Testing the Applicability of the Interpersonal Psychological Theory of Suicide Behavior Among Middle School Students in the Greater Accra Region of Ghana

Background and Purpose:

Suicide among children and Adolescents is a serious public health concern according to the World Health Organization, particularly in low- and middle-income countries. Although the Interpersonal Psychological Theory of Suicidal Behavior (IPTS) is widely applied to explain non-fatal suicide behaviors, it is yet to be tested empirically with a Ghanaian sample. The theory posits that suicide desire develops when an individual experience perceived burdensomeness, thwarted belongingness, and has acquired the capability to self-harm. The authors sampled 800 middle school students in the Greater Accra Region to test the utility of the IPTS. The findings of this study will lead to a better understanding of how suicide behavior is occurring among this young generation of Ghanaians and subsequently inform prevention and intervention of suicide to save adolescent lives.

Methods:

Paper-based surveys were administered to a sample (n=800) of middle school students in the Greater Accra region of Ghana, which has self-reported measures on suicide ideation, plan, and attempt, and the Interpersonal Needs questionnaire, which measures the elements of the IPTS model. Structural Equation Modelling (SEM) was performed using Mplus to test the applicability of the ITPS model to suicidal behavior among the sample. The analysis observed the overall fit for the model (RMSEA, CFI, TLI, and SRMR), which was compared with the cutoff points as specified by Hu & Bentler (1999), while the associations among the predictors (perceived burdensomeness and thwarted belongingness) and outcomes (suicide ideation, plan, and attempt) were tested for significance.

Results:

The study found that Joiner’s Interpersonal psychological theory of suicide (ITPS) was significant for explaining 12-month (χ² = 358.04 [df = 10] p < .001, RMSEA = .08, CFI = .98, TLI = .85, and SRMR = .02), and lifetime (χ² = 366.76 [df = 10] p < .001, RMSEA = .14, CFI = .95, TLI = .56, and SRMR = .02) suicide behaviors among middle school students in the Greater Accra region of Ghana. The study found that 12-month suicide attempt was significantly associated with increased 12-month Suicide ideation (β = 0.61; CI=0.46 – 0.74, p<0.05); increased Acquired capability (β = 0.02; CI=0.00 – 0.05, p<0.05); and increased Perceived Burdensomeness (β = 0.03; CI=0.02 – 0.05, p<0.05). In addition, 12-month suicide ideation was significantly associated with increased thwarted belongingness (β = 0.02; CI=0.01 – 0.03, p<0.05), and increased perceived burdensomeness (β = 0.02; CI=0.01 – 0.03, p<0.05).

Conclusions and Implications:

This study is the first to test the IPTS among middle school students in the Greater Region of Ghana. While the use of SEM makes it one of the most methodology robust study of suicide behavior among a Ghanaian adolescent sample. The findings of this study support evidence for all the components of the theory and its association with suicide behaviors, specifically the pathways of suicide behavior as explained by the model. This study provides new information for Ghanaian policy makers who are interested in setting the right policies and interventions that may work to reduce suicide behavior in the population.