The mediating effect of perceived burdensomeness on the relation between depressive symptoms and suicide ideation in a community sample of older adults

Objectives: Suicide is a prevalent problem in older adults. One of the best predictors of suicide in older adults is suicide ideation; suicide ideation has been frequently associated with depression. However, suicide ideation is not always present when an older adult is depressed and is sometimes present when an older adult is not depressed. Perceived burdensomeness, a recently proposed risk factor [Joiner Jr, T.E. (2005)], has been linked to suicide ideation in depressed samples and in older adults. Thus, perceived burdensomeness may be the necessary risk factor for suicide ideation. Method: The Geriatric Suicide Ideation Scale (GSIS; [Heisel et al. (2006)]), Center for Epidemiologic Studies Depression (CES-D; [Radloff, L.S. (1977)]) scale, and Suicide Cognitions Scale (SCS; [Rudd, M.D., Schmitz, B., McClenen, R., Joiner, T., Elkins, G., Claassen, C.A. (n.d.)]) were completed by a community sample of older adults recruited from primary care clinics (n = 106). A regression analysis was conducted following Baron and Kenny's [1986] guidelines to test the hypothesis that perceived burdensomeness (measured by the SCS perceived burdensomeness subscale) mediates the relation between depression (assessed with the CES-D) and suicide ideation (measured by the GSIS suicide ideation subscale) in older adults. Results: Perceived burdensomeness mediated the relation between depression and suicide ideation, accounting for 68.3% of the variance in suicide ideation. Conclusion: Perceived burdensomeness may explain the relation between depression and suicide ideation. Clinicians seeing older adults should assess for depression and perceived burdensomeness when determining suicide risk. Future research directions include treatment studies for perceived burdensomeness as a way to reduce suicide ideation.