Suicidal Cognitions Research Articles

Deep into that darkness peering: A computational analysis of the role of depression in Edgar Allan Poe's life and death

BackgroundTo help shed light on the peculiar circumstances surrounding the death of the famed macabre and mystery writer, poet, editor, and literary critic, we explored the potential role of depression in the life and death of Edgar Allan Poe via his written language. MethodUsing computerized language analysis, we analyzed works from Poe's corpora of personal letters (N = 309), poems (N = 49), and short stories (N = 63), and investigated whether a pattern of linguistic cues consistent with depression and suicidal cognition were discernible throughout the writer's life, particularly in his final years. Building on past work, language scores were collapsed into a composite depression metric for each text. Data from each work type was subsequently compiled and graphed into a single plot by year, with scores exceeding the 95th percentile (p < 0.05) considered statistically significant and treated as potential depressive episodes. ResultsSignificant, consistent patterns of depression were not found and do not support suicide as a cause of death. However, linguistic evidence was found suggesting the presence of several potential depressive episodes over the course of Poe's life – these episodes were the most pronounced during years of Poe's greatest success, as well as those following the death of his late wife. LimitationsGiven the sampling method, it is not possible to establish direct causality; results should be considered informed but tentative. ConclusionThis investigation demonstrates the utility of language analysis for capturing disruptive/maladaptive emotional responses to life events.

Prospective association between suicide cognitions and emotional responses to a laboratory stressor: The mediating role of nightly subjective sleep quality

BackgroundSleep is a reliable correlate of suicidal thoughts and behaviors (STBs), yet few studies have directly examined negative affect in the context of this association. The present study combined daily experience methods with a laboratory paradigm to investigate suicide cognitions as a predictor of emotional responses to environmental stressors, and tested the role of nightly sleep parameters. Method72 participants (Mage = 24.25; 41 with a recent history of suicide ideation and 31 without a history of STBs) completed a four-day study. Suicide cognitions were measured on the first day, and actigraphy-based sleep duration and fragmentation, and morning ratings of prior night subjective sleep quality (SSQ) were subsequently measured over three consecutive nights. Participants returned on the fourth day to complete the Trier Social Stress Task, where self-report changes in negative affect immediately post-task (i.e., reactivity) and five minutes post-task (i.e., recovery) were observed. ResultsRegression analyses indicated that suicide cognitions predicted negative affect reactivity and recovery. Simple mediation analyses revealed that SSQ partially mediated the relation between suicide cognitions and negative affect recovery (especially shame), but not reactivity. No significant associations were observed for the actigraphy-based sleep parameters. LimitationsJust three nights of actigraphy-based data collection. A single item was used to measure SSQ. ConclusionsSuicide cognitions predict negative affective responses to situational stressors and SSQ may have a key role in this effect, especially the duration of negative emotional reactions. Hence, sleep and emotional reactivity may be potential targets for suicide prevention efforts.

Investigation of the Relationship between Suicide Cognitions, Impulsivity and Meaning of Life

Although there are many works on the concept of suicide, it is still a subject that continues to be relevant. There are many factors that are thought to be related to suicide. Of these, impulsivity and meaning in life are factors that are considered to have an impact on suicide. The aim of this study is to investigate the relationships between suicide cognitions, impulsiveness and meaning in life. A survey model as the quantitative research method, was used in this study. The sample consisted of 433 participants, 327 women and 106 men. The Suicide Cognitions Scale, the Barratt Impulsiveness Scale Short Form, the Meaning in Life Questionnaire and a personal information form were used. From the Meaning in Life Questionaire, two subscales were derived relating to the presence of meaning in life and the search for meaning in life . Correlation analysis, multiple linear regression analysis and descriptive statistics were used in the data analysis using the software package SPSS (22). According to the results of the analysis, there was a significant positive relationship between the scores of the Suicide Cognition Scale and the scores of the Barratt Impulsiveness Scale Short Form and the scores of the search for meaning in life subscale. In addition, there was significant negative correlation between the scores of the Suicide Cognitions Scale and the scores of the presence of meaning in life Subscale. The independent variables explained 22% of the variance in Suicide Cognitions.

Prospective Validity of the Suicide Cognitions Scale Among Acutely Suicidal Military Personnel Seeking Unscheduled Psychiatric Intervention.

