6.8 Worth-Less-Ness: Glueing Together MDD, PTSD, and Lifetime Suicidality

Feelings of Worthlessness, Traumatic Experience, and Their Comorbidity in Relation to Lifetime Suicide Attempt in Community Adults with Major Depressive Disorder.

It's by Hongjin Jeon, et al., from the Journal of Affective Disorders, 2014.

And this article tells us, Suicide is not a simple A leads to B event.

It condensates from the convergence of several factors which generally have relationship to each other.

For instance, depression, and substance misuse support each other and act as suicide attempt risk factors.

One could also step back a few feet and suspect that trauma might be related to both, potentially through destructive perspectives that might connect the bunch, aka those core beliefs we've been talking about.

So it's not too surprising that sense of worthlessness is considered a proximal trigger of suicide attempt, while issues like PTSD are assessed as distal, or more distant background factors.

Roughly 0.014% of people commit suicide worldwide each year.

However, about 11 people attempt suicide for every one that is documented ending in death.

And how many are undocumented? We'll never know.

What we do know is major depression drives the behavior, and it's quite commonly accepted.

But we don't know what other risk factors might contribute in that sticky web of converging circumstances.

So, major depressive disorder is commonly accepted and clinically implicated for its relationship to suicide attempt.

And interestingly, while the experience of depression is unique between sufferers, worthlessness is one of the defining diagnostic criteria, suggesting it's a stable characteristic that many or most people experience.

In fact, CBT, cognitive behavioral therapy, for major depressive disorder, focuses on negative beliefs, such as worthlessness, partially due to its strong correlation with suicide attempt and other negative life outcomes.

But major depression doesn't wander alone.

It's often hand-in-hand with PTSD.

Trauma is also correlated with suicide attempt, with poor social experiences as one of the potential predisposing factors that leads into the self-harm.

With depression and low social support piggybacking on feelings of worthlessness and bolstering the post-traumatic stress symptomology experience, we might have a perfect storm for suicidal ideation and attempt between major depressive disorder, worthlessness, and trauma.

And so, these authors set out to better understand the interplay between these factors.