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Pratt D, Gooding P, Awenat Y, Eccles S, Tarrier N. Cognitive Behavioural Suicide Prevention for Male Prisoners: Case examples. COGNITIVE AND BEHAVIORAL PRACTICE 2016; 23:485-501. [PMID: 27713616 DOI: 10.1016/j.cbpra.2015.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to prevent suicide although cognitive behaviour therapies appear to offer some promise. Offering cognitive behaviour suicide prevention (CBSP) therapy to high risk prisoners may help to reduce the likelihood of preventable self-inflicted deaths. In this paper we present three cases drawn from a randomised controlled trial designed to investigate the feasibility of CBSP for male prisoners. Implications of the current findings for future research and clinical practice are considered.
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Affiliation(s)
- Daniel Pratt
- School of Psychological Sciences, University of Manchester, UK
| | | | - Yvonne Awenat
- School of Psychological Sciences, University of Manchester, UK
| | - Steve Eccles
- Manchester Mental Health and Social Care NHS Trust, UK
| | - Nicholas Tarrier
- Department of Psychology, Institute of Psychiatry, King's College London, UK
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Wartelsteiner F, Mizuno Y, Frajo-Apor B, Kemmler G, Pardeller S, Sondermann C, Welte A, Fleischhacker WW, Uchida H, Hofer A. Quality of life in stabilized patients with schizophrenia is mainly associated with resilience and self-esteem. Acta Psychiatr Scand 2016; 134:360-7. [PMID: 27497263 DOI: 10.1111/acps.12628] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Improving quality of life (QoL) is an important objective in the treatment of schizophrenia. The aim of the current study was to examine to what extent resilience, self-esteem, hopelessness, and psychopathology are correlated with QoL. METHOD We recruited 52 out-patients diagnosed with schizophrenia according to DSM-IV criteria and 77 healthy control subjects from the general community. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale. The following scales were used in both patients and control subjects: the Berliner Lebensqualitätsprofil, the Resilience Scale, the Rosenberg Self-Esteem Scale, and the Beck Hopelessness Scale to assess QoL, resilience, self-esteem, and hopelessness respectively. RESULTS Patients with schizophrenia presented with significantly less QoL, resilience, self-esteem, and hope compared to healthy control subjects. In patients, QoL correlated moderately with resilience, self-esteem, and hopelessness and weakly with symptoms. With respect to the latter, particularly depression and positive symptoms were negatively correlated with QoL. CONCLUSION Our results highlight the complex nature of QoL in patients suffering from schizophrenia. They underscore that significant efforts are necessary to enhance resilience and self-esteem and to diminish hopelessness as well as affective and positive symptoms in patients with schizophrenia.
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Affiliation(s)
- F Wartelsteiner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Y Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - B Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - S Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - C Sondermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - A Welte
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - W W Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - A Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria.
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Angelakis I, Gooding PA, Panagioti M. Suicidality in body dysmorphic disorder (BDD): A systematic review with meta-analysis. Clin Psychol Rev 2016; 49:55-66. [PMID: 27607741 DOI: 10.1016/j.cpr.2016.08.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 07/26/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022]
Abstract
Although a considerable number of studies have indicated that the rates of suicidal thoughts and behaviors in Body Dysmorphic Disorder (BDD) are high, no systematic review has been undertaken to explore the strength and patterns of the relationship between suicidality and BDD. This is the first systematic review and meta-analysis which aimed to examine the association between BDD and suicidality and the mechanisms underlying suicidality in BDD. Searches of five bibliographic databases including Medline, PsychINFO, Embase, Web of Science and CINAHL, were conducted from inception to June 2015. Seventeen studies were included in the review. Meta-analyses were performed using random effect models to account for the high levels of heterogeneity in the data. A positive and statistically significant association was found between BDD and suicidality (OR=3.63, 95% CI=2.62 to 4.63). Subgroup analyses showed that BDD was associated with increased odds for both, suicide attempts (OR=3.30, 95% CI=2.18 to 4.43) and suicidal ideation (OR=2.57, 95% CI=1.44 to 3.69). The evidence concerning suicide deaths in BDD was scarce. BDD-specific factors and comorbid diagnoses of Axis I disorders were likely to worsen suicidality in BDD. However, the modest number, and the low methodological quality, of the studies included in this review suggest caution the interpretation of these findings.
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Affiliation(s)
| | | | - Maria Panagioti
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, UK.
