Problem-solving skills in suicidal psychiatric patients

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1985
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Virginia Polytechnic Institute and State University
Abstract

Both popular clinical folklore and the findings of empirical research have suggested a relationship between cognitive rigidity and suicidal behavior. Specifically, it has been hypothesized that individuals deficient in the capacity for flexible thought become increasingly hopelessness and suicidal in the face of high levels of environmental stress. That is, these persons are thought to be cognitively unprepared to deal with negative life events. The present study sought to evaluate this model with hospitalized psychiatric patients placed on suicidal precautions status by hospital staff. Suicidal and non-suicidal control subjects completed measures of life stress, depression, cognitive rigidity, hopelessness, and suicidal intent. In addition, these subject also completed two measures of interpersonal problem-solving. Suicidal subjects were found to report higher levels of negative life stress in the previous year than members of the control group. Suicidal subjects were also significantly more cognitively rigid and the rigidity appears to have been reflected in their performance on the interpersonal problem-solving measures. Overall, suicidal subjects were observed to be poorer problem-solvers than the non-suicidal control group members on both measures of interpersonal problem-solving skills. More specific analyses showed that these subjects were not able to generate as many potential solutions to interpersonal problems from their own lives and when asked to evaluate these solutions, the suicidal subjects tended to rate them more negatively than did the control subjects. Suicidal subjects were also less likely than control subjects to employ these alternatives when subsequently attempting to solve the presented problem. Additionally, the suicidal subjects tended more often to implement irrelevant solutions. Although the suicidal subjects were significantly more hopeless than the non-suicidal subjects, it appears that this variable contributed independently to the level of suicide intent, rather than resulting from cognitive rigidity and interpersonal problem-solving deficits. Results are interpreted as supporting Beck's (1979) viewpoint that both deficits in problem-solving skills and hopelessness need to be addressed in the treatment of suicidal patients.

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