Background and Aim: The Suicide Cognitions Scale (SCS) was developed to assess a broad range of suicide-related cognitions. Research to date supports the scale's factor structure, internal consistency, and construct validity. The present study tested the scale's prospective validity for suicide attempts among 97 military personnel presenting to an emergency department or psychiatric outpatient clinic for an unscheduled walk-in evaluation. Method: Cox regression and receiver operator characteristic analyses were conducted to test the prospective validity of the SCS. Results: Results supported the prospective validity of the SCS (area under the curve [AUC] = 0.69) and indicate the scale's performance is comparable to an empirically supported measure of suicide ideation (AUC = 0.75). The SCS performance was not reduced by removing items containing the word suicide. Limitations: Homogeneous sample comprised of US soldiers, predominantly male, with recent suicidal ideation. Conclusion: Results support the SCS as an indicator of subsequent risk for suicidal behavior when used in acute care settings, and suggest the scale's performance is similar to more traditional suicide risk screening methods that depend on honest self-disclosure of suicidal thoughts.

Suicide by psychiatric patients: Nature of risk, risk categorisation and preventability.

This study considers risk factors associated with suicide by psychiatric patients, the perceived risk at last contact and risk categorisation and reflects upon the potential for prevention. Information regarding 63 consecutive suicides known to mental health services in Wolverhampton, UK, over a 15-year period was collected as part of an audit using a semi-structured questionnaire covering sociodemographic and clinical risk factors, along with information about preventability. A complex mixture of historical, enduring and current risk factors was observed. In addition to common risk factors, a considerable proportion had histories of multiple co-morbid psychiatric (52.5%) and physical diagnoses (27.6%) and psychiatric admission (70.5%). Common suicide methods included hanging (36.5%) and poisoning (36.5%). Most suicides occurred in the post-discharge months up to around two years (75.8%). Although a range of psychopathologies and suicidal cognitions were observed at the last clinical contact, the immediate suicide risk was considered low (46.2%) or not present (38.5%) in the majority of cases. Clinicians suggested various factors that could have made suicides less likely. Clinical assessment can identify risk factors, but categorisation may not be indicative of the outcome. A focus on modifiable factors, with support for psychosocial and clinical issues, may assist with prevention.

Psychometric properties of the German version of the suicide cognitions scale in two clinical samples

The present study aimed at evaluating the psychometric properties of German Suicide Cognitions Scale (SCS-18/SCS-9) in two clinical samples. Validity and reliability were established in an outpatient- (n = 277) and in an inpatient sample (n = 75). Statistical analyses included confirmatory factor analyses, correlation analyses, between-group comparison by history of lifetime suicide attempts, and regression analyses. The three-factor model showed good model fit for the long version of the SCS (SCS-18). For the short version of the SCS (SCS-9), a bifactor model yielded the best fit. Overall, the total scale of the SCS-18 and the SCS-9 and the subscales of the SCS-18 showed satisfactory internal consistency, as well as good convergent validity. The SCS-18 subscales and the SCS-9 demonstrated clinical utility by differentiating between participants with prior and without prior suicide attempts. The SCS (subscale unsolvability and SCS-9 score) predicted current suicide ideation as well as suicide ideation 7–10 days later – even after controlling for established risk-factors (e.g., depression, hopelessness, interpersonal variables). Results suggest that the SCS-18 and the SCS-9 are reliable and valid measures to assess suicidal cognitions that can be used in clinical as well as in research settings.

Negative Life Events (NLEs) Contributing to Psychological Distress, Pain, and Disability in a U.S. Military Sample.

The objective was to explore how negative life events (NLEs, e.g., litigation related to pain and disability, failing most recent physical fitness test, and financial difficulties) are related to pain coping and psychological adjustment to pain in active duty military personnel. Data were gathered as part of the Evaluation of Suicidality, Cognitions, and Pain Experience study, a DoD-funded cross-sectional assessment of chronic pain and emotional coping among a cohort of military members. The investigators examined data from 147 respondents with complete survey and pain assessment data. The sample was active duty, male (62.6%), in a relationship or married (83.0%), and had children (68.7%). The majority of the sample endorsed zero NLEs (72.0%); 23.8% endorsed one NLE, 4.2% endorsed two NLEs, and no one endorsed all three NLEs. A significantly higher proportion of participants endorsing one or more NLEs reported suicidal ideation compared to those who reported no NLEs (χ2(2) = 8.61, p = 0.014). A higher number of endorsed NLEs coincided with higher symptom severity related to psychosocial distress (depression, thwarted belongingness, perceived burdensomeness, PTSD, and suicide cognitions) and poor pain coping (rumination, helplessness, and less acceptance of chronic pain). Findings revealed that NLEs may impart a significant burden on military pain sufferers. Greater numbers of endorsed NLEs are associated with increased psychosocial distress and poor pain coping. Future longitudinal studies examining long-term psychosocial distress/poor pain coping as related to NLEs would help to elaborate the long-term consequences of NLEs on pain coping and psychosocial distress.

