A test of the interpersonal theory of suicide in a large sample of current firefighters
Open accessAbstract
Recent research suggests that firefighters experience elevated rates of suicidal ideation and behaviors. The interpersonal theory of suicide may shed light on this finding. This theory postulates that suicidal desire is strongest among individuals experiencing perceived burdensomeness and thwarted belongingness, and that the combination of suicide desire and acquired capability for suicide is necessary for the development of suicidal behaviors. We tested the propositions of the interpersonal theory in a large sample of current United States firefighters (N=863). Participants completed self-report measures of perceived burdensomeness, thwarted belongingness, fearlessness about death (FAD; a component of acquired capability), and career suicidal ideation and suicide attempt history. Regression models were used to examine the association between interpersonal theory constructs, career suicidal ideation severity, and the presence of career suicide attempts. In line with theory predictions, the three-way interaction between perceived burdensomeness, thwarted belongingness, and FAD was significantly associated with career suicide attempts, beyond participant sex. However, findings were no longer significant after accounting for years of firefighter service or age. Contrary to predictions, the two-way interaction between perceived burdensomeness and thwarted belongingness was not significantly related to career suicidal ideation severity. Applications of the theory to firefighters and future research are discussed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Individual stressors such as harassment, sleep disturbances, and social disconnectedness are associated with suicide-related symptoms among firefighter samples.
“while past research has found that individual stressors such as harassment (Hom et al., 2017), sleep disturbances (Carey et al., 2011; Hom et al., 2016), and social disconnectedness (Chu et al., 2016) are associated with suicide-related symptoms among firefighter samples”
From Occupational stress and suicidality among firefighters: Examining the buffering role of distress tolerance (2018) · cites this paper as Chu et al., 2016
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Multiple regression: testing and interpreting interactions
(1992) · Choice Reviews Online · doi:10.5860/choice.29-3352 · Cited by 36,644 · see citing works
The interpersonal theory of suicide.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010) · Psychological Review · doi:10.1037/a0018697 · Cited by 5,292 · cited 6× · see citing works
“The interpersonal theory of suicide (Joiner, 2005; Van Orden et al., 2010), one of the most empirically tested and corroborated theories of suicide, provides a framework through which to understand why individuals think about, attempt, and die by suicide.”
BackgroundInfluentialSelf-citationNock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008) · Epidemiologic Reviews · doi:10.1093/epirev/mxn002 · Cited by 2,897 · see citing works
Joiner, T. E. (2007) · Harvard University Press eBooks · doi:10.2307/j.ctvjghv2f · Cited by 2,891 · see citing works
Self-citationCross-national prevalence and risk factors for suicidal ideation, plans and attempts
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., Bruffaerts, R., Chiu, W. T., de Girolamo, G., Gluzman, S., et al. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.040113 · Cited by 2,654 · see citing works
Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001) · Assessment · doi:10.1177/107319110100800409 · Cited by 2,276 · see citing works
Orden, K. A. V., Cukrowicz, K. C., Witte, T. K., & Joiner, T. E. (2011) · Psychological Assessment · doi:10.1037/a0025358 · Cited by 1,415 · see citing works
Self-citationNock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007) · Psychological Assessment · doi:10.1037/1040-3590.19.3.309 · Cited by 1,352 · see citing works
Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.1.72 · Cited by 1,126 · see citing works
Self-citationA review of the healthy worker effect in occupational epidemiology
Li, C.-Y., & Sung, F.-C. (1999) · Occupational Medicine · doi:10.1093/occmed/49.4.225 · Cited by 829 · see citing works
Joiner, T. E., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0016500 · Cited by 814 · see citing works
Self-citationThe Interpersonal Theory of Suicide: Guidance for Working with Suicidal Clients
Joiner, T. E., Orden, K. V. V., Witte, T., & Rudd, M. (2009) · American Psychological Association eBooks · doi:10.1037/11869-000 · Cited by 417 · see citing works
Self-citationRibeiro, J. D., Witte, T. K., Orden, K. A. V., Selby, E. A., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2013) · Psychological Assessment · doi:10.1037/a0034858 · Cited by 408 · see citing works
Self-citationThe Hopelessness Depression Symptom Questionnaire
