Conclusions

This chapter has described elements of a cognitive intervention for depressed individuals with suicidal behavior. As indicated earlier, suicide among individuals with depression is a major public health problem. Individuals with MDD are at an increased risk for suicidal behavior, especially during the early years within the course of their illness. Our recommendation is that suicidal behavior itself is indicative of poor problem solving and needs to be targeted directly during treatment. The brief cognitive intervention described here has been examined empirically and found to be effective in preventing future suicidal behavior. Mental health providers who work with depressed individuals who engage in suicidal behavior are encouraged to utilize the information presented here to help patients in the development and maintenance of adaptive coping strategies, so that suicidal behavior is no longer the only available option that they consider.

ACKNOWLEDGMENTS

We acknowledge the research assistance of Kathryn Lou, Brian Dearnley, and Daniella Sosdjan. Our thanks to Amy Wenzel for her review of the manuscript. Preparation of this manuscript was supported by grants from the National Institute of Mental Health (Nos. R01 MH067805 and P20 MH072905915) and the Centers for Disease Control and Prevention (No. R49 CCR321714).

REFERENCES

American Psychiatric Association. (2003). Practice guidelines for the assessment and treatment of patients with suicidal behaviors. Arlington, VA: Author. Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian. Beck, A. T. (1996). Beyond belief: A theory of modes, personality, and psychopathol-ogy. In M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 1—25). New York: Guilford Press.

Beck, A. T., Brown, G., Berchick, R. J., Stewart, B. L., & Steer, R. A. (1990). Relationship between hopelessness and ultimate suicide: A replication with psychiatric outpatients. American Journal of Psychiatry, 147, 190—195. Beck, A. T., Brown, G. K., Steer, R. A., Dahlsgaard, K. K., & Grisham, J. R. (1999). Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients. Suicide and Life-Threatening Behavior, 29, 1—9. Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47, 343-352.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression.

New York: Guilford Press. Beck, A. T., & Steer, R. A. (1988). Manual for the Beck Hopelessness Scale. San Antonio,

TX: Psychological Corporation. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory (2nd ed.). San Antonio, TX: Psychological Corporation. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press. Berk, M. S., Henriques, G. R., Warman, D., Brown, G. K., & Beck, A. T. (2004). A cognitive therapy intervention for suicide attempters: Overview of the treatment and case examples. Cognitive and Behavioral Practice, 11, 265-277. Blair-West, G. W, Cantor, C. H., Mellsop, G. W, & Eyeson-Annan, M. L. (1999). Lifetime suicide risk in major depression: Sex and age determinants. Journal of Affective Disorders, 55, 171-178.

Borg, S. E., & Stahl, M. (1982). A prospective study of suicides and controls among psychiatric patients. Acta Psychiatrica Scandinavica, 65, 221-232.

Brown, G. K. (2002). A review of suicide assessment measures for intervention research in adults and older adults. National Institute of Mental Health, Suicide Research Consortium (www.nimh.nih.gov/suicideresearch/adultsuicide.pdf).

Brown, G. K., Beck, A. T., Steer, R. A., & Grisham,J. R. (2000). Risk factors for suicide in psychiatric outpatients: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68, 371-377.

Brown, G. K., Henriques, G. R., Ratto, C., & Beck, A. T. (2002). Cognitive therapy treatment manual for suicide attempters. Philadelphia: University of Pennsylvania, unpublished manuscript.

Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander,J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. Journal of the American Medical Association, 294, 563-570.

Cole, T. B., & Glass, R. M. (2005). Mental illness and violent death: Major issues for public health. Journal of the American Medical Association, 294, 623-624.

Dahlsgaard, K. K., Beck, A. T., & Brown, G. K. (1998). Inadequate response to therapy as a predictor of suicide. Suicide and Life-Threatening Behavior, 28,197-204.

Ellis, T. E., & Newman, C. F. (1996). Choosing to live: How to defeat suicide through cognitive therapy. Oakland, CA: New Harbinger.

Goldstein, R. B., Black, D. W, Nasrallah, A., & Winokur, G. (1991). The prediction of suicide: Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders. Archives of General Psychiatry, 48, 418-422.

Guthrie, E., Kapur, N., Mackway-Jones, K., Chew-Graham, C., Moorey,J., Mendel, E., et al. (2001). Randomised controlled trial of brief psychological intervention after deliberate self-poisoning. British Medical Journal, 323, 135-138.

