(PS11-51) Exploring the Moderating Role of LGBTQ+ Identity and Borderline Personality Disorder Symptoms on the Relationship Between Perceived Burdensomeness and Suicidal Ideation

Suicide is particularly prevalent among individuals with borderline personality disorder (BPD). Research shows that up to 10% of individuals diagnosed with BPD die by suicide and up to 70% attempt suicide in their lifetime (Paris, 2019). Among individuals with BPD, interpersonal stressors can exacerbate emotion dysregulation, though it remains unclear how interpersonal stressors relate to suicidal crises among individuals with BPD (Kaurin et al., 2022). The Interpersonal Theory of Suicide (ITS) may help explain the relationship between interpersonal stressors and increased suicidal ideation (SI), as it posits that perceptions of burdening others and of social alienation increase suicidal desire (Joiner, 2005). Additionally, given the identity-related invalidation LGBTQ+ individuals may experience (Clark et al., 2022), coupled with the higher rates of suicide and BPD diagnoses among this population (Rodriquez-Seijas et al., 2021; Hatchel et al., 2019), the present study extends research on the ITS by investigating whether BPD symptoms moderate the relationship between perceived burdensomeness (PB) and severity of SI, and whether this association is stronger among LGBTQ+ participants. 

302 adults admitted to a psychiatric hospital completed the Columbia Suicide Severity Rating Scale (C-SSRS) to assess severity of past month SI, the Interpersonal Needs Questionnaire (INQ-18) to assess PB, and the McLean Screening Instrument for BPD (MSI-BPD) to assess BPD symptoms, as well as a demographics questionnaire to assess gender and sexual orientation. 

There was a significant correlation between severity of SI (highest score from items 1-5 on the C-SSRS) and both PB (r[302] = 0.601, p < .001) and BPD symptomology (r[302] = .496, p < .001). The correlation between PB and BPD symptomology (r[302] = .685, p < .001) was also significant. There was a significant interaction effect between BPD symptomology and PB on SI severity (β = -.006, t = -2.77, p = .006), indicating that BPD symptoms moderated the relationship between PB and SI. LGBTQ+ status did not significantly moderate the relationship between PB and BPD symptoms on SI severity (β = 0.008, t = 1.75, p = .081). However, the trend toward significance indicates potential moderation effects of LGBTQ+ status on the relationships between PB, BPD, and SI. 

Findings indicate that people with higher BPD symptomology who experience feelings of burdensomeness may be at even greater risk of experiencing more severe SI compared to people with lower BPD symptomology. This suggests that interventions focused on reducing feelings of burdensomeness in the context of BPD may help reduce suicide risk. Future research should continue to investigate how the relationship between these constructs differs for LGBTQ+ individuals in order to develop more targeted, relevant interventions that take into account both mental health symptoms and identity characteristics.