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Mizuno Y, Hofer A, Suzuki T, Frajo-Apor B, Wartelsteiner F, Kemmler G, Saruta J, Tsukinoki K, Mimura M, Fleischhacker WW, Uchida H. Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study. Schizophr Res 2016; 175:148-153. [PMID: 27185483 DOI: 10.1016/j.schres.2016.04.047] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 04/29/2016] [Accepted: 04/29/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The concept of resilience is relevant in understanding the heterogeneous outcomes noted in schizophrenia and bipolar disorder. However, clinical and biological correlates of resilience in these populations have rarely been investigated. We aimed to identify key correlates of subjective resilience in such patients using comprehensive assessments and to explore associations between resilience levels and peripheral biomarkers. METHOD 180 subjects with DSM-IV schizophrenia, bipolar disorder, and healthy controls (60 per group) were included. Demographic and clinical variables were assessed by means of interview and various psychometric scales. Furthermore, blood and saliva samples were obtained for the assessment of brain-derived neurotrophic factor, adrenocorticotropic hormone, cortisol, high sensitivity C-reactive protein, and alpha-amylase levels. Cross-sectional associations with resilience, as assessed by the 25-item Resilience Scale were sought. RESULTS Resilience Scale total scores were significantly higher in healthy individuals (130.1, 95% confidence intervals (CI): 124.8-135.4) compared to subjects with schizophrenia (109.9, 95% CI: 104.6-115.2, p<0.001) and bipolar disorder (119.0, 95% CI: 113.8-124.3, p=0.012), while the difference between patient groups was non-significant (p=0.055). Self-esteem, spirituality, quality of life, and hopelessness were correlated with resilience in all three groups. In addition, internalized stigma and depression were relevant factors in the schizophrenia and bipolar disorder group, respectively. Correlations between resilience levels and peripheral biomarkers did not reach significance. CONCLUSION Although causal relationships must be confirmed in prospective studies, our results have implications in developing psychological interventions to enhance resilience in patients with schizophrenia and bipolar disorder. The biological correlates of resilience in these populations warrant further investigations.
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Affiliation(s)
- Yuya Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Alex Hofer
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Takefumi Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Department of Psychiatry, Inokashira Hospital, Tokyo, Japan
| | - Beatrice Frajo-Apor
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Fabienne Wartelsteiner
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Georg Kemmler
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Juri Saruta
- Division of Environmental Pathology, Department of Oral Science, Kanagawa Dental University Graduate School of Dentistry, Kanagawa, Japan
| | - Keiichi Tsukinoki
- Division of Environmental Pathology, Department of Oral Science, Kanagawa Dental University Graduate School of Dentistry, Kanagawa, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Abstract
This study focused on resilience in patients who recently received a diagnosis of schizophrenia spectrum disorder (SSD). Psychopathological symptoms, depressive symptoms, and hopelessness were considered as sources of stress in the context of psychosis. Forty-eight SSD patients (mean period between diagnosis and recruitment, 20.79 months) were enrolled. Psychopathological symptoms were assessed by the Positive and Negative Syndrome Scale, depression by the Calgary Depression Scale for Schizophrenia, hopelessness by the Beck Hopelessness Scale, and functioning by the Social and Occupational Functioning Scale. Resilience was evaluated by the Connor-Davidson Resilience Scale, which was additionally completed by 81 healthy controls. Patients demonstrated less resilience than did healthy participants. Female patients showed higher resilience levels and functioning than did males. High resilience levels were associated with less severe positive symptoms, general psychopathological symptoms, depression, and hopelessness. Apart from negative symptoms, results indicated that resilience may be a potential moderator of functioning. Thus, resilience-oriented interventions might constitute an additional therapeutic approach for SSD patients.