The Structure of Suicidal Beliefs: A Bifactor Analysis of the Suicide Cognitions Scale

The Suicide Cognitions Scale (SCS) was developed to measure a broad spectrum of suicidogenic cognitions collectively referred to as the suicidal belief system. Prior confirmatory factor analyses have suggested both a unidimensional and multidimensional structure and high intercorrelations among identified factors, suggesting the possible influence of an underlying general factor. The present study used bifactor analysis in a clinical sample of 97 treatment-seeking Army personnel with recent suicide ideation and a nonclinical sample of 193 military personnel and veterans with a lifetime history of suicide ideation or attempts. Results supported the strong influence of a general factor in addition to several specific factors that aligned with constructs articulated by several theories of suicide, and suggested the SCS is best interpreted as a unidimensional measure. Results suggest that narrower suicidogenic cognitions are influenced in large part by a strong general latent variable.

Decreases in Suicide Cognitions After Cognitive Processing Therapy Among Veterans With Posttraumatic Stress Disorder Due to Military Sexual Trauma: A Preliminary Examination.

Posttraumatic stress disorder (PTSD) is associated with suicidal ideation (SI) and suicidal self-directed violence (SDV). Military sexual trauma (MST) is a common precursor to PTSD among veterans. Survivors of MST are more likely to be diagnosed with PTSD and are at greater risk for SI than survivors of other forms of trauma. Suicide-specific beliefs (e.g., unlovability, unbearability, unsolvability) have been shown to be strong predictors of SI and future suicidal SDV. Suicide-specific beliefs were examined over the course of treatment and follow-up in 32 veterans (23 women, 9 men) who received cognitive processing therapy (CPT) for MST-related PTSD. Hierarchical linear models revealed that veterans who received CPT had significant reductions in suicide-specific cognitions regarding unbearability, unlovability, and unsolvability. These preliminary findings warrant replication in a randomized controlled trial with a larger sample that includes participants with more acute suicidal intent.

Predictors of Unbearability, Unlovability, and Unsolvability in Veterans With Military-Sexual-Trauma-Related Posttraumatic Stress Disorder.

Military sexual trauma (MST) and posttraumatic stress disorder (PTSD) both increase risk for suicidal self-directed violence (SDV). Suicide cognitions (i.e., unbearability, unlovability, and unsolvability) are strong predictors of future suicidal SDV. The present study investigated potential predictors of unbearability, unlovability, and unsolvability in veterans with MST-related PTSD. Suicide cognitions, depression, PTSD, quality of life, trauma-related negative cognitions, physical health functioning, mental health functioning, and childhood sexual assault were assessed in 12 male and 103 female veterans with MST-related PTSD. Higher depression scores, greater trauma-related negative cognitions about self, and poorer physical health functioning predicted increased unbearability scores. Greater trauma-related negative cognitions about self and self-blame, higher level of education, and higher depression scores predicted increased unlovability scores. Higher depression scores and greater trauma-related negative cognitions about self predicted increased unsolvability scores. In veterans with MST-related PTSD who express unbearability, unlovability, and unsolvability, assessing and addressing depression, trauma-related negative cognitions about self and self-blame, and physical health functioning may be an important step in reducing SDV.

Investigation of Psychometric Properties of Suicide Cognitions Scale: Validity and Reliability Study

Investigation of Psychometric Properties of Suicide Cognitions Scale: Validity and Reliability Study

Prevalence of Suicidal Ideation and Suicidal Cognition among the Local Population of Karachi, Pakistan

Objective: Suicide has become a leading cause of death worldwide, thus it has become a public health problem for every country in the world and thereby in Pakistan too. The aim of present study was to find out the prevalence of suicidal thoughts among the local population of Karachi. Correlations were also assessed among suicidal thoughts and demographic characteristics. Method: A survey was conducted to fill out a pre-structured questionnaire from the participants between the age group of 18-30. The questionnaire contains Beck’s scale of suicide cognition, Modified scale of suicide ideation and a detailed demographic profile. Subjects were taken from different universities, medical colleges, offices and business schools. Mentally ill patients were not included in the study. Result: Severe Suicide ideation and suicidal cognitions are prevalent in the population to about 4% and 3% respectively. Also in the study, demographic variations exist in subjects with respect to suicidal thoughts; male, non-working, unhappy, in-pain subjects, unmarried, being in the 18-21 age brackets and undergraduate reported higher suicidal thoughts as compared to their correspondent parameters. Conclusion: It has been concluded that severe suicidal thoughts are prevalent among youngsters. And certain demographic characters are strongly correlated with amplified suicidal thoughts among youth of Karachi.

