Coping Card Usage can Further Reduce Suicide Reattempt in Suicide Attempter Case Management Within 3‐Month Intervention

This randomized controlled trial was designed to evaluate the effectiveness of using crisis coping cards (n = 32) in the case management of suicide prevention compared with case management without the use of coping cards (n = 32) over a 3‐month intervention period. The generalized estimating equation was used to examine the interaction effect between treatments and time on suicide risk, depression, anxiety, and hopelessness. Results indicated that subsequent suicidal behaviors, severity of suicide risk, depression, anxiety, and hopelessness were reduced more in the coping card intervention group compared to the case management only group. Moreover, for the survival curves of time to suicide reattempt, the coping card group showed a significantly longer time to reattempt than the case management only group at 2‐month and 3‐month intervention periods.     

Impulsivity in suicidal and nonsuicidal adolescents

Nonsuicidal and suicidal adolescent inpatients were compared to community high school students using behavioral measures of impulsivity. Measures of problem solving ability, hopelessness, and depression were also administered to all groups. The suicidal inpatients were characterized by greater impulsivity, hopelessness, and depression than both nonsuicidal inpatients and community high school students. There were no differences in problemsolving abilities found between the suicidal inpatients and either the nonsuicidal inpatients or the community controls.     

Family Centered Brief Intensive Treatment: A Pilot Study of an Outpatient Treatment for Acute Suicidal Ideation

Family Centered Brief Intensive Treatment (FC BIT), a hospital diversion treatment program for individuals with acute suicidal ideation, was developed to treat suicidal clients and their families. Individuals who met criteria for hospitalization were treated as outpatients using FC BIT (n = 19) or an intensive outpatient treatment without the family component (IOP; n = 24). Clients receiving FC BIT identified family members or supportive others to participate in therapy. FC BIT clients had significantly greater improvement at the end of treatment compared to IOP clients on measures of depression, hopelessness, and suicidality. Further research is needed to test the efficacy of FC BIT.     

Suicidal tendencies and ego identity in adolescence

Studies distinguishing between adolescent suicide attempters and others usually deal with demographic, physiological, or familial contributing factors. The objective of this study was to investigate the relationship between ego identity development and suicidal inclinations at adolescence. The main hypothesis was that ego identity formation at adolescence may serve as a "buffering" force by providing stability, continuity, meaningfulness, social recognition, commitment, and inner strength against suicidal attempts. Two groups of adolescents, a suicidal group (n = 10) recruited from mental health clinics and a normative group (n = 30), were matched for intelligence, demographic variables, and socioeconomic status. The Adolescent Ego Identity Scale (AEIS; Tzuriel, 1984) and the Israeli Index of Potential Suicide (IIPS) based on Zung's (1974) scale were administered to both groups. The results indicated that the normative group scored significantly higher than did the suicidal group on all but one of the AEIS factors and lower on the IIPS. A MANOVA carried out on ego identity factors revealed a significant overall difference between the two groups. Univariate analyses indicated that most of the ego identity factors differentiated between the two groups. Negative correlations between AEIS and IIPS were found in both groups, especially between total AEIS score and IIPS in the normative group (r = -.89, p less than .001). The findings in general confirm the "buffering" force hypothesis. These preliminary results are discussed in regard to theoretical and preventive aspects.     

Impact of a Theory-Guided Encouragement Intervention on an Employee Walking Pilot Program

This study investigated the impact of encouraging e-mails on self-efficacy, adherence, and step-count in a 10-week walking program. Using a 3 × 3 mixed design, participants randomly received task-involving/caring (n = 37), ego-involving (n = 35), or neutral (n = 34) e-mails and completed pre-/mid-/post surveys. Exercise self-efficacy increased over time, regardless of e-mail content. More of the task/care group adhered (63%) than ego (41%) or neutral groups (50%). The task/care group members who adhered reported significantly more daily-steps than ego or neutral groups. Results suggest that the theoretical framework used to guide encouragement in walking programs may impact participants’ adherence and steps.     

Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

Gender Differences in Coping Styles of Chinese Military Officers Undergoing Intensive Training

This study investigated gender differences in anxiety and coping styles under the stress of intense military training. We surveyed Chinese female (n = 470) and male (n = 379) military officers who were surveyed during the third month of a 10-month intensive training program. Results indicated that state and trait anxiety were highly correlated in both women and men. In general, female officers had higher levels of anxiety, greater negative coping tendencies, and less perceived self-efficacy than their male counterparts. When compared with the norm, both women and men had significantly more positive coping strategies. A hierarchical multiple regression analysis showed factors that influenced male and female state anxiety. Avoidance, which was chosen by women more often than men, in general was less useful for female officers. The most common positive coping style for female officers was problem solving, whereas for men it was help seeking. We suggested that even female officers with lower mental health levels than their male counterparts made active cognitive changes to their coping styles when undergoing intense military training.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

