Perceived burdensomeness and suicide-related behaviors in clinical samples: current evidence and future directions.

CONTEXT The interpersonal-psychological theory of suicide identifies perceived burdensomeness as a primary component of suicidal desire and a possible point of intervention for suicide prevention. A growing literature has explored the relationship between perceived burdensomeness and suicide-related behaviors. OBJECTIVE The aim of this review is to integrate the evidence, identify critical gaps in the evidence-base, and explore implications for translation to prevention and intervention science. METHODS Papers published that reported on the association between perceived burdensomeness and suicide-related behaviors were included. RESULTS The literature indicates (a) significant cross-sectional associations between perceived burdensomeness and suicidal ideation and suicide attempts and (b) that perceived burdensomeness acts as either a moderator or a mediator of the association between risk and protective factors and suicide-related behaviors. CONCLUSION Research is needed to examine the longitudinal association between perceived burdensomeness and suicide-related behaviors, develop additional measurement approaches, generalize findings to other samples, and begin translating findings to prevention and intervention science.