title: Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study.
abstract: Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.
authors: Department of Psychology, Temple University, Philadelphia, PA, United States.
authors: Jonathan P
authors: JP
authors: Stange
authors: Department of Psychology, Temple University, Philadelphia, PA, United States.
authors: Jessica L
authors: JL
authors: Hamilton
authors: Department of Psychology, Temple University, Philadelphia, PA, United States.
authors: Taylor A
authors: TA
authors: Burke
authors: Harvard University, Cambridge, MA, United States.
authors: Evan M
authors: EM
authors: Kleiman
authors: Department of Psychology, Temple University, Philadelphia, PA, United States.
authors: Jared K
authors: JK
authors: O'Garro-Moore
authors: Department of Psychology, Temple University, Philadelphia, PA, United States.
authors: Nicole D
authors: ND
authors: Seligman
authors: Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States.
authors: Lyn Y
authors: LY
authors: Abramson
authors: Department of Psychology, Temple University, Philadelphia, PA, United States. Electronic address: lalloy@temple.edu.
authors: Lauren B
authors: LB
authors: Alloy
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012647:Self-Assessment; D059020:Suicidal Ideation; D013850:Thinking / Q000502:physiology*; D055815:Young Adult
keywords: Bipolar disorder; Bipolar spectrum; Cognitive styles; Rumination; Self-criticism; Suicidal ideation; Suicide