TPC-Vol12-Issue1

4 The Professional Counselor | Volume 12, Issue 1 Perceived Burdensomeness Perceived burdensomeness is characterized by self-hatred and the belief that one is a burden to others, including family and friends, leading to the idea that they would be better off without them. It deals with the misperceptions of being a liability for family and intimate peers. As a dynamic interpersonal construct, it responds well to both interpersonal and intrapersonal interventions. However, although perceived burdensomeness responds more slowly to intervention, it may be a more significant predictor of suicide ideation and behavior than thwarted belongingness. There is also research that suggests that thwarted belongingness and perceived burdensomeness are more enmeshed in adolescents, suggesting that only one of the dynamic interpersonal constructs is necessary to be coupled with acquired capability and lead to suicidal behavior (Chu et al., 2016; Joiner et al., 2012; Stewart et al., 2017). Thwarted Belongingness Thwarted belongingness is a dynamic condition of social disconnection described by the interpersonal state of loneliness in which the psychological need to belong is not met. Of the two dynamic interpersonal constructs within the IPTS that respond to both interpersonal and intrapersonal interventions (thwarted belongingness and perceived burdensomeness), research suggests that thwarted belongingness may be easier to treat and respond more quickly to intervention than perceived burdensomeness (Chu et al., 2016; Joiner et al., 2012; Stewart et al., 2017). It has been well established that positive and negative effects of close relationships are particularly formative in the adolescent years, and therein lies the difficult developmental task of establishing strong peer relationships while also maintaining familial bonds (Miller et al., 2014). Relatedly, adolescents with histories of abuse or other maltreatment are at particular risk. It has been shown that low perceived quality of family and peer connectedness and belonging contribute to thwarted belongingness and its dynamic interpersonal state. Acquired Capability Acquired capability is a static construct in the IPTS, describing a decrease in or lack of fear about death and an elevated tolerance of physical pain. It is suggested to be developed through repeated exposure to painful and provocative events (Chu et al., 2016; Joiner et al., 2012; Stewart et al., 2017). Stewart et al. (2017) characterized it as “the combination of increased pain tolerance and decreased fear of death [that] results in progression from suicide intent to suicidal behavior, culminating in a suicide attempt” (p. 438). This construct’s combination of pain tolerance and fearlessness about death is significant in current conversations around adolescents engaging in violent video games, which could correlate to fearlessness about death but not necessarily pain tolerance (Stewart et al., 2017). Acquired capability as the combination of pain tolerance and fearlessness is also significant to other mental health disorders, including anorexia nervosa, in which risk factors for suicide ideation and behavior are prevalent and are characterized by increased pain tolerance and fearlessness about death. According to the IPTS, these three constructs are proximal to suicidal behavior. Horton et al. (2016) suggested that “an important strength of the theory is that it explains the lower frequency of more severe levels of suicidality (such as suicide attempt) compared to less severe levels (such as passive suicide ideation)” (p. 1134) because it is the combination of the three constructs that leads to suicidal behavior. The theory also posits that the difference between passive and active suicide ideation is the difference between the presence of one or both of the dynamic interpersonal states of thwarted belongingness and perceived burdensomeness. In other words, one dynamic interpersonal construct suggests passive ideation, two suggest active ideation, and all three constructs lead to suicidal behavior.

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