Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide

Psychol Med. 2012 Jun;42(6):1185-93. doi: 10.1017/S0033291711002169. Epub 2011 Oct 19.

Abstract

Background: Cognitive therapy has been found to be effective in decreasing the recurrence of suicide attempts. A theoretical aim of cognitive therapy is to improve problem-solving skills so that suicide no longer remains the only available option. This study examined the differential rate of change in problem-solving appraisal following suicide attempts among individuals who participated in a randomized controlled trial for the prevention of suicide.

Method: Changes in problem-solving appraisal from pre- to 6-months post-treatment in individuals with a recent suicide attempt, randomized to either cognitive therapy (n = 60) or a control condition (n = 60), were assessed by using the Social Problem-Solving Inventory-Revised, Short Form.

Results: Improvements in problem-solving appraisal were similarly observed for both groups within the 6-month follow-up. However, during this period, individuals assigned to the cognitive therapy condition demonstrated a significantly faster rate of improvement in negative problem orientation and impulsivity/carelessness. More specifically, individuals receiving cognitive therapy were significantly less likely to report a negative view toward life problems and impulsive/carelessness problem-solving style.

Conclusions: Cognitive therapy for the prevention of suicide provides rapid changes within 6 months on negative problem orientation and impulsivity/carelessness problem-solving style. Given that individuals are at the greatest risk for suicide within 6 months of their last suicide attempt, the current study demonstrates that a brief cognitive intervention produces a rapid rate of improvement in two important domains of problem-solving appraisal during this sensitive period.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Cognitive Behavioral Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Impulsive Behavior / prevention & control
  • Linear Models
  • Male
  • Middle Aged
  • Negativism
  • Problem Solving*
  • Psychiatric Status Rating Scales
  • Secondary Prevention
  • Suicide / psychology
  • Suicide Prevention*
  • Suicide, Attempted / prevention & control
  • Suicide, Attempted / psychology
  • Time Factors
  • Treatment Outcome
  • Young Adult