DSM-5 PTSD and Passive Suicidal Ideation: An Application of the Interpersonal-Psychological Theory of Suicide
Type of DegreePhD Dissertation
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The relationship between posttraumatic stress disorder (PTSD) and passive suicidal ideation (passive SI) is well established, but the underlying mechanisms have not been sufficiently explicated (Panagioti, Gooding, & Tarrier, 2012). Two recent studies (Davis, Witte, & Weathers, 2014; Davis, Witte, Weathers, & Blevins, 2014) sought to enhance understanding of the PTSD/ passive SI relationship using the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005) as a conceptual framework. Both found evidence of a relationship between emotional numbing symptoms and passive SI. Since the completion of these studies, DSM-5 introduced substantial changes to the diagnostic criteria for PTSD, including combining emotional numbing symptoms with new symptoms to form a cluster labeled negative alterations in cognitions and mood (NACM; Freidman, Resick, Bryant, & Brewin, 2011). The current study is a replication and extension of Davis et al. (2014), designed to examine how DSM-5 changes to the PTSD diagnostic criteria affect understanding of the PTSD/passive SI relationship. Participants were trauma-exposed undergraduates (N = 380). PTSD was specified as having six factors, following the anhedonia model (Liu et al., 2014), which splits DSM-5 NACM (Cluster D) into NACM (D1-D4) and anhedonia (D5-D7). As hypothesized, of the six PTSD clusters anhedonia had the strongest bivariate relationship with perceived burdensomeness. However, PTSD clusters were not differentially related to thwarted belongingness or passive SI. In structural models, no PTSD cluster was directly related to passive SI; rather, each cluster was indirectly related to passive SI through perceived burdensomeness. Further, in all structural models, perceived burdensomeness was the only variable with a direct relationship with passive SI. Taken together, these findings do not support the idea that PTSD symptom clusters are differentially related to passive SI. However, they do implicate perceived burdensomeness as playing an important role in the PTSD/passive SI relationship.