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Nagra GS, Lin A, Upthegrove R. What bridges the gap between self-harm and suicidality? The role of forgiveness, resilience and attachment. Psychiatry Res 2016; 241:78-82. [PMID: 27156028 DOI: 10.1016/j.psychres.2016.04.103] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/08/2016] [Accepted: 04/29/2016] [Indexed: 12/20/2022]
Abstract
Self-harm is the most robust risk for completed suicide. There is a lack of understanding of why some people who self-harm escalate to suicidal behaviour when others do not. Psychological factors such as attachment, self-forgiveness and self-appraisal may be important. To determine whether factors from the Interpersonal Theory and Schematic Appraisals models are useful to identify suicidal behaviour in populations that self-harm. Specifically we investigate whether resilience factors of secure attachment, self-forgiveness and positive self-appraisals significantly influence suicidality in people who self-harm. A cross-sectional online study of 323 participants recruited from self-harm support forum. Validated self-report measures were used to assess appraisals, relationships, self-forgiveness, attachment style, suicidality and self-harm. Emotion coping and support seeking self-appraisals and self-forgiveness were negatively associated with suicidality in participants with a history of self-harm. Dismissing attachment was positively associated with suicidality. The perceived ability to cope with emotions, the perceived ability to gain support and self-forgiveness may protect against suicide in people who self-harm. Conversely the presence of dismissing attachment may increase the risk of suicidality. Findings provide therapeutic targets to reduce risk of suicidality in this high risk group.
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Affiliation(s)
- Gurmokh S Nagra
- University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom
| | - Ashleigh Lin
- University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom; Telethon Kids Institute, The University of Western Australia, 6008 PO Box 855, West Perth 6872, Australia
| | - Rachel Upthegrove
- University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom; Birmingham and Solihull Mental Health NHS Foundation Trust, 50 Summer Hill Road, Birmingham B1 3RB, United Kingdom.
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Morrison AP, Law H, Barrowclough C, Bentall RP, Haddock G, Jones SH, Kilbride M, Pitt E, Shryane N, Tarrier N, Welford M, Dunn G. Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this.ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users.MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme.ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total;p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78;p < 0.006).ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Anthony P Morrison
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Heather Law
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | | | - Richard P Bentall
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Gillian Haddock
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Steven H Jones
- The Spectrum Centre for Mental Health Research, University of Lancaster, Lancaster, UK
| | - Martina Kilbride
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Elizabeth Pitt
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Nicholas Shryane
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Nicholas Tarrier
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Mary Welford
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Graham Dunn
- Centre for Biostatistics, University of Manchester, Manchester, UK
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Hofer A, Mizuno Y, Frajo-Apor B, Kemmler G, Suzuki T, Pardeller S, Welte AS, Sondermann C, Mimura M, Wartelsteiner F, Fleischhacker WW, Uchida H. Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan. Schizophr Res 2016; 171:86-91. [PMID: 26805413 DOI: 10.1016/j.schres.2016.01.027] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 12/27/2015] [Accepted: 01/14/2016] [Indexed: 11/26/2022]
Abstract
Resilience is becoming an important topic in people with schizophrenia since there is evidence that it increases the probability for long-term recovery. The current study investigated transcultural differences in resilience across schizophrenia patients from two different geographical regions, Austria and Japan. Another objective was to examine transcultural differences in internalized stigma, self-esteem, and hopelessness, which can be expected to be relevant in this context, as well as the interrelations between these subjective elements of recovery and symptom severity. To this end, patients from outpatient mental health services in Innsbruck, Austria (N=52) and Tokyo, Japan (N=60) as well as 137 healthy comparison subjects from both countries were included into this cross-sectional study. Notably, we detected a significant country effect with markedly lower resilience (F=74.4, p<0.001) and self-esteem scores (F=226.0, p<0.001) as well as higher hopelessness scores (F=37.4, p<0.001) among Japanese subjects in general. In addition, both Austrian and Japanese patients indicated significantly lower degrees of resilience (F=57.5, p<0.001), self-esteem (F=51.8, p<0.001), and hope (F=29.5, p<0.001) compared to healthy control subjects. The inter-correlations between subjective elements of recovery were comparable in size in the two patient samples, but the inter-correlations between these issues and residual symptoms of schizophrenia as objective domains of recovery were markedly higher in Austrian subjects. This suggests that schizophrenia patients from Western European and Japanese cultures may have different needs to achieve recovery. In conclusion, it will be critical to develop culture-specific psychosocial programs and to examine their feasibility and effectiveness among these patients.
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Affiliation(s)
- Alex Hofer
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria.
| | - Yuya Mizuno
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Beatrice Frajo-Apor
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Georg Kemmler
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Takefumi Suzuki
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Silvia Pardeller
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Anna-Sophia Welte
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Catherine Sondermann
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Masaru Mimura
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - Fabienne Wartelsteiner
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - W Wolfgang Fleischhacker
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, and Psychosomatics, Innsbruck, Austria
| | - Hiroyuki Uchida
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
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Liu DWY, Fairweather-Schmidt AK, Burns R, Roberts RM, Anstey KJ. Psychological Resilience Provides No Independent Protection From Suicidal Risk. CRISIS 2016; 37:130-9. [DOI: 10.1027/0227-5910/a000364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.