Coping among african-american,hispanic, and non-hispanic white women recently treated for early stage breast cancer

Relatively little is known about how members of minority groups cope with experiences such as diagnosis and treatment of breast cancer – in particular, whether coping patterns among minorities differ from that of the majority. This study adds to the existing knowledge base using a cross-sectional sample of middle-class African-American (n = 26), Hispanic (n = 59), and non-Hispanic White women (n = 151) who had been treated for early stage breast cancer in the past year. We tested for differences in coping responses per se and also for the possibility that coping would relate to distress differently in different groups. There were only two differences in coping (controlling for medical variables, education, and distress): compared to non-Hispanic White women, the other two groups both reported using humor-based coping less, and religion-based coping more. There was one difference in how coping related to distress: venting related more strongly to elevated distress among Hispanic than among non-Hispanics. Discussion centers on a growing consensus on ethnic differences in religious and humor-based coping, and on the relative absence of other coping differences among these populations.     

Adolescent suicidal behaviors as a function of depression,hopelessness, alcohol use,and social support: A longitudinal investigation

Surveyed two high school cohorts (ns=698 and 283) to study independent prospective predictors of adolescent suicidal behaviors (thoughts, communicatio to others, attempts). Within each cohort, there were two measurements conducted 6 months apart. Structural equation models were tested, with depressive symptoms, hopelessness, alcohol consumption, social support, and gender serving as predictors. In the larger cohort, depression predicted later levels of all three suicidal behaviors controlling for baseline suicidal behaviors. Also, suicidal thoughts predicted later communications, and suicide attempts predicted future thoughts. In the smaller cohort, alcohol consumption predicted all three suicidal behaviors at the later measurement, whereas depression was predictive only of later thoughts. Major issues regarding prevention, theories of suicide and negative affect, and methodological/analytical approaches were discussed.     

Examining the Three-Step Theory (3ST) of Suicide in a Prospective Study of Adult Psychiatric Inpatients

This study examined the validity and predictive utility of the three-step theory (3ST) of suicide in psychiatric patients. Participants were 190 consecutively admitted adult psychiatric inpatients (53% female, 60% White, ages 18–73) assessed at three time points: baseline, 4 weeks later (n = 112), and 3 months postdischarge (n = 102). Results were broadly supportive of the 3ST. First, at baseline, an interactive model of pain and hopelessness accounted for substantial variability in suicidal desire, even when controlling for depression and lifetime ideation. This result replicated in different genders and age ranges (i.e., 18–32 and 33–73). Further, pain and hopelessness were robust predictors of suicidal desire weeks and months into the future. Second, among those with pain and hopelessness, lower connectedness, as well as the extent to which pain exceeds connectedness, were robust predictors of higher suicidal desire. Last, a baseline measure of practical capability for suicide predicted suicide attempts both retrospectively and prospectively, even when controlling for lifetime ideation—however, dispositional and acquired contributors to capability were less predictive. Results support the validity and predictive utility of the 3ST, and suggest that the theory may have utility for guiding risk assessment and intervention.     

Dimensions of achievement goal orientation and coping in South African wheelchair rugby players with quadriplegia

This study investigated the relationship between dispositional achievement goal orientation (task and ego) and coping ability in wheelchair rugby players with quadriplegia. The sample consisted of 16 (15 males and 1 female) players between the ages of 25 and 44 (M=33.7 years; SD=8.7) who were selected for South Africa's national training squad in preparation for the 2011 International Wheelchair Rugby Federation (IWRF) Asia-Oceania Championship. Players self-reported on their perception of success and athletic coping skills. The data were analysed for correlational associations between dimensions of achievement goal orientation and psychological skills associated with coping in sport. Findings revealed that players have both high task and fairly high ego orientation of which task orientation was significantly correlated with coping ability.     

Characteristics of Suicidality Among Adolescents

The identification of high-risk adolescent suicide attempters in a population of depressed and suicidal adolescents is of crucial importance. This retrospective study examined characteristics of suicidality (recent and lifetime, active and passive) and psychopathology (depression, aggression, impulsivity, stressful life events, SCL-90 dimensions) among four groups of depressed adolescent outpatients: (1) suicide attempters who required medical treatment (n = 84), (2) suicide attempters who did not require medical treatment (n = 57), (3) suicidal ideators who had never made a suicide attempt (n = 40), and (4) nonsuicidal patients (n = 44). Results indicate that the nonsuicidal group could be differentiated from the three suicidal groups on the basis of suicidality and psychopathology, and that the three suicidal groups could be differentiated from one another on the basis of suicidality but not psychopathology. These findings are discussed in terms of the usefulness of certain self-report measures of suicidality for identifying suicidal adolescents and for differentiating among them. Furthermore, the findings suggest that psychopathological factors do not determine which suicidal adolescents make a medically dangerous suicide attempt and which do not.     

