PS47 - Advancing Suicide Prevention: Insights, Innovations, and Psychotherapeutic Mechanisms of Action

Self-Compassion as a Potential ASSIP Mechanism: Integration With the Interpersonal Theory of Suicide
August, 31 | 08:30 - 10:00

The narrative interview, video playback, and sharing back of a personalized formulation in ASSIP provide a poignant therapeutic experience of being valued and insight into unmet needs. The experience of self-compassion when viewing oneself in the video and in the therapist formulation may be one mechanism for change. Self-compassion is considered a protective factor against suicide risk and is linked to less severe suicide ideation (SI) and lower likelihood of prior suicide attempts. Mechanisms whereby self-compassion may confer suicide risk are not clear, as few studies consider self-compassion in the context of other factors that confer risk for suicide. Within the context of the Interpersonal Theory of Suicide, we explored thwarted belonging (TB) and perceived burden (PB) as potential proximal mechanisms whereby self-compassion may impact suicide risk. PB is conceptualized as being closely associated with self-hate and other self-referential states while TB may be more highly influenced by environmental and contextual factors. We hypothesized: higher self-compassion would be associated with lower PB but not with TB; and when PB occurs in the context of higher self-compassion, it would attenuate the potency of PB in increasing suicide risk (less severe SI, lower likelihood of prior attempts). This sample included baseline data from N=320 adults enrolled in a randomized controlled trial of ASSIP. We examined hypotheses via moderated multiple regression and logistic regression, controlling for depression. Higher self-compassion was correlated with both lower PB and TB at the bivariate level. As expected, higher PB was associated with more severe SI. This was moderated by self-compassion such that higher self-compassion attenuated the relation between PB and SI. Regarding attempts, lower self-compassion was associated with lower likelihood of prior attempts. A significant three-way interaction was present between self-compassion, PB, and TB. Simple slopes analyses revealed higher PB was associated with higher likelihood of prior attempts only at low/mean levels of TB and mean/high levels of self-compassion. Findings suggest self-compassion may serve as an additional treatment target to reduce SI severity within ASSIP, particularly in the context of higher PB. However, for adults presenting with both higher self-compassion and belonging, it may be more effective to target feelings of perceived burden within ASSIP to reduce the likelihood of future attempts.

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