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Affiliation(s)
- Danica W. Y. Liu
- School of Psychology, The University of Adelaide, SA, Australia
- School of Management, University of South Australia, Adelaide, SA, Australia
| | | | - Richard Burns
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
| | | | - Kaarin J. Anstey
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
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Johnson J, Wood AM. Integrating Positive and Clinical Psychology: Viewing Human Functioning as Continua from Positive to Negative Can Benefit Clinical Assessment, Interventions and Understandings of Resilience. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9728-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Owen R, Gooding P, Dempsey R, Jones S. A qualitative investigation into the relationships between social factors and suicidal thoughts and acts experienced by people with a bipolar disorder diagnosis. J Affect Disord 2015; 176:133-40. [PMID: 25706607 DOI: 10.1016/j.jad.2015.02.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence rate of completed suicide in bipolar disorder is estimated to be as high as 19%. Social factors or influences, such as stigmatisation and family conflict, contribute to the development of suicidal ideation in clinical and non-clinical populations. Yet, there is a lack of studies examining suicidality from a psychosocial perspective in people who experience bipolar disorder. METHOD Semi-structured interviews were used to collect qualitative data from 20 participants with bipolar disorder. The interview focused on the effects of social factors upon participants׳ experiences of suicidality (suicidal thoughts, feelings or behaviours). A thematic analysis was used to understand the data. RESULTS Social or interpersonal factors which participants identified as protective against suicidality included, 'the impact of suicide on others' and, 'reflecting on positive social experiences'. Social factors which triggered suicidal thoughts included, 'negative social experiences' and, 'not being understood or acknowledged'. Social factors which worsened suicidal thoughts or facilitated suicidal behaviour were, 'feeling burdensome,' and 'reinforcing negative self-appraisals'. LIMITATIONS Some participants had not experienced suicidal thoughts for many years and were recalling experiences which had taken place over ten years ago. The accuracy and reliability of these memories must therefore be taken into consideration when interpreting the results. CONCLUSIONS The themes help to enhance current understanding of the ways in which social factors affect suicidality in people who experience bipolar disorder. These results highlight the importance of considering the social context in which suicidality is experienced and incorporating strategies to buffer against the effects of negative social experiences in psychological interventions which target suicide risk in bipolar disorder.
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Affiliation(s)
- Rebecca Owen
- School of Psychological Sciences, University of Manchester, UK.
| | | | - Robert Dempsey
- Centre for Health Psychology, Staffordshire University, UK
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Lancaster University, UK
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Min JA, Lee CU, Chae JH. Resilience moderates the risk of depression and anxiety symptoms on suicidal ideation in patients with depression and/or anxiety disorders. Compr Psychiatry 2015; 56:103-11. [PMID: 25248467 DOI: 10.1016/j.comppsych.2014.07.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 07/25/2014] [Accepted: 07/29/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Few studies have investigated the role of protective factors for suicidal ideation, which include resilience and social support among psychiatric patients with depression and/or anxiety disorders who are at increased risk of suicide. METHODS Demographic data, history of childhood maltreatment, and levels of depression, anxiety, problematic alcohol use, resilience, perceived social support, and current suicidal ideation were collected from a total of 436 patients diagnosed with depression and/or anxiety disorders. Hierarchical multiple logistic regression analyses were used to identify the independent and interaction effects of potentially influencing factors. RESULTS Moderate-severe suicidal ideation was reported in 24.5% of our sample. After controlling for relevant covariates, history of emotional neglect and sexual abuse, low resilience, and high depression and anxiety symptoms were sequentially included in the model. In the final model, high depression (adjusted odds ratio (OR)=9.33, confidence interval (CI) 3.99-21.77) and anxiety (adjusted OR=2.62, CI=1.24-5.53) were independently associated with moderate-severe suicidal ideation among risk factors whereas resilience was not. In the multiple logistic regression model that examined interaction effects between risk and protective factors, the interactions between resilience and depression (p<.001) and between resilience and anxiety were significant (p=.021). A higher level of resilience was protective against moderate-severe suicide ideation among those with higher levels of depression or anxiety symptoms. CONCLUSIONS Our results indicate that resilience potentially moderates the risk of depression and anxiety symptoms on suicidal ideation in patients with depression and/or anxiety disorders. Assessment of resilience and intervention focused on resilience enhancement is suggested for suicide prevention.
