Examining the relationship between borderline personality disorder traits and suicide desire through the lens of the Three-Step Theory

The present study used the Three Step Theory of Suicide (3ST) to explain the association between BPD traits and suicide desire. The 3ST states that pain and hopelessness cause suicide desire, and that the extent to which pain exceeds connectedness determines the intensity of suicide desire. The ability of these premises to explain elevated suicide desire in BPD was examined in 852 participants, including 456 with histories of suicide ideation or attempts. BPD traits, current suicide desire, pain, hopelessness, and connectedness were measured using validated self-report questionnaires. Consistent with step 1 of the 3ST, pain and hopelessness explained most of the association between BPD traits and suicide desire. Consistent with step 2, the association between BPD and intensity of suicide desire was fully accounted for by a pain-connectedness difference score. In a simpler model, pain, hopelessness, and connectedness reduced the correlation between BPD and suicide desire from r=.41 to r=.08. This research improves our understanding of why people with BPD traits experience suicide desire and informs the development of treatment and prevention strategies.Arts, Faculty ofPsychology, Department ofGraduat