Durkheim’s Theory of Social Integration and Suicide Revisited

Objective: Poor social support is a robust predictor of suicidal thoughts and behaviors (STB). However, little is known about which components of social support (ie, diversity of social networks and perceived strength of social support) may play a protective role for STB.Methods: We analyzed data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions Wave III to examine whether diversity of social networks or perceived strength of social support was inversely associated with lifetime STB (ie, suicidal ideation and suicide attempts). Multivariable-adjusted analyses examined the independent association between components of social support and STB, while accounting for sociodemographic, clinical, and behavioral covariates.Results: Among adults with a history of suicide attempt, the majority reported low diversity/high perceived support (48.5%), followed by high diversity/high perceived support (36.0%). Similar patterns were found among adults with lifetime suicidal ideation. In multivariable-adjusted analyses, greater social network diversity was associated with a lower relative risk (RR) of suicidal ideation (RR = 0.83; 95% confidence interval [CI], 0.75-0.83) and attempt (RR = 0.79; 95% CI, 0.67-0.94). While greater perceived strength of social support was linked to a lower risk of suicide attempt (RR = 0.81; 95% CI, 0.68-0.97), such an association was not observed for ideation.Conclusions: Greater diversity of social networks was more strongly associated with lower risks of suicidal ideation and attempt than perceived strength of social support. Psychosocial interventions to enhance the diversity of social networks may be a source to mitigate risks for STB, but further research is warranted.