Contributions of Cognitions, Psychological Flexibility, and Therapeutic Alliance to Suicidal Ideation in Psychiatric Inpatients.

Although suicide treatment is an expanding area of research, there is relatively less in the literature with respect to how specific vulnerabilities to suicide are addressed by treatment. Utilizing measures of suicide cognitions, therapeutic alliance, and psychological flexibility, we compared their relative contributions to suicidal ideation during and posttreatment among a group of adult psychiatric inpatients (N=434). Results revealed that cognitions contributed considerably more unique variance to suicidal ideation than alliance and flexibility at discharge and at 2weeks postdischarge, and to change in suicidal ideation over the course of treatment. Psychological flexibility explained a small amount of variance at the 6-month time point. Factor level analyses also were conducted, with the unsolvability factor within suicide cognitions accounting for the largest portion of variance at both discharge and 2weeks postdischarge. Study limitations, implications, and future directions are discussed.

Collaborative Assessment and Management of Suicidality (CAMS) compared to treatment as usual (TAU) for suicidal patients: study protocol for a randomized controlled trial.

BackgroundCollaborative Assessment and Management of Suicidality (CAMS) is a therapeutic framework that appears promising to reduce suicidal ideation and suicidal cognition. CAMS has not previously been evaluated in a standard specialized mental health care setting for patients with suicidal problems in general. In this pragmatic randomized controlled trial (RCT) we will investigate if CAMS is more effective than treatment as usual (TAU) in reducing suicidal thoughts and behaviors. Effects will also be investigated on mental health and symptom relief in general and upon readmissions to inpatient units.Methods/designThe study is a multicenter, observer-blinded, superiority, two-armed RCT which will include patients from four clinical departments at Vestre Viken Hospital Trust, Norway. We aim to include 100 patients with moderate to strong suicidal problems, as defined by a score of 13 or more on Beck’s Scale for Suicide Ideation - Current. Patients are included regardless of diagnosis. Randomization will be performed using a stratified four-block procedure with treatment unit as the stratification variable. The duration of treatment will vary depending on patients’ needs and clinical assessments. Patients are interviewed by research staff at four checkpoints: baseline, 2 weeks, 6 months, and 12 months. Central outcome measures are the Beck Scale for Suicide Ideation - Current, Outcome Questionnaire – 45, and Suicide Attempt Self-Injury Count.DiscussionThis pragmatic trial is effectuated within the Public Health Care System in Norway, where patients have multiple problems and diagnoses and therapists have a high work load. Results from this trial are highly generalizable to a typical everyday clinical setting, and one should expect similar results if CAMS is implemented in the future as a standard component in specialized mental health care systems.Trial registrationOpen Science Framework: DOI 10.17605/OSF.IO/JHRM2. Registered 5 July 2015. ClinicalTrials.gov: NCT02685943. Registered on 8 February 2016.

1 Suicidal Cognitions and Behaviors in Early Childhood: Why Does It Arise and What Does It Mean?

1 Suicidal Cognitions and Behaviors in Early Childhood: Why Does It Arise and What Does It Mean?

A Shortened Version of the Suicide Cognitions Scale for Identifying Chronic Pain Patients at Risk for Suicide.

Research in psychiatric outpatient and inpatient populations supports the utility of the Suicide Cognitions Scale (SCS) as an indicator of current and future risk for suicidal thoughts and behaviors. Designed to assess suicide-specific thoughts and beliefs, the SCS has yet to be evaluated among chronic pain patients, a group with elevated risk for suicide. The purpose of the present study was to develop and test a shortened version of the SCS (the SCS-S). A total of 228 chronic pain patients completed a battery of self-report surveys before or after a scheduled appointment. Three outpatient medical clinics (pain medicine, orofacial pain, and clinical health psychology). Confirmatory factor analysis, multivariate regression, and graded item response theory model analyses. Results of the CFAs suggested that a 3-factor solution was optimal. A shortened 9-item scale was identified based on the results of graded item response theory model analyses. Correlation and multivariate analyses supported the construct and incremental validity of the SCS-S. Results support the reliability and validity of the SCS-S among chronic pain patients, and suggest the scale may be a useful method for identifying high-risk patients in medical settings.

