Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial.
ABSTRACT Suicide attempts constitute a major risk factor for completed suicide, yet few interventions specifically designed to prevent suicide attempts have been evaluated.
To determine the effectiveness of a 10-session cognitive therapy intervention designed to prevent repeat suicide attempts in adults who recently attempted suicide.
Randomized controlled trial of adults (N = 120) who attempted suicide and were evaluated at a hospital emergency department within 48 hours of the attempt. Potential participants (N = 350) were consecutively recruited from October 1999 to September 2002; 66 refused to participate and 164 were ineligible. Participants were followed up for 18 months.
Cognitive therapy or enhanced usual care with tracking and referral services.
Incidence of repeat suicide attempts and number of days until a repeat suicide attempt. Suicide ideation (dichotomized), hopelessness, and depression severity at 1, 3, 6, 12, and 18 months.
From baseline to the 18-month assessment, 13 participants (24.1%) in the cognitive therapy group and 23 participants (41.6%) in the usual care group made at least 1 subsequent suicide attempt (asymptotic z score, 1.97; P = .049). Using the Kaplan-Meier method, the estimated 18-month reattempt-free probability in the cognitive therapy group was 0.76 (95% confidence interval [CI], 0.62-0.85) and in the usual care group was 0.58 (95% CI, 0.44-0.70). Participants in the cognitive therapy group had a significantly lower reattempt rate (Wald chi2(1) = 3.9; P = .049) and were 50% less likely to reattempt suicide than participants in the usual care group (hazard ratio, 0.51; 95% CI, 0.26-0.997). The severity of self-reported depression was significantly lower for the cognitive therapy group than for the usual care group at 6 months (P= .02), 12 months (P = .009), and 18 months (P = .046). The cognitive therapy group reported significantly less hopelessness than the usual care group at 6 months (P = .045). There were no significant differences between groups based on rates of suicide ideation at any assessment point.
Cognitive therapy was effective in preventing suicide attempts for adults who recently attempted suicide.
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ABSTRACT: Loneliness is one of the psychological variables related to high risk behaviors that should be investigated more. The current study aimed to assess emotional, social, romantic, and familial dimensions of loneliness in drug abuser and nondrug abuser individuals. Two hundred and twenty eight individuals were enrolled in this cross sectional study. Hundred and eighteen drug abusers were recruited through random sampling among the clients referred to Baharan Psychiatric Hospital, and 110 non-substance dependent individuals were selected from their companions, students, and staffs. In addition to clinical interview, the Iranian short version of the social and emotional loneliness scale for adults (SELSA-S) was used to evaluate the participants. There were statistically significant difference between the scores of all four emotional, social, familial, and romantic dimensions of loneliness in substance dependent individuals. Although there was no difference between the scores of men and women, the mean scores of romantic and emotional dimensions were higher in non-substance dependent women. The feeling of loneliness is stronger in drug abusers rather than non-drug abusers that could develop the sense of being different from community and increase the probability of taking high risk behaviors and abusing drugs. Thus, it is suggested to consider the feeling of loneliness in all programs designed to prevent or treat addiction.09/2014; 3(3):e22688. DOI:10.5812/ijhrba.22688
Professional Psychology Research and Practice 01/2015; 46(1):21-29. DOI:10.1037/a0038642 · 1.34 Impact Factor
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ABSTRACT: This study aimed to examine the association between negative life events (NLEs) and attempted suicide in rural China. Six rural counties were selected from disease surveillance points in Shandong province, China. A total of 409 suicide attempters in rural areas between October 1, 2009, and March 31, 2011, and an equal number of matched controls were interviewed. We compared negative life events experienced within 1 month, 1-3 months, 3-6months, and 6-2 months prior to attempted suicide for cases and prior to interview for controls. We used multivariate logistic regression to examine the association between NLEs and attempted suicide. Suicide attempters experienced more NLEs within the last year prior to suicide attempt than controls prior to interview (83.1% vs. 33.5%). There was a significant dose-response relationship between NLEs experienced within the last year and increased risk of attempted suicide. Timing of NLEs analysis showed that NLEs experienced in the last month and 6-12 months prior to suicide attempt were significantly associated with elevated risk of attempted suicide, even after adjusting for mental disorders and demographic factors. Of NLEs, quarrelling with spouse, quarrelling with other family members, conflicting with friends or neighbors, family financial difficulty, and serious illness were independently related to attempted suicide. NLEs are significantly associated with increased risk for attempted suicide in rural China. Stress management and intervention may be important to prevent suicidal behavior in rural China.PLoS ONE 01/2015; 10(1):e0116634. DOI:10.1371/journal.pone.0116634 · 3.53 Impact Factor