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Mediating Effects of Perceived Burdensomeness on the Relation Between Depressive Symptoms and Suicide Ideation in a Community Sample of Older Adults


Many individuals agree that the suicide rates for older adults age 60 and above continue to increase. There are many aspects of life that determine the thought of suicide in older patients. Depression is a significant cause of suicide, as this population is unable to enjoy life as a result of burdensome health issues, reoccurring death, and the lack of independence and respect. Providers should taken into consideration the physical and mental aspects of providing services to older adults with shifting life circumstances, and how this can play a significant increase for suicidal ideation.

As providers become more skilled in the area of geriatric suicide causes and interventions, this population will ensure to gain the necessary treatment needed to decrease the risk of suicide. Joiner (2005) proposed a theory of suicide called the Interpersonal-Psychological Theory, which consists of three variables that contribute to the risk of death by suicide. It was hypothesized that the cognition of older individuals in relation to how they feel about frequent dependence on their caretakers makes them feel burdensome to their current caretaker(s). When this behavior is displayed, behavioral health providers are alerted, and can define the necessary treatment interventions to decrease risk of suicide.

There were 106 adults between the ages of 60-93 years old, who were recruited from the Community and Family Medicine clinic at Texas Tech University Health Sciences Center (i.e., Cukrowicz et al., n.d.). 74.3 % of the participants were female, 25.7% were male (i.e., Cukrowicz et al., n.d.). The marital status of participants was: 58.1% married, 21.9% widowed, 11.4% divorced, 4.8% living with a partner, 1.9% were single, 1.0% separated, and 1.0% in a relationship but not residing together (i.e., Cukrowicz et al., n.d.). There was 92.4% Caucasian, 5.7% Hispanic, 1.0% each of African American and others (i.e., Cukrowicz et al., n.d.). The scale (shortly CES-D) was used to assess depressive symptoms (Radloff, 1977). This tool tested different dimensions of depression, including loss of appetite, helplessness, and hopelessness, and depressed mood (Radloff, 1977). The scale (shortly SCS) is a questionnaire that includes subscales evaluating unlovability and unbearability (Rudd et al., n.d.). The two item, scale that perceived burdensomeness in older adults was also used (Slee, Garnefski, Spinhoven, & Arensman, 2008; Slee Garnefski, van der Leeden, Arensman, & Spinhoven, 2008). The scale (shortly BHS) is a true-false measure that measured the positive and negative views about the future (Beck & Steer, 1988). The (shortly GSIS) item addressed suicide ideation, death ideation, perceived meaning of life, and loss of personal and social worth (Heisal & Flett, 2006). The MSSI is a clinician administered interview used to assess for current suicide risk and was used solely to screen participants for suicide risk in this study (Miller, Norman, Bishop, & Dow, 1986).

The results of this study are consistent with the hypothesis. The issue of older individuals being burdensome on their caretaker(s) is proven to result in increased suicide ideation as a result of decreased autonomy. Integrated Behavioral Health providers can provide the necessary support to allow this population to increase positive cognition, while creating increased autonomy and vitality through use of interventions that include cognitive behavioral therapy and psychoeducation.

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     Perceived burdensomeness is critical and may explain gender

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