Guze, S. B., & Robins,E. (1970). Suicide and primary affective disorders. British Journal of Psychiatry, 19, 437-448.

Hoyert, D. L., Kung, H. C., & Smith, B. (2005). Deaths: Preliminary data for 2003. National Vital Statistics Reports, 53(15), 1-48.

Inskip, H. M., Harris, E. C., & Barraclough, B. (1998). Lifetime risk of suicide for affective disorder, alcoholism, and schizophrenia. British Journal of Psychiatry, 172, 35-37.

Jacobs, D. G. (Ed.). (1999). The Harvard Medical School guide to suicide assessment and intervention. San Francisco: Jossey-Bass.

Kessler, R. C., Borges, G., & Walters, E. E. (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry, 56, 617-626.

Lewis, G., Hawton, K., & Jones, P. (1997). Strategies for preventing suicide. British Journal of Psychiatry, 171, 351-354.

Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-year randomized controlled trial and follow-up of dia lectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757—766.

Malone, K. M., Haas, G. L., Sweeney, J. A., & Mann, J. J. (1995). Major depression and the risk of attempted suicide. Journal of Affective Disorders, 34, 173—185.

Modestin,J., Schwarzenbach, F A., & Wurmle, O. (1992). Therapy factors in treating severely ill psychiatric patients. British Journal of Medical Psychology, 65, 147—156.

Motto, J., Heilborn, D. C., & Juster, R. P. (1985). Development of a clinical instrument to estimate suicide risk. American Journal of Psychiatry, 142, 680—686.

O'Brien, G., Holton, A. R., Hurren, K., & Watt, L. (1987). Deliberate self-harm and predictors of out-patient attendance. British Journal of Psychiatry, 150, 246—247.

Oslin, D. W, Zubritsky, C., Brown, G., Mullahy, M., Puliafico, A., & Ten Have, T. (2004). Managing suicide risk in late life: Access to firearms as a public health concern. American Journal of Geriatric Psychiatry, 12, 30—36.

Papakostas, G. I., Petersen, T., Pava, J., Masson, E., Worthington, J. J., Alpert, J., et al. (2003). Hopelessness and suicidal ideation in outpatients with treatment-resistant depression: Prevalence and impact on treatment outcome. Journal of Nervous and Mental Disease, 191, 444-449.

Pearson, J. L., & Brown, G. K. (2000). Suicide prevention in late life: Directions for science and practice. Clinical Psychology Review, 20, 685—705.

Placidi, G. P. A., Oquendo, M. A., Malone, K. M., Brodsky, B., Ellis, S. P., & Mann,J. J. (2000). Anxiety in major depression: Relationship to suicide attempts. American Journal of Psychiatry, 157, 1614—1618.

Rudd, M. D., Joiner, T. E., & Rajab, M. H. (2001). Treating suicidal behavior. New York: Guilford Press.

Szanto, K., Reynolds, C. F, Conwell, Y, Begley, A. E., & Houck, P. (1998). High levels of hopelessness persist in geriatric patients with remitted depression and a history of attempted suicide. Journal of the American Geriatric Society, 46, 1401— 1406.

U.S. Public Health Service. (2001). National strategy for suicide prevention: Goals and objectives for action. Rockville, MD: U.S. Department of Health and Human Services.

Van Heeringen, C., Jannes, S., Buylaert, W, Henderick, H., de Bacquer, D., & Van Remoortel, J. (1995). The management of non-compliance with referral to out-patient after-care among attempted suicide patients: A controlled intervention study. Psychological Medicine, 25, 963—970.

Vieta, E., Nieto, E., Gasto, C., & Cirera, E. (1992). Serious suicide attempts in affective patients. Journal of Affective Disorders, 24, 147—152.

Young, M. A., Fogg, L. F., Scheftner, W, Fawcett, J., Akiskal, H., & Maser, J. (1996). Stable trait components of hopelessness: Baseline and sensitivity to depression. Journal of Abnormal Psychology, 105, 155—165.

Positive Thinking Power Play

Positive Thinking Power Play

Learning About A Positive Thinking Power Play Can Have Amazing Benefits For Your Life And Success. Learn About Positive Thinking Power Play -And Have A Look At 10 Steps to Success To Create Amazing Results.

Get My Free Ebook


Post a comment