The relationship among attachment styles, interpersonal needs, and suicidal ideation in patients with psychiatric disorders

Suicide is a major public health concern; therefore, numerous factors have been investigated for their role in increasing suicide risk. Distal factors, such as attachment style, and proximal factors, like unmet interpersonal needs, interact with each other and may influence suicidal ideation. Understanding this interplay is crucial for developing effective interventions for suicide prevention. The present study aimed to investigate the association between attachment and interpersonal needs in suicidal ideation. For this study, we administered the Attachment Style Questionnaire and the Interpersonal Needs Questionnaire-15, and suicide risk was assessed using the Columbia-Suicide Severity Rating Scale. We collected data from 181 psychiatric inpatients at the Sant'Andrea Hospital in Rome. The results indicated that suicidal ideation was negatively and significantly associated with ASQ Confidence and positively associated with ASQ's Need for Approval and Discomfort with Closeness and INQ's perceived burdensomeness. The mediation model showed that perceived burdensomeness mediated the relationship between secure attachment style and suicidal ideation. The results have also shown significant associations among suicidal ideation, some attachment styles, and interpersonal needs. Secure attachment showed a potential protective role in suicidal ideation through lower levels of perceived burdensomeness, highlighting the importance of a careful evaluation of the patient's individual experiences and characteristics that can guide the adaptation of therapeutic goals and strategies. Interventions that promote functional interpersonal beliefs, as well as interventions oriented to limit the negative effects of disruptive models of attachment, may contribute to reconstructing trust towards others, reducing perceived burden, and preventing suicide risk.