Suicide — 30 April 2014

A new study recommends that providers should focus on identifying suicidal individuals with distorted, catastrophic thoughts about the future.

“Such thoughts are characteristic of those who attempt suicide,” said clinical psychologist Dr. Shari Jager-Hyman of the University of Pennsylvania.

Jager-Hyman led a study that reviewed how distorted thoughts influence suicidal behaviors in patients who seek emergency psychiatric treatment.

In the study, researchers recruited a relatively large and ethnically diverse group of 168 participants from emergency departments or psychiatric inpatient units in Philadelphia.bigstock_In_The_Park_583041

Of these, 111 people had attempted suicide in the 30 days prior to the study. The other 57 participants were receiving emergency psychiatric treatment, but had not tried to commit suicide in the two years prior to the study.

The research study is the first to use the Inventory of Cognitive Distortions, a 69-item self-report questionnaire designed to be used among various clinical populations, to measure cognitive distortions in people who have recently tried to commit suicide.

As published in the journal Cognitive Therapy and Research, investigators found that people who attempt suicide are more likely to have distorted thoughts than others.

These include the way in which they think about their own self-worth, how they negatively compare hemselves to others, and how they generally slap derogatory labels on themselves. This is true even when the effects of depression and feelings of hopelessness are taken into account.

The findings add weight to the many theories that suicidal people have unique cognitive styles by which they misinterpret or wrongly process experiences or stimuli.

Uniquely, people who made suicide attempts were found to be especially prone to so-called “fortune-telling,” predicting and firmly believing that bad things will happen in the future.

Fortune-telling is akin to catastrophizing, and does not consider other, more probable outcomes.

Importantly, when the researchers took thoughts of hopelessness into account, fortune-telling was no longer strongly linked to suicidal attempts. Jager-Hyman and her colleagues believe this is because fortune-telling and hopelessness may be overlapping constructs or ideas which share the fear of negative future events.

“To prevent suicides, therapists would benefit from directly targeting patients’ thoughts of hopelessness in clinical interventions,” said Jager-Hyman.

“A cognitive approach can help patients evaluate their beliefs that negative outcomes will inevitably occur, and show them how to entertain other possible options.

“This can help to minimize patients’ thoughts of hopelessness, help them to cope better, and ideally decrease their suicidal ideation and behaviors.”

This article first appeared on ‘Psych Central’ on 29 April 2014.


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