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


METHODS
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.
Department of Medical and Clinical Psychology, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA. mholloway@usuhs.edu
M
M
Ghahramanlou-Holloway
S S
SS
Bhar
G K
GK
Brown
C
C
Olsen
A T
AT
Beck
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007175:Impulsive Behavior / Q000517:prevention & control; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009341:Negativism; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D000092864:Suicide Prevention