title: Toward an integrative model of suicide attempt: a cognitive psychological approach.
abstract: Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.
authors.affiliation: National Institute of Public Health, Oslo, Norway. gudrun.dieserud@baerum.kommune.no
authors.forename: G
authors.initials: G
authors.lastname: Dieserud
authors.forename: E
authors.initials: E
authors.lastname: Røysamb
authors.forename: O
authors.initials: O
authors.lastname: Ekeberg
authors.forename: P
authors.initials: P
authors.lastname: Kraft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008016:Life Change Events; D008132:Loneliness; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011340:Problem Solving; D012649:Self Concept; D013406:Suicide, Attempted / Q000523:psychology*