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The TBS was developed to expand the availability of valid measurement approaches for interpersonal suicide risk. It is a self-report instrument that measures the interpersonal risk factor of thwarted belongingness (i.e., feeling alone and lacking reciprocal relationships), as outlined by the Interpersonal Psychological Theory of Suicide (IPTS; Joiner, 2005; Van Orden et al., 2010). 

To develop the TBS, a 42-item pool underwent refinement via three consecutive stages: (1) expert feedback, (2) item selection study using a sample of community-dwelling Australian adults (Study 1, N = 284), and (3) validation study and test of IPTS predictions in a larger sample of community-dwelling Australian adults (Study 2, N = 747). 

The TBS was found to provide enhanced identification of thwarted belongingness in individuals with moderate to high levels of this interpersonal risk factor and be applicable for use in low literacy populations.

Thwarted Belongingness Scale

Please rate on the scale below, how you have been feeling recently about the following: 

1.     I feel isolated
2.     I don’t matter to other people
3.     Nobody cares about me
4.     I feel there is no one I can talk to
5.     I don’t fit in
6.     I don’t play an important role in other people’s lives
7.     I am not close to anyone
8.     I am alone in this world

Scoring

Total scores are calculated as the sum of the eight items (range 8-56).

Norms and psychometric properties

The TBS has been validated in an online survey of 747 community-based Australian adults (18+). The Flesch Kincaid Reading Ease grade for the TBS was 90.1 out of 100, with a US school grade level of 2.2 (easily understood by 8 to 9 year olds).    

Internal consistency: The TBS had high internal consistency (Cronbach alpha = 0.94).

Factor structure: Bi-factor exploratory and confirmatory factor analyses supported the uni-dimensionality of the TBS (Explained Common Variance = 0.87; Omega Hierarchical = 0.94; CFI = 0.98; TLI = 0.97). All eight items loaded on a single factor accounting for 73.93% of variance, with loadings of 0.81 or higher. 

Item Response Theory analysis indicated that the TBS captured approximately double the amount of information across moderate to high levels of thwarted belongingness compared to the Interpersonal Needs Questionnaire (INQ) Thwarted Belongingness Sub-scale.

Key references

Ma, J., Batterham, P. J., Calear, A. L., & Sunderland, M. (2019). The development and validation of the Thwarted Belongingness Scale (TBS) for interpersonal suicide risk. Journal of Psychopathology and Behavioral Assessment, 1-14. doi: 10.1007/s10862-019-09721-6

Contacts

Jennifer Ma (Lead developer); jennifer.ma@anu.edu.au

Phil Batterham (Co-developer); philip.batterham@anu.edu.au