Testing Joiner's Interpersonal Theory of Suicide Among Latina Adolescent Suicide Attempters

Background and Purpose. One out of seven Latina adolescents reports attempting suicide (CDC, 2016). Joiner’s Interpersonal Psychological Theory of Suicide (IPTS) is a well-known framework used to understand suicidal behaviors. IPTS suggests that suicide happens only if a person has both the desire to die by suicide and the ability to do so (Joiner et al., 2009). In this theory, the desire to die emerges from perceived burdensomeness and low belongingness or social isolation. The ability to die by suicide rests in the acquired capacity to self-injure (Joiner et al., 2009). Despite IPTS’ prominence in the suicide literature, to date, no study has explored its utility among suicidal Latina adolescents. This study seeks to examine if IPTS can help to understand the suicidal behaviors of Latina teens.

Methods. The data for this project were drawn from individual qualitative interviews conducted with Latina adolescent suicide attempters (n = 32). Participants were recruited from hospitals and community-based agencies providing mental health services. The adolescents were between the ages of 11 and 19 years. Girls were, on average, 15 years old, and predominantly self-identified as Dominican (n = 11) and Puerto Rican (n = 11). We used a deductive thematic approach, a qualitative research method, to capture how perceived burdensomeness, low belongingness, and acquired ability to self-injure helped explain Latina teens’ suicidality. Qualitative comparative analysis (QCA) was then used to determine how themes patterned in different combinations across cases.

Results. Participants reported several combinations of the three constructs advanced by IPTS. The most common combination was present among 18 teens (56%), who reported that their suicidal behaviors emerged from perceived burdensomeness, low belongingness, and acquired ability to self-injure. The combination of burdensomeness and capability for suicide was the second most prevalent among suicidal Latinas (n = 4, 13%). Lastly, three girls reported burdensomeness and low belongingness (9%) as driving their suicidality.

Conclusions and Implications. This study tested the applicability of Joiner’s Interpersonal Psychological Theory of Suicide (IPTS) to explain the suicidal behaviors of Latina adolescents. Our findings suggest that IPTS is a useful theoretical framework to explain the suicide attempts of Latina teens. Specifically, for a large group of girls, their desire to die resulted from their feelings of being a burden to loved ones and their sense of social isolation. They became capable of attempting suicide through an acquired ability to self-injure, which occurred within a context of violent and painful experiences. Traditional Latino collectivist and gendered values may contribute to the importance of perceived burdensomeness in precipitating the suicidal behaviors of Latina adolescents. Yet, our findings also point to the importance of broader social and economic factors that put Latina teens at risk of low belongingness and experiences of violence. Understanding what drives Latina adolescents to attempt suicide provides insight into how to better help Latina teens. Specifically, culturally-competent suicide prevention and treatment models for Latinas should focus on addressing those circumstances that give rise to perceived burdensomeness, low belongingness, and acquired capability.