Metalsky, G. I., & Joiner, T. E. (1997) · Cognitive Therapy and Research · doi:10.1023/a:1021882717784 · Cited by 403 · see citing works
Self-citationJoiner, T. E., Pfaff, J. J., & Acres, J. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00017-1 · Cited by 387 · see citing works
Self-citationBias in occupational epidemiology studies
Pearce, N. E., Checkoway, H., & Kriebel, D. (2006) · Occupational and Environmental Medicine · doi:10.1136/oem.2006.026690 · Cited by 350 · see citing works
Carey, M. G., Al-Zaiti, S. S., Dean, G. E., Sessanna, L., & Finnell, D. S. (2011) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e318225898f · Cited by 350 · see citing works
Corneil, W., Beaton, R. D., Murphy, S. A., Johnson, C., & Pike, K. (1999) · Journal of Occupational Health Psychology · doi:10.1037//1076-8998.4.2.131 · Cited by 336 · see citing works
Corneil, W., Beaton, R., Murphy, S., Johnson, C., & Pike, K. (1999) · Journal of Occupational Health Psychology · doi:10.1037/1076-8998.4.2.131 · Cited by 336 · see citing works
Nock, M. K., Stein, M. B., Heeringa, S. G., Ursano, R. J., Colpe, L. J., Fullerton, C. S., Hwang, I., Naifeh, J. A., Sampson, N. A., Schoenbaum, M., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.30 · Cited by 329 · see citing works
Impulsivity and suicidality: The mediating role of painful and provocative experiences
Bender, T. W., Gordon, K. H., Bresin, K., & Joiner, T. E. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.07.023 · Cited by 317 · see citing works
Self-citationRoutinized Assessment of Suicide Risk in Clinical Practice: An Empirically Informed Update
Chu, C., Klein, K. M., Buchman‐Schmitt, J. M., Hom, M. A., Hagan, C. R., & Joiner, T. E. (2015) · Journal of Clinical Psychology · doi:10.1002/jclp.22210 · Cited by 269 · see citing works
Self-citationPerceived Burdensomeness as an Indicator of Suicidal Symptoms
Van Orden, K. A., Lynam, M. E., Hollar, D., & Joiner, T. E. (2006) · Cognitive Therapy and Research · doi:10.1007/s10608-006-9057-2 · Cited by 244 · see citing works
Self-citationBryan, C. J., Morrow, C. E., Anestis, M. D., & Joiner, T. E. (2009) · Personality and Individual Differences · doi:10.1016/j.paid.2009.10.023 · Cited by 243 · see citing works
Self-citationSmith, P. N., Cukrowicz, K. C., Poindexter, E. K., Hobson, V., & Cohen, L. M. (2010) · Depression and Anxiety · doi:10.1002/da.20701 · Cited by 202 · see citing works
Career prevalence and correlates of suicidal thoughts and behaviors among firefighters
Stanley, I. H., Hom, M. A., Hagan, C. R., & Joiner, T. E. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.08.007 · Cited by 192 · see citing works
Self-citationClarifying the role of pain tolerance in suicidal capability
Franklin, J. C., Hessel, E. T., & Prinstein, M. J. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2011.08.001 · Cited by 187 · see citing works
Selby, E. A., Anestis, M. D., Bender, T. W., Ribeiro, J. D., Nock, M. K., Rudd, M. D., Bryan, C. J., Lim, I. C., Baker, M. T., Gutierrez, P. M., et al. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.12.004 · Cited by 183 · see citing works
Self-citationSuicide as a derangement of the self-sacrificial aspect of eusociality.
Joiner, T. E., Hom, M. A., Hagan, C. R., & Silva, C. (2015) · Psychological Review · doi:10.1037/rev0000020 · Cited by 161 · see citing works
Self-citationA test of the Interpersonal Theory of Suicide in a large community-based cohort
Christensen, H. M., Batterham, P. J., Soubelet, A., & Mackinnon, A. J. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.07.002 · Cited by 156 · see citing works
Smith, A. R., Ribeiro, J. D., Mikolajewski, A. J., Taylor, J. E., Joiner, T. E., & Iacono, W. G. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.01.010 · Cited by 141 · see citing works
Self-citationJahn, D. R., Cukrowicz, K. C., Linton, K., & Prabhu, F. (2011) · Aging & Mental Health · doi:10.1080/13607863.2010.501064 · Cited by 137 · see citing works
Examining the Interpersonal–Psychological Theory of Suicide in an Inpatient Veteran Sample
Monteith, L. L., Menefee, D. S., Pettit, J. W., Leopoulos, W. L., & Vincent, J. P. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12027 · Cited by 134 · see citing works
Vargas de Barros, V., Martins, L. F., Saitz, R., Bastos, R. R., & Ronzani, T. M. (2013) · Journal of Health Psychology · doi:10.1177/1359105312443402 · Cited by 114 · see citing works
Cukrowicz, K. C., Jahn, D. R., Graham, R. D., Poindexter, E. K., & Williams, R. B. (2013) · Journal of Abnormal Psychology · doi:10.1037/a0034953 · Cited by 112 · see citing works
Behind the Brotherhood: Rewards and Challenges for Wives of Firefighters
Regehr, C., Dimitropoulos, G., Bright, E., George, S., & Henderson, J. (2005) · Family Relations · doi:10.1111/j.1741-3729.2005.00328.x · Cited by 111 · see citing works
Anestis, M. D., Khazem, L. R., & Law, K. C. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12120 · Cited by 105 · see citing works
Social Support, Stress, and Suicidal Ideation in Professional Firefighters
