title: When the solution is part of the problem: problem solving in elderly suicide attempters.
abstract: OBJECTIVE
  Depression, loss, and physical illness are associated with suicide in the elderly. However, the nature of individual vulnerability remains poorly understood. Poor problem solving has been suggested as a risk factor for suicide in younger adults. Unresolved problems may create an accumulation of stressors. Thus, those with perceived deficits in problem-solving ability may be predisposed to suicidal behavior. To test this hypothesis, we investigated whether elderly suicide attempters perceived their problem solving as deficient.
  
  
  METHODS
  Sixty-four individuals aged 60 and older participated in the study including depressed suicide attempters, depressed non-attempters, and non-depressed controls. The social problem solving inventory-revised: short-version was used to measure participants' perceived social problem solving, assessing both adaptive problem-solving dimensions (positive problem orientation and rational problem solving) and dysfunctional dimensions (negative problem orientation, impulsivity/carelessness, and avoidance).
  
  
  RESULTS
  Depressed elderly who had attempted suicide perceived their overall problem solving as deficient, compared to non-suicidal depressed and non-depressed elderly. Suicide attempters perceived their problems more negatively and approached them in a more impulsive manner. On rational problem solving and avoidant style sub-scales, suicide attempters did not differ from non-suicidal depressed. However, both depressed groups reported lower rational problem solving and higher avoidance compared to non-depressed controls.
  
  
  CONCLUSIONS
  A perception of life problems as threatening and unsolvable and an impulsive approach to problem solving appear to predispose vulnerable elderly to suicide attempts.
authors.affiliation: Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Gibbs
authors.forename: Alexandre Y
authors.initials: AY
authors.lastname: Dombrovski
authors.forename: Jennifer
authors.initials: J
authors.lastname: Morse
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Siegle
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Houck
authors.forename: Katalin
authors.initials: K
authors.lastname: Szanto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012649:Self Concept; D012940:Social Problems; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*