title: Therapeutic mechanisms of suicidal ideation: the influence of changes in automatic thoughts and immature defenses.
abstract: The treatment processes associated with reduced suicidal ideation have received little research attention. This study evaluates the influence on suicidal ideation of theory-based intrapsychic processes: maladaptive cognition and defensive style. Thirty-three community mental health patients completed questionnaires at two time points. Decreases in automatic thoughts were a strong correlate of decreased suicidal ideation, and decreases in immature defenses were a moderate strength correlate. These relationships remained significant even when controlling for initial level of depression. The theorized mechanisms of cognitive-behavioral and psychodynamic therapy had the expected effects on suicidal ideation. The strong association of decreased maladaptive cognitions with decreased suicidal ideation supports further development of cognitive-behavioral suicide interventions and clinical use of cognitive interventions. Psychodynamic processes in suicidal ideation and behavior warrant further exploration.
authors.affiliation: Portland State University, Portland, OR 97207, USA. dcoleman@pdx.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Coleman
authors.forename: John T
authors.initials: JT
authors.lastname: Casey
mesh_terms: D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009511:New England; D012044:Regression Analysis; D013405:Suicide / Q000523:psychology*; D013850:Thinking; D000092864:Suicide Prevention