Carpenter, G. S. J., Carpenter, T. P., Kimbrel, N. A., Flynn, E. J., Pennington, M. L., Cammarata, C. M., Zimering, R. T., Kamholz, B. W., & Gulliver, S. B. (2014) · American Journal of Health Behavior · doi:10.5993/ajhb.39.2.5 · Cited by 95 · see citing works
Czyz, E. K., Berona, J., & King, C. A. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12125 · Cited by 90 · see citing works
Clinical applications of the interpersonal‐psychological theory of attempted and completed suicide
Stellrecht, N. E., Gordon, K. H., Orden, K. A. V., Witte, T. K., Wingate, L. R., Cukrowicz, K. C., Butler, M. A., Schmidt, N. B., Fitzpatrick, K. K., & Joiner, T. E. (2005) · Journal of Clinical Psychology · doi:10.1002/jclp.20224 · Cited by 89 · see citing works
Self-citationAnestis, M. D., Khazem, L. R., Mohn, R. S., & Green, B. A. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.03.006 · Cited by 89 · see citing works
The Interpersonal Theory of Suicide: Guidance for Working With Suicidal Clients
Chessick, C. A. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09050679 · Cited by 56 · see citing works
Chiu, S., Webber, M. P., Zeig-Owens, R., Gustave, J., Lee, R., Kelly, K. J., Rizzotto, L., & Prezant, D. J. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.05.028 · Cited by 43 · see citing works
Zuromski, K. L., Davis, M. T., Witte, T. K., Weathers, F. W., & Blevins, C. A. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12098 · Cited by 38 · see citing works
Bullman, T. A., Hoffmire, C. A., Schneiderman, A., & Bossarte, R. M. (2015) · Annals of Epidemiology · doi:10.1016/j.annepidem.2015.09.008 · Cited by 22 · see citing works
Batterham, P. J., Calear, A. L., & van Spijker, B. A. J. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12140 · Cited by 19 · see citing works
Gender Differences in Acquired Capability Among Active-Duty Service Members at High Risk for Suicide
Kerbrat, A. H., Comtois, K. A., Stiles, B. J., Huh, D., Chalker, S. A., & Luxton, D. D. (2015) · Military Behavioral Health · doi:10.1080/21635781.2015.1093982 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., Rogers, M. L., Podlogar, M. C., Chiurliza, B., Ringer, F. B., et al. (2017) · Psychological Bulletin · doi:10.1037/bul0000123 · Cited by 1,231 · see citing works
“Moreover, research on the theory has been conducted across samples derived from locations outside of the United States (U.S.), such as South Korea (Chu et al., 2016b) and Australia (Christiansen et al., 2014).”
BackgroundSelf-citationStanley, I. H., Hom, M. A., & Joiner, T. E. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.12.002 · Cited by 433 · see citing works
Self-citationCorrelates of suicidality in firefighter/EMS personnel
Martin, C. E., Tran, J. K., & Buser, S. J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.08.078 · Cited by 71 · see citing works
Stanley, I. H., Boffa, J. W., Smith, L. J., Tran, J. K., Schmidt, N. B., Joiner, T. E., & Vujanovic, A. A. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.05.058 · Cited by 67 · see citing works
Self-citationChu, C., Walker, K. L., Stanley, I. H., Hirsch, J. K., Greenberg, J. H., Rudd, M. D., & Joiner, T. E. (2018) · Journal of Personality and Social Psychology · doi:10.1037/pspp0000152 · Cited by 56 · see citing works
Self-citationBing-Canar, H., Ranney, R. M., McNett, S., Tran, J. K., Berenz, E. C., & Vujanovic, A. A. (2019) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000947 · Cited by 35 · see citing works
Leonard, S. J., & Vujanovic, A. A. (2022) · Behavior Modification · doi:10.1177/01454455211002105 · Cited by 15 · see citing works
- Authors
- Chu, C., Buchman-Schmitt, J. M., Hom, M. A., Stanley, I. H., & Joiner, T. E.
- Affiliations
- Florida State University (US)
- Corresponding author
- Chu, Carol
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 240
- Pages
- 26-33
- ISSN
- 0165-1781 (ISSN-L)
- PMC
- PMC5333767
- OpenAlex
- W2321298794
- Cited by
- 62
- References
- 47
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 7 · 2020: 11 · 2019: 3 · 2018: 7 · 2017: 9 · 2016: 4 · 2015: 1
- FWCI
- 10.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Psychiatry Research (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32 MH093311-04)
- National Fallen Firefighters Foundation
- Military Suicide Research Consortium
- Office of the Assistant Secretary of Defense for Health Affairs (W81XWH-10-2-0181)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Keywords
- interpersonal theory of suicide, firefighters, suicidal ideation, suicide attempts, perceived burdensomeness, thwarted belongingness, fearlessness about death, acquired capability for suicide, occupational stress, workplace mental health
- MeSH terms
- Adolescent, Adult, Attitude to Death, Dependency, Psychological, Female, Humans, Male, Middle Aged, Models, Psychological, Motivation, Perception, Risk Factors, Psychological Distance, Suicide, Attempted, Young Adult, Suicidal Ideation, Firefighters
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
