{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:09:40Z","timestamp":1788786580700,"version":"build-2803163510"},"reference-count":96,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000874","name":"Brain and Behavior Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000874","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp; Life Threat Behav"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bipolar disorder, socioeconomic deprivation, and social isolation are major risk factors for suicide. The interpersonal theory of suicide (IPTS) posits perceived burdensomeness and thwarted belongingness as proximal causes of suicidal thoughts and behaviors, while the social determinants of health (SDOH) framework highlights distal socioeconomic factors. Studies of suicidality in bipolar disorder have used the IPTS and the SDOH framework, but few have integrated them to explore connections between distal and proximal factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study examined perceived burdensomeness and thwarted belongingness as mediators of the relationship between cumulative socioeconomic risk and suicide risk. Participants were 171 outpatients in a United States (U.S.) bipolar clinic (mean age\u2009=\u200939.0, 69.6% female, 73.7% Black\/African American).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cumulative socioeconomic risk, perceived burdensomeness, and thwarted belongingness were positively associated with suicide risk. Perceived burdensomeness mediated the relationship between cumulative socioeconomic risk and suicide risk, but thwarted belongingness did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings broadly suggest the IPTS and the SDOH framework can be fruitfully integrated to guide research and prevent suicide. The pathway from cumulative socioeconomic risk to suicide risk via perceived burdensomeness warrants further attention, particularly for individuals diagnosed with bipolar disorder. Implications for future studies of the IPTS, SDOH, and suicidality are discussed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sltb.70003","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T11:22:53Z","timestamp":1737544973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Integrating Social Determinants With the Interpersonal Theory of Suicide in a Study of Bipolar Outpatients"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-6627","authenticated-orcid":false,"given":"Daniel J.","family":"Mulligan","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Emory University School of Medicine\/Grady Health Systems  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Psychology Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5405-0239","authenticated-orcid":false,"given":"Dorian A.","family":"Lamis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Emory University School of Medicine\/Grady Health Systems  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.49.1.15"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12638"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.02.084"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association.2022.\u201cDiagnostic and Statistical Manual of Mental Disorders.\u201d (5th ed. text rev.).https:\/\/doi.org\/10.1176\/appi.books.9780890425787.","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.08.006"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/3348839"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126\u2010019\u201009667\u20108"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20102909.117.3.497"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/acrefore\/9780190264079.013.253"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.2.285"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11743-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2014.11.016"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/9836967"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.14718\/ACP.2015.18.2.10"},{"key":"e_1_2_7_16_1","unstructured":"Centers for Disease Control and Prevention (CDC).2022.\u201cSuicide Prevention: Risk and Protection.\u201dhttps:\/\/www.cdc.gov\/suicide\/factors\/index.html."},{"issue":"4","key":"e_1_2_7_17_1","first-page":"2482","article-title":"Change in Employment Status in Bipolar Disorder: A Longitudinal Study Using National Claims Data","volume":"77","author":"Chang H. 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