Pre#enting help-negation for suicidal ideation/ Implications for thwarted belongingness, social networ' si0e and fre+uency of social

interaction( 'venson, A.,Cilson, 4. D 4aputi, P.

University of Wollongong, Illawarra Health and Medical Research Institute
Bac'ground
Help-negation is the processes of withdrawal that occurs for many individuals as suicidal ideation becomes more intense [1]. Perception of social support and distorted affect regulation are associated with the development of suicidal ideation, and implicated in the development of help-negation [2]. As suicidal individuals have interpersonal needs rejected they may cease to see or accept help [!]. "he Interpersonal Theory of Suicide (IPTS) [#,$] proposes that suicidal ideation is, in part, caused %y Thwarted Belongingness (TB), a construct which is theorised to reflects %oth& - 'elf-report perceptions of not %elonging, and - (eductions in o%jective social varia%les such as social networ s si)e and fre*uency of social interaction. (educed social networ si)e and fre*uency of social interaction has %een found to differentiate suicidal individuals from controls [+,,]. Biased information processing facilitated by suicide schemas !" and an inability to assign accurate #alue to the social en#ironment $" may influence whether selfreport TB corresponds with reductions in ob%ecti#e social #ariables

1ethod Help-negation
(Suicidal ideation)
-uided %y the P(.'/A statement [10], a systematic review of # electronic data%ases was conducted from 1anuary to 2e%ruary 201!. 3ata %ases were& 4ochrane 5i%rary, /635.76 with 2ull"e8t, Psyc.729 and Pu%/ed 4entral. 'earch terms used in the review were& !ecords identified n$%&% !ecords identified outside the formal search n$()

!ecords after duplicates removed n$'%' !ecords screened based on title and abstract te*t n$'%' !ecords e*cluded n$,-+ull te*t articles e*cluded:

TB

'elf report "= 8 !educed social networks si"e and fre#uenc of social interaction

:interpersonal theory of suicide;, :perceived A73 %elongingness;, and :%elongingness A73 suicid<;. (ecords were e8luded during screening if they did not discuss the .P"' or "=. Articles were included in the review if they assessed the relationship %etween "=, suicidal ideation or %ehaviour, and help-see ing or o%jective social varia%les.

-igure . & Proposed relationship between TB, intensit of suicidal ideation and help-seeking for suicidal thoughts. Hypothesis/ Self-report TB, reduced social networ' si0e and fre+uency of interaction will strengthen the help-negation relationship for suicidal thoughts

+ull te*t articles assessed for eligibilit n$(,-

Articles included in review n$%

-.ot available electronicall n$) -!eview articles n$-/ -0id not measure TB n$%& -0id measure TB but not help-seeking or objective social variables n$'/

)esults
/ost studies find a significant association %etween self-report "= and suicidality. 'i8 studies e8amined the relationship %etween self-report "= and o%jective social varia%les. 5ower "= has %een associated with more hours spent volunteering [11] and clu% participation [12]. 9ne study found "= to correlate moderately with indicators of social networ si)e and social interaction. >owever, limitations of this study included small sample si)e ?n@+AB, using a single score to represent %oth si)e and interaction, and restricting nomination of networ mem%ers to those living within 1 hours travel [1!]. Pro8y measures of %elongingness have %een associated with parental displacement [1#] and e8tracurricular activities [1$] The review found no evidence that previous research has assessed whether: - "= is implicated in help-see ing for suicidal ideation 9( - 9%jective social varia%les are related to self-report "=, as the severity of suicidal ideation changes. The results suggest that ob%ecti#e characteristics of peoples& social networ's ha#e recei#ed relati#ely little attention in suicide research(

Implications and future directions

- Assess the relationship between self-report TB and objective social network characteristics among suicidal individuals compared to nonsuicidal individuals. - .nvestigate psycho-social factors that may %e directly implicated in the help-negation processes associated with suicidal ideation. "his will su%stantiate the .P"', as well as determine whether resources aim to promote help and support see ing for suicidal thoughts, should %e focused on changing su%jective feelings of %elonging or on mending and %uilding actual interpersonal relationships. )esearch to e*plore these +uestions is currently underway , depicted in -igure .

)esearch 2uestions
1. >as previous research implicated "= in help-negation following suicidal ideationE 2. >as previous research investigated the relationship %etween self-report "= and o%jective social varia%les such as reduced social networ s si)e and fre*uency of social interactionE !. .s this relationship effected %y changes in the severity of suicidal ideationE

)eferences

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2. Cilson 41, 'venson A, 4aputi P ?201!B. 4ognitive, affective and social processes involved in help-negation after critical suicidal thoughts, Pater presented at the 201! 'uicide Prevention Australia 4onference, /el%ourne 1uly, 201!

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Ale8ander 'venson. =Psych ?>onorsB