Semester

Summer

Date of Graduation

2020

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Amy Fiske

Committee Co-Chair

Barry Edelstein

Committee Member

Nicholas Turiano

Committee Member

Mary LeCloux

Abstract

Suicide consistently ranks among the top 10 leading causes of death in the United States. Depressive disorders as well as depression symptoms are risk factors for suicide. Depression symptoms typically fall under a cognitive affective domain and a somatic domain. Males and older adults may have a more somatic presentation of depression. Among those with physical health problems, these somatic symptoms may be confounded with symptoms of physical conditions. Not all symptoms of depression are equally useful for predicting suicide risk. The types of depression symptoms that are risk factors may vary depending on the characteristics of the sample and how depression typically presents in these samples. The present study sought to investigate the utility of cognitive affective and somatic symptoms of depression in predicting suicide risk and whether this relation is moderated by age, gender, and physical health problems. Additionally, the study sought to investigate whether a measure designed specifically to assess depression in men adds predictive utility over and above convention depression screeners. Participants were recruited from Amazon’s Mechanical Turk. A total of 1009 participants were recruited. Inclusion criteria were being 18 or older and being from the United States. Participants were excluded for taking the study survey multiple times, not completing the survey, or failing three or more attention checks. The final sample consisted of 944 participants who met inclusion and exclusion criteria. Depression was assessed with the Center for Epidemiological Studies Depression 11 (CES-D11), Patient Health Questionnaire-9 with item 9 excluded (PHQ-8), and Male Depression Risk Scale. Suicide risk was assessed using the Suicidal Behaviors Questionnaire-Revised. Physical health was assessed with a health conditions checklist. The sample comprised of primarily middle aged (M = 51.77), Caucasian (86.4%), females (53.3%) who were partnered (51.6%). Cognitive affective and somatic symptoms of the CES-D11 and PHQ-8 both added independent predictive utility in predicting suicide risk. The predictive utility of cognitive affective and somatic symptoms was not moderated by gender or health conditions. Age was found to moderate the relation between cognitive affective as well as somatic symptoms of depression and suicide risk. Younger age exacerbated the negative effect of both cognitive affective and somatic symptoms on suicide risk. The male depression screener predicted suicide risk over and above conventional depression screeners. This effect was moderated by gender with females demonstrating higher levels of risk as compared to their male counterparts with similar levels of male depression symptoms. Across the CES-D11 and PHQ-8, negative affect, psychomotor retardation, and sleep problems emerged as the individual depression symptoms that were significantly related to suicide risk. Taken together, findings indicate that both cognitive affective and somatic symptoms of depression are important suicide risk factors among males and females and those with many as well as few health problems. Cognitive affective and somatic symptoms pose a risk for suicide among younger and older adults although younger age seems to amplify the risk that depression symptoms convey. The symptoms of depression that convey the greatest risk overall were negative affect, psychomotor retardation, and sleep difficulties. Lastly, symptoms hypothesized to be a part of the male depression phenotype serve as risk factors for both men and women who endorse these atypical depression symptoms.

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