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Affiliation(s)
- Jung-Ah Min
- Health Promotion Center, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Chang-Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
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Abdollahi A, Abu Talib M. Hardiness, spirituality, and suicidal ideation among individuals with substance abuse: the moderating role of gender and marital status. J Dual Diagn 2015; 11:12-21. [PMID: 25415536 DOI: 10.1080/15504263.2014.988558] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Substance abuse is a serious and major public health problem in Iran and potentially increases the risk of suicidal behavior; therefore, it is essential to increase our knowledge concerning the etiology of suicide among individuals with substance use disorders. The present study sought to examine the associations among hardiness, spirituality, and suicidal ideation in Iranian individuals with substance abuse. METHODS This cross-sectional study was conducted in 2012, and participants comprised 450 individuals seeking substance abuse treatment at 10 addiction treatment centers in Tehran, Iran. All data were collected via self-report questionnaires. RESULTS Sixty-seven percent of participants were male, 47% were married, and 59% were working. Structural equation modeling (SEM) suggested that, as expected, spirituality and hardiness were positively associated with each other. Findings also showed that spirituality and hardiness were negatively associated with suicidal ideation among this group of individuals with substance abuse, explaining 46% of the variance in suicidal ideation. That is, those with low levels of spirituality and low levels of hardiness were more likely to report suicidal ideation. There was a moderating effect of gender, such that greater hardiness predicted a lower likelihood of suicidal ideation for males but not for females. CONCLUSIONS These findings reinforce the importance of spirituality and hardiness as protective factors against suicidal ideation in individuals with substance abuse, as well as the particular role of hardiness for men.
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Liu DWY, Fairweather-Schmidt AK, Burns RA, Roberts RM. The Connor-Davidson Resilience Scale: Establishing Invariance Between Gender Across the Lifespan in a Large Community Based Study. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9452-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abdollahi A, Abu Talib M, Yaacob SN, Ismail Z. The Role of Hardiness in Decreasing Stress and Suicidal Ideation in a Sample of Undergraduate Students. JOURNAL OF HUMANISTIC PSYCHOLOGY 2014. [DOI: 10.1177/0022167814543952] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Suicide is a serious and growing public health problem, and it remains a serious cause of death in the world; therefore, it is essential to increase our knowledge concerning the etiology of suicide among undergraduate students. Previous studies have shown that perceived stress increases vulnerability to suicidal ideation. However, factors that may explain the association have not been studied empirically. A cross-sectional study was conducted to examine hardiness as a potential mediator between perceived stress and suicidal ideation among undergraduate students. The participants comprised 500 undergraduate students from Malaysian public universities. They completed the Personal Views Survey, Beck Scale for Suicidal Ideation, and the Perceived Stress Scale. Structural equation modeling estimated that undergraduate students with low levels of hardiness were more likely to report suicidal ideation. As expected, hardiness partially mediated between perceived stress and suicidal ideation. Our findings demonstrated that lower hardiness and greater perceived stress significantly predicted suicidal ideation among undergraduate students. These findings reinforce the importance of hardiness as a protective and predictive factor against perceived stress and suicidal ideation among undergraduate students.
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Affiliation(s)
- Abbas Abdollahi
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Mansor Abu Talib
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Siti Nor Yaacob
- Family, Adolescent and Child Research Center of Excellent (FACE), Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zanariah Ismail
- Faculty of Human Ecology, Universiti Putra Malaysia, Selangor, Malaysia
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O'Donoghue B, Lyne JP, Fanning F, Kinsella A, Lane A, Turner N, O'Callaghan E, Clarke M. Social class mobility in first episode psychosis and the association with depression, hopelessness and suicidality. Schizophr Res 2014; 157:8-11. [PMID: 24924403 DOI: 10.1016/j.schres.2014.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/01/2014] [Accepted: 05/18/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Psychotic disorders are associated with a significant impairment in occupational functioning that can begin in the prodromal phase of the disorder. As a result, individuals with a psychotic disorder may not maintain their social class at birth. The aim of this study was to examine the distribution of the social classes of individuals presenting with a first episode of psychosis (FEP) compared to the general population and to their family of origin. We evaluated whether social drift was associated with depression, hopelessness and suicidality at first presentation. METHODS All individuals with a FEP presenting to a community mental health service between 1995 and 1999 and to an early intervention service between 2005 and 2011were included. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses and clinical evaluations included the Calgary Depression Scale for Schizophrenia, Beck Hopelessness Scale and the Suicidal Intent Scale. RESULTS 330 individuals were included in the study and by the time of presentation, individuals with a FEP were more likely to be represented in the lower social classes compared to the general population. 43% experienced a social drift and this was associated with a diagnosis of a non-affective disorder, co-morbid cannabis abuse and a longer DUP. Individuals who did not experience a social drift had a higher risk of hopelessness. CONCLUSIONS Social drift is common in psychotic disorders; however, individuals who either maintain their social class or experience upward social class mobility are more susceptible to hopelessness.
