and AC were both found to have significant interactions with interpersonal assaultive trauma. Implications of this study include the clinical focus on elevated PTSD symptomology, younger age at time of trauma exposure, and feelings of burdensomeness in the assessment and treatment of individuals with history of trauma exposure. Limitations include the cross-sectional nature of this research as well as limited generalizability due to characteristics of the participants. This study further contributes to empirical evidence for IPTS by supporting the relationship between constructs and suicide-related outcomes, and by being the first known study to explore the interactions between IPTS constructs and trauma type. A Dissertation submitted to the Department of Educational Psychology and Learning Systems in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Summer Semester 2018. June 8, 2018. Interpersonal Trauma, IPTS, Posttraumatic Stress Disorder, PTSD, Suicide, Trauma Includes bibliographical references. Angela I. Canto, Professor Directing Dissertation; Stephen J. Tripodi, University Representative; Martin A. Swanbrow Becker, Committee Member; Debra S. Osborn, Committee Member. Psychology Clinical psychology Counseling psychology 2018_Su_Blankenship_fsu_0071E_14669_Comp http://purl.flvc.org/fsu/fd/2018_Su_Blankenship_fsu_0071E_14669_Comp http://diginole.lib.fsu.edu/islandora/object/fsu%3A650251/datastream/TN/view/Impact%20of%20Interpersonal%20Trauma%20Exposure%20and%20Posttraumatic%20Stress%20Disorder%20on%20Suicide-Related%20Outcomes.jpg |