Cognitive behavioral therapy for suicidal behaviors: improving patient outcomes.

This systematic review provides an overview of the effectiveness of cognitive behavioral therapy (CBT) in reducing suicidal cognitions and behavior in the adult population. We identified 15 randomized controlled trials of CBT for adults (aged 18 years and older) that included suicide-related cognitions or behaviors as an outcome measure. The studies were identified from PsycINFO searches, reference lists, and a publicly available database of psychosocial interventions for suicidal behaviors. This review identified some evidence of the use of CBT in the reduction of both suicidal cognitions and behaviors. There was not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. On the other hand, CBT focusing on suicidal cognitions and behaviors was found to be effective. Given the current evidence, clinicians should be trained in CBT techniques focusing on suicidal cognitions and behaviors that are independent of the treatment of mental illness.

Cognition and suicide: Effectiveness of cognitive behaviour therapy

The aim of this review paper is to show an overview of the empirical evidence of effectiveness of cognitive behavioral therapy (CBT) in reducing suicidal cognitions and suicidal behavior. The topic of suicidal cognition and suicidal behavior is of special importance to clinicians and practitioners. Analyses of empirical findings from the oldest, first systematic review and meta-analysis and the newest one shown that there not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. But, from the other hand, CBT focusing on suicidal cognitions and suicidal behaviors was found to be effective. Taking into consideration the effectiveness of this psychotherapy, we can conclude that it is preferable for clinicians to be trained in working with CBT techniques focused on suicidal cognition and behavior that are independent of treatment of mental disorders. In addition, it is necessary to initiate new research that will make it possible to create preventive and interventional programs dedicated to reducing the risk of suicide. Keywords: cognition, suicide, cognitive behavior, psychotherapy, effectiveness.

Mindfulness-based cognitive therapy (MBCT) reduces the association between depressive symptoms and suicidal cognitions in patients with a history of suicidal depression.

Objective: In patients with a history of suicidal depression, recurrence of depressive symptoms can easily reactivate suicidal thinking. In this study, we investigated whether training in mindfulness, which is aimed at helping patients “decenter” from negative thinking, could help weaken the link between depressive symptoms and suicidal cognitions. Method: Analyses were based on data from a recent randomized controlled trial, in which previously suicidal patients were allocated to mindfulness-based cognitive therapy (MBCT), an active control treatment, cognitive psychoeducation (CPE), which did not include any meditation practice, or treatment as usual (TAU). After the end of the treatment phase, we compared the associations between depressive symptoms, as assessed through self-reports on the Beck Depression Inventory–II (Beck, Steer, & Brown, 1996), and suicidal thinking, as assessed through the Suicidal Cognitions Scale (Rudd et al., 2001). Results: In patients with minimal to moderate symptoms at the time of assessment, comparisons of the correlations between depressive symptoms and suicidal cognitions showed significant differences between the groups. Although suicidal cognitions were significantly related to levels of symptoms in the 2 control groups, there was no such relation in the MBCT group. Conclusion: The findings suggest that, in patients with a history of suicidal depression, training in mindfulness can help to weaken the association between depressive symptoms and suicidal thinking, and thus reduce an important vulnerability for relapse to suicidal depression.

Effects of Suicide Awareness Material on Implicit Suicide Cognition: A Laboratory Experiment

In spite of the increasing adoption of suicide awareness campaigns to prevent suicide, little is known about the effective construction of awareness messages used and on their impact on suicidal cognition. We hypothesized that media reporting on an individual overcoming a suicidal crisis increases the automatic association between “life” and self. University students (N = 112) were randomly allocated to one of three groups in a laboratory experiment. Participants allocated to treatment group 1 or group 2 read awareness material about a person coping with suicidal ideation by getting professional help. The only difference between the two groups was the amount of social similarity (low vs. high) between the protagonist and the participants. The control group read an article unrelated to suicide. Awareness material increased implicit cognition in terms of a strengthening of self-life associations. This effect was restricted to participants scoring low on wishful identification with the suicidal protagonist. This finding suggests that only individuals who do not wishfully identify with a protagonist going through difficult life circumstances benefit from the awareness material in terms of suicidal cognition. These findings provide a rich basis for further research and have potentially high relevance to the construction of suicide-awareness messages.