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Affiliation(s)
- Brian O'Donoghue
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - John P Lyne
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Felicity Fanning
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Anthony Kinsella
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; Department of Psychiatry, Royal College of Surgeons, 123 St Stephen's Green, Dublin 2, Ireland.
| | - Abbie Lane
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Niall Turner
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Eadbhard O'Callaghan
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland
| | - Mary Clarke
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; St John of God Hospitaller Services, Stillorgan, Co Dublin, Ireland.
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Tarrier N, Kelly J, Maqsood S, Snelson N, Maxwell J, Law H, Dunn G, Gooding P. The cognitive behavioural prevention of suicide in psychosis: a clinical trial. Schizophr Res 2014; 156:204-10. [PMID: 24853059 DOI: 10.1016/j.schres.2014.04.029] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Suicide behaviour in psychosis is a significant clinical and social problem. There is a dearth of evidence for psychological interventions designed to reduce suicide risk in this population. AIMS To evaluate a novel, manualised, cognitive behavioural treatment protocol (CBSPp) based upon an empirically validated theoretical model. METHODS A randomly controlled trial with independent and masked allocated and assessment of CBSPp with TAU (n=25, 24 sessions) compared to TAU alone (n=24) using standardised assessments. Measures of suicide probability, and suicidal ideation were the primary outcomes and measures of hopelessness, depression, psychotic symptoms, functioning, and self-esteem were the secondary outcomes, assessed at 4 and 6 months follow-up. RESULTS The CBSPp group improved differentially to the TAU group on two out of three primary outcome measures of suicidal ideation and suicide probability, and on secondary outcomes of hopelessness related to suicide probability, depression, some psychotic symptoms and self-esteem. CONCLUSIONS CBSPp is a feasible intervention which has the potential to reduce proxy measures of suicide in psychotic patients.
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Affiliation(s)
| | - James Kelly
- Greater Manchester West Mental Health NHS Foundation Trust, UK
| | - Sehar Maqsood
- Greater Manchester West Mental Health NHS Foundation Trust, UK
| | - Natasha Snelson
- Greater Manchester West Mental Health NHS Foundation Trust, UK
| | - Janet Maxwell
- Faculty of Human and Medical Sciences, University of Manchester, UK
| | - Heather Law
- Greater Manchester West Mental Health NHS Foundation Trust, UK
| | - Graham Dunn
- Faculty of Human and Medical Sciences, University of Manchester, UK
| | - Patricia Gooding
- Faculty of Human and Medical Sciences, University of Manchester, UK
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Stratta P, Capanna C, Carmassi C, Patriarca S, Di Emidio G, Riccardi I, Collazzoni A, Dell'Osso L, Rossi A. The adolescent emotional coping after an earthquake: a risk factor for suicidal ideation. J Adolesc 2014; 37:605-11. [PMID: 24931563 DOI: 10.1016/j.adolescence.2014.03.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 03/18/2014] [Accepted: 03/29/2014] [Indexed: 10/25/2022]
Abstract
The study aims to investigate the relationship of suicidal ideation with coping and resilience in a sample of adolescents who survived an earthquake. Three hundred forty-three adolescents who had experienced the L'Aquila earthquake were investigated for a screening distinguishing Suicidal Screen-Negative (SSN) from the Positive (SSP) subjects. Resilience Scale for Adolescents (READ) and Brief Cope were administered. Emotion-focused coping score was significantly higher in SSP subjects. In the SSN but not in the SSP sample the READ total score correlated with problem-focused total score. A positive correlation was seen between emotion-focused and problem-focused scores in both samples, with a higher coefficient in SSP sample. Externalising problems and maladaptive behaviours can arise in adolescents exposed to traumatic events. Attention should be paid in reducing risk factors and in the development of psychological abilities, improving the coping strategies that can protect from emotional despair and suicidal ideation.
