Spiritual Struggles and Suicidal Ideation in Veterans Seeking Outpatient Treatment: The Mediating Role of Perceived Burdensomeness

Recent research has documented a link between spiritual struggles and suicidal factors in veterans. Despite this evidence base, research has not examined possible intervening variables or applied contemporary ideation-to-action frameworks to understand the role of spiritual struggles on suicide risk. Drawing on a sample of 110 treatment-seeking veterans, the purpose of this study was to replicate and extend previous research by exploring the mediating role of two interpersonal psychological risk factors for suicide, thwarted belongingness and perceived burdensomeness, in the well-established association between spiritual struggles and suicidal factors. Results revealed significant associations between religious and spiritual struggles and suicide symptom severity, even after controlling for overall levels of depression. Moreover, perceived burdensomeness but not thwarted belongingness mediated this association. The current investigation provides initial evidence that perceived burdensomeness, or the perception that one is a burden on family members and significant others, partially accounts for the emerging links between spiritual struggles and risk for suicide. Results highlight the potential utility in assessing both spiritual struggles and perceived burdensomeness among veterans with heightened suicide risk.