Examining Factors Involved in Suicide Deaths in the National Violent Death Reporting System

OBJECTIVE: Suicide claims thousands of Americans' lives every year. A leading theory explaining suicide is the Interpersonal Theory of Suicide (ITS), yet little is known about how well this theory applies to suicide deaths. We assessed how well the ITS fit suicide deaths, followed by exploratory theoretical examination, in a national dataset using psychosocial variables. METHOD: The sample (N = 289,329) comprised individuals who died by suicide or by undetermined intent in the National Violent Death Reporting System (NVDRS). Factor analyses were conducted to examine how well ITS-supported indicators fit the data, and to identify novel theoretical patterns, for the group who died by suicide. Measurement invariance compared the resulting model across groups. RESULTS: The ITS was a poor fit to the data. Exploratory analyses suggested a 2-factor model (i.e., justice-involvement and substance misuse) best fit the data. Model fit was found to vary at the configural level, indicating the 2-factor model was not the same for those who died by suicide and for those who died by deaths of undetermined intent. CONCLUSIONS: Results identified a unique subset of suicide decedents characterized by justice involvement and substance use. Further work should explore the validity and clinical utility of the combination of justice involvement and substance misuse for suicide for those involved with the legal system.