SUICIDAL IDEATION IN MEDICALLY ILL OLDER ADULTS: THE IMPORTANCE OF CONTROL STRATEGIES

Abstract

Suicide rates are elevated among older men globally. Suicides in this age group often reflect concerns about threats to the older adult’s independence and sense of control. Physical illness and associated functional limitations are common in late life, but most individuals adapt by altering their strategies for exerting control (Heckhausen et al., 2010). Evidence suggests that those who do not adapt may be at risk for depression and suicidal thinking (Fiske et al., 2013). In this pilot study, N = 7 adults aged 50–85 with a heart attack or a new diagnosis of heart failure within the past six months were assessed for health-related limitations, control strategies, and affective states at baseline and 6-week follow up. The Wilcoxson sign rank test was used to test the hypothesis that more limited use of control strategies would be associated with greater risk of depressive symptoms, hopelessness and suicidal ideation. At baseline, 87% of participants endorsed clinically significant levels of depressive symptoms (CESDR) and 14% scored above the recommended cutoff on the Geriatric Suicide Ideation Scale. Results indicated that both Selective Primary Control (SPC) strategies and Compensatory Primary Control (CPC) strategies (e.g., getting help from others or modifying the task) were significantly linked to hopelessness and suicidal ideation at baseline. At the 6-week follow up, both SPC and CPC were associated with depressive symptoms and hopelessness. These findings suggest that it may be important to focus on strategies older adults may use to cope with functional impairments.