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Affiliation(s)
- Paolo Stratta
- Mental Health Center, Department of Mental Health, ASL 1, L'Aquila, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Cristina Capanna
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Patriarca
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Gabriella Di Emidio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ilaria Riccardi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Collazzoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Gooding PA, Sheehy K, Tarrier N. Perceived stops to suicidal thoughts, plans, and actions in persons experiencing psychosis. CRISIS 2014; 34:273-81. [PMID: 23608231 DOI: 10.1027/0227-5910/a000194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Suicide has been conceived as involving a continuum, whereby suicidal plans and acts emerge from thoughts about suicide. Suicide prevention strategies need to determine whether different responses are needed at these points on the continuum. AIMS This study investigates factors that were perceived to counter suicidal ideation, plans, and acts. METHOD The 36 participants, all of whom had had experiences of psychosis and some level of suicidality, were presented with a vignette describing a protagonist with psychotic symptoms. They were asked to indicate what would counter the suicidal thoughts, plans, and acts of the protagonist described in the vignette. Qualitative techniques were first used to code these free responses into themes/categories. Correspondence analysis was then applied to the frequency of responses in each of these categories. RESULTS Social support was identified as a strong counter to suicidal ideation but not as a counter to suicidal plans or acts. Help from health professionals was strongly related to the cessation of suicidal plans as were the opinions of the protagonist's children. Changing cognitions and strengthening psychological resources were more weakly associated with the cessation of suicidal ideation and plans. The protagonist's children were considered potentially helpful in addressing suicidal acts. CONCLUSION These results suggest that both overlapping and nonoverlapping factors need to be considered in understanding suicide prevention, dependent on whether individuals are thinking about, planning, or attempting suicide.
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Affiliation(s)
- P A Gooding
- School of Psychological Sciences, University of Manchester, UK.
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A model of suicidal behavior in posttraumatic stress disorder (PTSD): the mediating role of defeat and entrapment. Psychiatry Res 2013; 209:55-9. [PMID: 23541244 DOI: 10.1016/j.psychres.2013.02.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 11/19/2012] [Accepted: 02/14/2013] [Indexed: 11/22/2022]
Abstract
The aim of this study was to examine whether depression, hopelessness and perceptions of defeat and entrapment mediated the effects of posttraumatic stress disorder (PTSD) symptoms on suicidal behavior. Participants were 73 individuals (mean age=29.2, S.D.=10.9, 79.5% female) diagnosed with current or lifetime PTSD who reported at least one PTSD symptom in the past month. Participants completed a series of self-report measures assessing depression, hopelessness and perceptions of defeat and entrapment. The Clinician Administrated Posttraumatic Scale for DSM-IV was administered to assess the presence and severity of PTSD symptoms. The results of Structural Equation Modeling supported a model whereby perceptions of defeat and entrapment fully mediated the effects of PTSD symptom severity upon suicidal behavior. The finding that perceptions of defeat and entrapment mediate the relationship between PTSD symptom severity and suicidal behavior was replicated in a subgroup of participants (n=50) who met the full criteria for a current PTSD diagnosis. The results support a recent theoretical model of suicide (The Schematic Appraisal Model of Suicide) which argues that perceptions of defeat and entrapment have a key role in the development of suicidal behaviors. We discuss the clinical implications of the findings.
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71
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Kumar MB, Walls M, Janz T, Hutchinson P, Turner T, Graham C. Suicidal ideation among Métis adult men and women--associated risk and protective factors: findings from a nationally representative survey. Int J Circumpolar Health 2012; 71:18829. [PMID: 22901287 PMCID: PMC3417687 DOI: 10.3402/ijch.v71i0.18829] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 06/28/2012] [Accepted: 07/02/2012] [Indexed: 11/14/2022] Open
Abstract
Objective To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Study design Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.
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Affiliation(s)
- Mohan B Kumar
- Métis Centre, National Aboriginal Health Organization, Ottawa, ON, Canada.