Accurately Imagining Suicide: Imagine-Self,Imagine-Person,Observer Instructions1

To see if actor versus observer instructions influenced students' perceptions of social support during a suicidal crisis, 80 students completed social support, interpersonal reactivity, and suicidal behaviors questionnaires. In a yoked design, students who had been suicidal were matched with those who were instructed to imagine themselves being suicidal, to imagine that another person was suicidal, or to observe a person who was suicidal. Those who had been suicidal in the past (n= 20) were more suicidal than the other 3 groups (ns= 20). The suicidal group perceived high social support (belonging and appraisal), compared to the others, who perceived moderate support. Overall, nonsuicidal college students consistently underestimated their suicidal peer's social support, regardless of the instructions they were given.     

Mediators of the Daily Hassles–Suicidal Ideation Link in African American Women

Depressive symptoms and hopelessness as mediators of the daily hassles–suicidal ideation link in low‐income African American women exposed to intimate partner violence (n = 100) were investigated. As hypothesized, daily hassles, depressive symptoms, and hopelessness were each significantly and positively associated with suicidal ideation. Moreover, the relation between daily hassles and suicidal ideation was, in part, accounted for by depressive symptoms and hopelessness. This study demonstrates the importance of assessing for the presence of these risk factors when determining the likelihood that an abused African American woman will consider suicide. The findings further highlight the value of designing and implementing interventions that target the reduction in depressive symptoms and hopelessness in abused African American women exposed to daily hassles to reduce their suicide risk.     

Effects of Cognitive Behavioral Therapy and Vocational Rehabilitation on Metacognition and Coping in Schizophrenia

The Indianapolis Vocational Intervention Program (IVIP) is a cognitive behaviorally based program of group and individual interventions that seeks to help persons with schizophrenia improve vocational function and sustain hope. In this study we compared baseline and follow-up assessments of coping and metacognition among 50 participants with schizophrenia spectrum disorders offered a six-month job placement and randomized to receive IVIP (n = 25) or standard services (n = 25). ANCOVA controlling for baseline suggest that the IVIP group gained greater ability to think about their own thinking and to cope by seeing what were previously perceived as negative stressors in more positive light. An erratum to this article can be found at     

Social Problem-Solving and Suicidal Ideation Among Homeless Youth Receiving a Cognitive Therapy Intervention: A Moderated Mediation Analysis

Despite the high prevalence of suicidal ideation and attempts among homeless youth, little research has examined how suicide prevention interventions influence suicide-related risk and protective factors, and ultimately produce positive outcome in suicidality in this population. Drawing on the Diathesis-Stress Model and the Interpersonal Theory of Suicide, the current study examined whether participation in Cognitive Therapy for Suicide Prevention (CTSP) moderated the mediation link between social problem-solving, perceived burdensomeness and thwarted belongingness, and suicidal ideation among a sample of homeless youth experiencing suicidal ideation. Social problem-solving refers to a set of cognitive, emotional, and behavioral coping responses in the face of stressful situations, and it is identified as a potent protective factor in alleviating perceived burdensomeness and thwarted belongingness, and reducing suicidal ideation. Participants included 150 homeless youth (M age = 20.99, range = 18-24; 41% female) who were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (n = 75) or Treatment as Usual alone (n = 75). Participants were assessed at baseline, 3, 6, and 9 months post-baseline. Findings showed that perceived burdensomeness mediated the association of social problem-solving with suicidal ideation only among youth participating in the CTSP condition. These findings provide evidence to support the promising effects of CTSP in enhancing the protective effects of social problem-solving on suicidal ideation through the mediating effects of perceived burdensomeness. Findings also have implications for improving intervention effectiveness with a community-based population at high risk of suicide.     

Dissociation,Physical Pain,and Suicide: A Hypothesis

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self-harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.     

Mental toughness, stress, stress appraisal, coping and coping effectiveness in sport

The aim of the present study was to investigate the relationship between mental toughness, stressor appraisal, coping strategies and coping effectiveness among a sample of athletes. Participants were 482 athletes (male n = 305; female n = 177), aged between 16 and 45 years (M age = 20.44 years, SD = 3.98). In support of a priori predictions, mental toughness was associated with stress intensity and control appraisal, but not the type of stressor experienced by athletes. Total mental toughness and its six components predicted coping and coping effectiveness in relation to the self-selected stressor. In particular, higher levels of mental toughness were associated with more problem-focused coping, but less emotion-focused and avoidance coping. Coping effectiveness was influenced by the coping strategy employed by the athletes.     

Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents

Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12–19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior “drinking alcoholic beverages” and “smoking cigarettes” were positively associated with suicidal ideation. “Watching TV,” “playing online/mobile games,” and “sleeping” were negatively associated with suicidal ideation in both groups. In males, “engaging in sports” was negatively related to suicidal ideation. In females, “venting by talking to others” and “eating” were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.