So why are theories important?
1) Guides research
2) Guides clinical work
3) Creates new hypotheses
Joiner’s Interpersonal-Psychological
Theory of Suicidal Behavior
Those Who Desire to Die
Thwarted
Belongingness
May endorse suicidal
ideation
Those who are
capable of suicide
Perceived
Burdensomeness
At greatest risk of
suicide
Van Orden, Witte, Gordon, Bender & Joiner, 2008
•
•
The interpersonal-psychological theory of suicidal
behavior argues that, in order to enact lethal selfharm, an individual must habituate to physical pain
and the fear of death.
This process of habituation occurs through repeated
exposure to painful and provocative events.
•
Examples of habituation?
www.youtube.com/watch?v=Jrjf3V7Tc1c
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
Emphasized collective social forces and dismissed
most other factors
Disturbed regulation of the individual by society
Two basic types of regulation:
1) Social integration
- Low integration = “egoistic” - when people feel like they don’t
belong, purposeless and become desperate
* Similar to Joiner’s concept of belongingness
- High integration = “altruistic” – Excessive integration leads people
to lose themselves and to commit to a larger goal
* Similar to Joiner’s concept of burdernsomeness
2) Moral regulation
- Low regulation = “anomic” - Sudden changes in the social position
of an individual due to abrupt changes in society lead to a lack of
social direction
- High regulation = “fatalistic” – Occurs among people who live
overregulated, unrewarding lives.

Why was he so influential?
1) Emphasized social disconnection as a major
source for one’s desire to end his/her life
2) Introduced the concept of perceived
burdensomeness as a risk factor to serious
suicidal behavior
3) There were very few theorists during this time
-
Sullivan
Menninger
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Focused on the nature of psychological needs
and the consequences of having those needs
thwarted
“Suicide is caused by a certain kind of
psychological pain called “psychache”.
◦ Psychache is defined as a general psychological and
emotional pain that reaches intolerable intensity.
◦ Risk factors operate by increasing psychache which
predisposes one to suicidality.

Psychache is compatible with Joiner’s
concepts of perceived burdensomeness and
failed belongingnes.

Emphasized the role of hopelessness
◦ In one study Beck and colleagues correctly
identified 91% of those who later died by suicide.
◦ Those with high hopelessness were 11 times more
likely to die by suicide than those with lower scores.

Joiner believes that hopelessness doesn’t tell
the whole story and is not sufficient for
suicidal behavior.
◦ Hopelessness about belongingness and
burdensomeness is required, together with the
acquired capability for serious self-harm

Beck also argued that previous suicidal
experience sensitizes suicide-related
thoughts and behaviors so that they become
more accessible and active.
◦ Allows for subsequent episodes to be more easily
triggered and more severe
◦ Shares similarities with Joiner’s model which
proposes an escalating course of suicidal behavior
over time through habituation.


Proposed an escaped theory of suicide
Described a series of steps leading up to
serious suicidal behavior:
1) Individual experiences a negative and
severe discrepancy between expectations
and actual events
2) An aversive state of high self-awareness
develops, which produces negative affect
* Person may dwell on personal inadequacies
leading to distress, sadness, and worry.

3) Person attempts to escape from negative
affect as well as from the aversive selfawareness by retreating into a numb state of
cognitive deconstruction.
* Person disregards meaningful thoughts about
self and replaces them with lower-level more
immediate goals and tasks.
* Reduced inhibition results which leads to a lack
of impulse control in general (particularly with
respect to suicidal behavior).

Fluid Vulnerability Model
◦ Suicidal episodes are time-limited.
◦ Risk factors that both trigger a suicidal episode and
determine the duration and severity of an episode
are fluid.
◦ Imminent risk cannot endure beyond periods of
heightened arousal.
◦ Baseline risk varies from person to person.
Fluid Vulnerability Model
Acute
Risk
Suicidal
Mode
Acute
Risk
Baseline
Risk
Person 1
Baseline
Risk
Person 2
Adapted from Rudd, 2006