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Hopelessness, defeat, and entrapment in posttraumatic stress disorder: their association with suicidal behavior and severity of depression. J Nerv Ment Dis 2012; 200:676-83. [PMID: 22850302 DOI: 10.1097/nmd.0b013e3182613f91] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research has shown an increased frequency of suicidal behaviors in those with PTSD, but few studies have investigated the factors that underlie the emergence of suicidal behavior in PTSD. Two theories of suicide, the Cry of Pain and the Schematic Appraisal Model of Suicide, propose that feelings of hopelessness, defeat, and entrapment are core components of suicidality. This study aimed to examine the association between suicidal behavior and hopelessness, defeat, and entrapment in trauma victims with and without a PTSD diagnosis. The results demonstrated that hopelessness, defeat, and entrapment were significantly positively associated with suicidal behavior in those with PTSD. Hopelessness and defeat were also significantly positively associated with suicidal behavior in trauma victims without PTSD. In those with PTSD, the relationship between suicidal behavior and hopelessness and entrapment remained significant after controlling for comorbid depression. The findings provide support for the contemporary theories of suicidality and have important clinical implications.
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73
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Kelly J, Gooding P, Pratt D, Ainsworth J, Welford M, Tarrier N. Intelligent real-time therapy: Harnessing the power of machine learning to optimise the delivery of momentary cognitive–behavioural interventions. J Ment Health 2012; 21:404-14. [DOI: 10.3109/09638237.2011.638001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Johnson J, Wood AM, Gooding P, Taylor PJ, Tarrier N. Resilience to suicidality: the buffering hypothesis. Clin Psychol Rev 2011; 31:563-91. [PMID: 21276646 DOI: 10.1016/j.cpr.2010.12.007] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/19/2010] [Accepted: 12/21/2010] [Indexed: 11/30/2022]
Abstract
Recent years have seen a growing interest into resilience to suicidality, which has been described as a perception or set of beliefs which buffer individuals from suicidality in the face of stressors. The current review extends this research by introducing the buffering hypothesis, a framework for the investigation of resilience to suicidality. The key proposal of this is that psychological resilience factors should be viewed as existing on a separate dimension to risk which acts to moderate the impact of risk on suicidality. Furthermore, like risk factors, resilience factors are bipolar, with their positive pole conferring resilience and their negative pole acting to amplify suicidality. Seventy-seven studies were identified which investigated (a) whether psychological moderators of risk exist and (b) the particular psychological constructs which may act as moderators. The review found strong support for the existence of psychological moderators and indicated a moderating impact of attributional style, perfectionism, agency and hopelessness. These findings support the buffering hypothesis and suggest that a range of psychological factors may confer resilience to suicidality. These results suggest that the identification of moderators may improve estimates of suicide risk and that the development of buffering factors could be a key focus of suicide interventions.
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Affiliation(s)
- Judith Johnson
- School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, UK.
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Wood AM, Tarrier N. Positive Clinical Psychology: a new vision and strategy for integrated research and practice. Clin Psychol Rev 2010; 30:819-29. [PMID: 20655136 DOI: 10.1016/j.cpr.2010.06.003] [Citation(s) in RCA: 186] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This review argues for the development of a Positive Clinical Psychology, which has an integrated and equally weighted focus on both positive and negative functioning in all areas of research and practice. Positive characteristics (such as gratitude, flexibility, and positive emotions) can uniquely predict disorder beyond the predictive power of the presence of negative characteristics, and buffer the impact of negative life events, potentially preventing the development of disorder. Increased study of these characteristics can rapidly expand the knowledge base of clinical psychology and utilize the promising new interventions to treat disorder through promoting the positive. Further, positive and negative characteristics cannot logically be studied or changed in isolation as (a) they interact to predict clinical outcomes, (b) characteristics are neither "positive" or "negative", with outcomes depending on specific situation and concomitant goals and motivations, and (c) positive and negative well-being often exist on the same continuum. Responding to criticisms of the Positive Psychology movement, we do not suggest the study of positive functioning as a separate field of clinical psychology, but rather that clinical psychology itself changes to become a more integrative discipline. An agenda for research and practice is proposed including reconceptualizing well-being, forming stronger collaborations with allied disciplines, rigorously evaluating the new positive interventions, and considering a role for clinical psychologists in promoting well-being as well as treating distress.
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Affiliation(s)
- Alex M Wood
- School of Psychological Sciences, Oxford Road, University of Manchester, Manchester, M13 9PL, UK.
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