A cognitive model of suicidal behavior: Theory and treatment
Section snippets
A Cognitive model of suicidal behavior: theory and treatment
The public health significance of research into the causes and treatment of suicidal behavior is profound—suicide is the 11th leading cause of death among all age groups and the second leading cause of death among adults between ages 25 and 34 (Centers for Disease Control, 2007). Surviving family members and friends struggle to understand why their loved one resorted to suicide and what they could have done to prevent it, often experiencing complicated bereavement for an extended period of time
A cognitive model of suicidal behavior
Our cognitive model of suicidal behavior (Wenzel, Brown, et al., 2008) is presented in Fig. 1. The large ovals represent the three main constructs that underlie suicidal behavior from a cognitive perspective. The ovals become darker as the constructs become more directly relevant to understanding suicidal behavior, rather than abnormal behavior in general. We propose that dispositional vulnerability factors are long-standing, trait-like variables that confer non-specific risk for psychiatric
Cognitive therapy for suicidal patients
Cognitive therapy for suicidal patients is an active, targeted psychosocial intervention that aims to provide patients skills to (a) modify suicide schemas, (b) interrupt cognitive processes associated with suicidal crises, and (c) modify dispositional vulnerability factors that played a central role in the recent suicidal crisis that brought them into treatment. By developing strategies to achieve these aims, it is hoped that patients will be less likely to engage in future suicidal behavior
Conclusion and future directions
Our cognitive model of suicidal behavior was designed to (a) incorporate relevant constructs that have been demonstrated in the empirical literature to be associated with suicide ideation, attempts, and completions, and (b) differentiate between distal and proximal factors associated with suicidal crises, such that it provides a template for understanding long-standing vulnerabilities as well as the cognitive phenomena experienced by suicidal patients in crisis. This model should be viewed as a
Acknowledgements
Completion of this manuscript was facilitated by support from the National Institute of Mental Health (P20-MH072905915, R01-MH067805), awarded to Dr. Aaron T. Beck, the American Foundation for Suicide Prevention, awarded to Dr. Amy Wenzel, and the National Alliance for Research in Schizophrenia and Depression, awarded to Dr. Amy Wenzel.
References (135)
- et al.
A cognitive therapy intervention for suicide attempters: An overview of the treatment and case examples
Cognitive and Behavioral Practice
(2004) - et al.
Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents
Journal of the American Academy of Child and Adolescent Psychiatry
(1993) - et al.
Understanding impulsivity in severe depression? A psychometrical contribution
Progress in Neuro-Psychophamacology & Biological Psychiatry
(2003) - et al.
Impulsivity: A relevant dimension of depression regarding suicide attempts?
Journal of Affective Disorders
(1999) - et al.
Personality and suicidal behavior in depressed patients
Comparative Psychiatry
(1989) - et al.
Treatment of suicide ideators: A problem solving approach
Behavior Therapy
(1990) - et al.
EPQ-R and suicide attempt: The relevance of psychoticism
Personality and Individual Differences
(1991) Practice guideline for the assessment and treatment of patients with suicidal behaviors
(2003)Cognition and suicide: A methodological review
Suicide and Life-Threatening Behavior
(1983)- et al.
Suicide attempts and impulsivity
European Archives of Psychiatry and Clinical Neuroscience
(2005)
Anxiety and impulsiveness related to psychomotor efficiency
Perceptual and Motor Skills
Suicide as escape from self
Psychological Review
Depression: Clinical, experimental, and theoretical aspects
Hopelessness as a predictor of eventual suicide.
The current state of cognitive therapy: A 40-year retrospective
Archives of General Psychiatry
Relationship between hopelessness and ultimate suicide: A replication with psychiatric outpatients
American Journal of Psychiatry
Differentiating anxiety and depression: A test of the cognitive content specificity hypothesis
Journal of Abnormal Psychology
Anxiety disorders and phobias: A cognitive perspective
Cognitive therapy of personality disorders
Hopelessness and suicidal behavior: An overview
Journal of the American Medical Association
Cognitive approaches to schizophrenia: Theory and therapy
Annual Review of Clinical Psychology
Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation
American Journal of Psychiatry
Cognitive therapy of substance abuse
A specific attentional bias in suicide attempters
The Journal of Nervous and Mental Disease
Personality, parental rearing behavior, and parental loss in attempted suicide: A comparative study
Acta Psychiatrica Scandinavia
Suicide and mental disorders: Do we know enough?
British Journal of Psychiatry
Family genetic studies, suicide, and suicidal behavior
American Journal of Medical Genetics Part C
Familial pathways to suicidal behavior: Understanding and preventing suicide among adolescents
New England Journal of Medicine
Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: A systematic review
Acta Psychiatrica Scandinavia
The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression
American Journal of Psychiatry
Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial
Journal of the American Medical Association
Clinical features of inpatient suicide
Psychiatric Annals
Clinical correlates of inpatient suicide
Journal of Clinical Psychiatry
Assessing risk for completed suicide in patients with alcohol dependence: Clinicians’ views of critical factors
Professional Psychology: Research and Practice
Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene
Science
Patient suicide: Occupational hazard for psychologists and psychiatrists
Professional Psychology: Research and Practice
Scientific foundations of cognitive theory and therapy of depression
Empirical based comprehensive treatment program for parasuicide
Journal of Consulting and Clinical Psychology
Psychological dimensions associated with suicide ideation and attempts in the National Comorbidity Survey
Suicide and Life-Threatening Behavior
Inadequate response to therapy as a predictor of suicide
Suicide and Life-Threatening Behavior
The escape theory of suicide in college students: Testing a model that includes perfectionism
Suicide and Life-Threatening Behavior
Problem-solving appraisal, stress, hopelessness, and suicide ideation in a college population
Journal of Counseling Psychology
Laboratory measured behavioral impulsivity relates to suicide attempt history
Suicide and Life-Threatening Behavior
Age differences in personality characteristics of suicide completers: Preliminary findings from a psychological autopsy study
Psychiatry
Cognitive characteristics of suicidal and non-suicidal psychiatric inpatients
Cognitive Therapy and Research
Elucidation of impulsivity
Australian Psychologist
Autobiographical memory and problem solving strategies or parasuicidal patients
Psychological Medicine
The Cardiff sib-pair study
Crisis
Cited by (279)
Exploring risk factors and their differences on suicidal ideation and suicide attempts among depressed adolescents based on decision tree model
2024, Journal of Affective DisordersImpairment in recognition memory may be associated with near-term risk for suicide attempt in a high-risk sample
2024, Journal of Affective DisordersInduced optimism to lessen hopelessness-related cognitions among young adults at risk for suicidal thoughts and behavior
2023, Journal of Affective Disorders ReportsEEG wakefulness regulation in transdiagnostic patients after a recent suicide attempt
2023, Clinical NeurophysiologyMental health literacy and suicidal ideation among Chinese college students: The mediating role of depressive symptoms and anxiety symptoms
2023, Journal of Affective Disorders