Feasibility and utility of positive psychology exercises for suicidal inpatients.
OBJECTIVE
The objective was to assess the feasibility and acceptability of nine positive psychology exercises delivered to patients hospitalized for suicidal thoughts or behaviors, and to secondarily explore the relative impact of the exercises.


METHODS
Participants admitted to a psychiatric unit for suicidal ideation or behavior completed daily positive psychology exercises while hospitalized. Likert-scale ratings of efficacy (optimism, hopelessness, perceived utility) and ease of completion were consolidated and compared across exercises using mixed models accounting for age, missing data and exercise order. Overall effects of exercise on efficacy and ease were also examined using mixed models.


RESULTS
Fifty-two (85.3%) of 61 participants completed at least one exercise, and 189/213 (88.7%) assigned exercises were completed. There were overall effects of exercise on efficacy (χ(2)=19.39; P=.013) but not ease of completion (χ(2)=11.64; P=.17), accounting for age, order and skipped exercises. Effect (Cohen's d) of exercise on both optimism and hopelessness was moderate for the majority of exercises. Exercises related to gratitude and personal strengths ranked highest. Both gratitude exercises had efficacy scores that were significantly (P=.001) greater than the lowest-ranked exercise (forgiveness).


CONCLUSIONS
In this exploratory project, positive psychology exercises delivered to suicidal inpatients were feasible and associated with short-term gains in clinically relevant outcomes.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jhuffman@partners.org.
Jeff C
JC
Huffman
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Christina M
CM
DuBois
Harvard Medical School, Boston, MA, USA; Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
Brian C
BC
Healy
Department of Psychology, Chapman University, Orange, CA, USA.
Julia K
JK
Boehm
Department of Psychology, George Mason University, Fairfax, VA, USA.
Todd B
TB
Kashdan
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Christopher M
CM
Celano
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Benson Henry Institute for Mind Body Medicine, BostonMA, USA.
John W
JW
Denninger
Department of Psychology, University of California-Riverside, Riverside, CA, USA.
Sonja
S
Lyubomirsky
D000328:Adult; D001290:Attitude; D005240:Feasibility Studies; D065026:Hope; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D059020:Suicidal Ideation; D016896:Treatment Outcome; D000092864:Suicide Prevention
Gratitude; Hopelessness; Optimism; Positive psychology; Suicide