Title: Theory Use In Research on Intimate Partner Violence and Suicide: A Systematic Review and Narrative Synthesis

Background and Purpose: The literature has consistently demonstrated an association between intimate partner violence (IPV) victimization and suicide. However, the application of theory in empirical research to explain this relationship has yet to be examined, limiting our understanding of underlying mechanisms and their implications for intervention and prevention. Thus, we conducted a systematic review and narrative synthesis to address the following research questions: 1) what is the level of theory application among empirical studies examining IPV and suicide?; 2) among studies that use theory, which theories and their tenets are applied and how?; and 3) what are the strengths and limitations of theory use in the IPV-suicide literature?

Methods: Using PRISMA guidelines, six databases (i.e., Academic Search Ultimate, PubMed, Medline, PsycINFO, CINAHL, SocINDEX) were searched from inception to March 2025, then sorted and screened using Covidence. Search terms targeted three domains: (1) IPV (e.g., IPV, domestic violence, dating violence, coercive control), (2) suicide (e.g., ideation, planning, attempt), and (3) theory (e.g., framework, model, theoretical). Titles and abstracts were screened for eligibility (i.e., articles contained constructs relevant to IPV and suicide). Eligible articles underwent full-text review to determine inclusion (i.e., articles focused on IPV/suicide relationship and included theory). Included articles were coded to assess the extent to which theory was used to inform their framing, design, methods, or interpretation of findings related to the IPV-suicide relationship. Initial screening, full review, and theory evaluation were conducted independently by at least two researchers; conflicts were resolved via consensus.

Results: Our search yielded 1,853 records, of which 164 were screened in and thus fully reviewed. Of the 164 fully reviewed, 112 articles accurately measured the variables of interest (i.e., IPV victimization and suicide); however, only 47% (n=53) incorporated a theoretical framework and met full inclusion for narrative synthesis. In evaluating the use of theory in included articles, we found that 24% (n=13) integrated theory to conceptualize the relationship between IPV and suicide, inform study design (e.g., constructs under measure), and explain findings. The same amount (n=13) used theory to link IPV and suicide while also guiding select aspects of their study (e.g., variables, design, etc.) but did not include theory in contextualizing their findings. Forty percent (n=21) of articles briefly mentioned theory to explain the link between IPV and suicide but did not use it to inform their investigation or understand findings. Finally, 13% (n=7) applied theories unrelated to the IPV-suicide relationship.

Conclusions and Implications: The relationship between IPV and suicide is a complex, multifaceted phenomenon. Overall, we found that theory application was inconsistent and superficial, often focused on justifying specific study elements rather than explaining the connection between IPV and suicide. Our findings underscore the need for more comprehensive theoretical applications that integrate sociological, interpersonal, and individual mechanisms to understand and address suicide risk in this population. Finally, future research that attempts to elucidate the mechanisms contributing to IPV and suicide should incorporate theory-driven designs to enhance translation into practice by identifying risk factors that could inform clinical interventions.