The Three-Step Theory of Suicide: An Independent Replication and Conceptual Extension.

Objective Well-tested and validated theories of suicide can help professionals understand, predict, and prevent suicide. This article presents two studies testing the suicidal ideation components of the Three-Step Theory (3ST) of suicide and comparing it to the Interpersonal Theory of Suicide (ITS). We tested the 3ST's prediction that high levels of pain and hopelessness lead to suicidal ideation, which strengthens when pain and hopelessness outweigh connection to life. Method Study 1 (n = 204, mean age = 35, 56% female, 83% White) provides an independent, direct replication of the original analyses. Study 2 (n = 295, mean age = 25, 75% female, 68% White) presents the first conceptual extension of the 3ST using diverse measures of pain, hopelessness, and connection. In both studies, participants completed self-report questionnaires assessing the relevant variables. Results Both studies largely supported the first two steps of the 3ST, although adding connection to the model did not account for greater variability of suicidal ideation. The ITS accounted for comparable or greater amounts of variance in suicidal ideation than the 3ST. Conclusions Both the 3ST and the ITS have utility to explain suicidal ideation. Limitations and future directions are discussed.