Cognitive therapy for depression is based on an assumption that depressed individuals have inaccu... more Cognitive therapy for depression is based on an assumption that depressed individuals have inaccurate, negative biases. Whether this assumption is accurate remains unresolved. Thus, this study sought to examine the relationship between depressive symptoms and bias in three sets of predictions (i.e., predictions of future life events, how one would be rated by a significant other, and performance on a vocabulary test). Following study announcements made to a subset of people pre-screened for depressive symptoms, 85 participants with widely varying depressive symptoms (17 of whom met diagnostic criteria for depression) made predictions on three judgment tasks and the outcomes for these tasks were assessed. Optimistic/pessimistic biases were related to depressive symptoms for each of the three tasks. Participants with high levels of depressive symptoms and depressed participants exhibited substantial pessimistic bias. Those high in depressive symptoms exhibited significant pessimistic bias on all three tasks. Participants meeting diagnostic criteria for depression exhibited pessimistic bias on two of three tasks. There was no evidence that depressive symptoms were associated with greater accuracy in judgments. Results are largely consistent with cognitive models of depression which postulate that depression is associated with pessimistic biases.
This study examined effortful cognitive skills and underlying maladaptive beliefs among patients ... more This study examined effortful cognitive skills and underlying maladaptive beliefs among patients treated with Cognitive Therapy for depression (CT). Depressed patients (n = 44) completed cognitive measures before and after 16 weeks of CT. Measures included: an assessment of CT skills (Ways of Responding Scale, WOR), an implicit test of maladaptive beliefs (Implicit Association Test, IAT), and a self-report questionnaire of maladaptive beliefs (Dysfunctional Attitude Scale, DAS). A matched sample of never-depressed participants (n = 44) also completed study measures. Prior to treatment, depressed patients endorsed significantly more undesirable cognitions on the WOR, IAT, and DAS compared to never-depressed participants. Patients displayed improvement on the WOR and DAS over the course of treatment, but showed no change on the IAT. Additionally, improvements on the WOR and DAS were each related to greater reductions in depressive symptoms. Results suggest that the degree of symptom reduction among patients participating in CT is related to changes in patients' acquisition of coping skills requiring deliberate efforts and reflective thought, but not related to reduced endorsement of implicitlyassessed maladaptive beliefs.
This study used a mixed methods approach to examine pathways to suicidal behavior by identifying ... more This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within one day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.
Attentional fixation is a cognitive process characterized by a narrowing of attention on and preo... more Attentional fixation is a cognitive process characterized by a narrowing of attention on and preoccupation with suicide as the only solution to one's problems. The present study sought to investigate the experience of attentional fixation on suicide by establishing the psychometric properties of the Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ) in a sample of 64 patients who recently attempted suicide. The AFSEQ evidenced strong psychometric properties, including good internal consistency and construct validity through moderate correlations with measures of suicidal ideation, depressive symptoms, and suicide-relevant cognitive distortions. In addition, an exploratory factor analysis of the AFSEQ identified two factors: Cognitive Dysfunction and Cognitive Stuckness. Results suggest the AFSEQ is a reliable method for assessing the experience of attentional fixation in relation to suicide. We propose future research to further examine attentional fixation as a proximal risk factor for suicidal behavior.
This study aimed to identify barriers to treatment seeking and service utilization among previous... more This study aimed to identify barriers to treatment seeking and service utilization among previously deployed Army soldiers who recently experienced a suicidal crisis. Methods: Confidential interviews were conducted on a psychiatric inpatient unit with 12 Army soldiers with a deployment history following a suicidal crisis. Qualitative analysis focused on statements coded as "barriers to seeking help" and "explicit recommendations." Results: Suicidal Army soldiers with a deployment history experienced different barriers to seeking help, including stigma and logistical challenges (e.g., long wait times for appointments). Negative and positive perceptions of support were reported for various resourcesfor example, family, crisis hotlines, chaplains, and command. Conclusions: Suicidal Army soldiers, interviewed in this study, experienced a number of challenges and frustrations associated with various helping resources. This study highlights the need for greater attention toward understanding these challenges and subsequently addressing them through appropriate resource allocation and additional training for those working directly with Army soldiers at risk for suicide.
The evidence for combat experience per se as a risk factor for suicide is reviewed in this chapte... more The evidence for combat experience per se as a risk factor for suicide is reviewed in this chapter. The chapter discusses assessing the risk of suicide with combat veterans with a particular emphasis on suicide risk factors associated with combat-related PTSD. A controversy about whether combat-related PTSD actually is a risk factor for suicide is reviewed. In conducting a risk assessment with veterans, clinicians are encouraged to be sensitive to issues of particular relevance to veterans who have experienced combat. Finally, the chapter offers suggestions for the management of suicide risk, including comments on when and how suicidal patients can be managed on an outpatient basis and when an emergency intervention might be needed.
In this paper, we compare the effectiveness of logo therapy (LT) and cognitive therapy (CT) in al... more In this paper, we compare the effectiveness of logo therapy (LT) and cognitive therapy (CT) in alleviating symptoms of depression. For this purpose 45 elderly men aged between 65 to 85 years who inhabit in nursing houses were randomly put into two experimental and one control group (n = 45). The experimental groups received techniques of cognitive and logo therapies for 10 treatment sessions, 75 min for each sessions per week. All depressed participants were assessed using the 15-question Geriatric depression scale (GDS-15) before and after the treatment and the results were analyzed by two sample t-test, ANOVA and Tukey test. The results indicated that there were significant differences between the experimental groups and the control group. Both CT and Logo therapy reduced symptoms of depression. Analysis of the results of Tukey test showed that CT had the most and the control group had the least depression and logo therapy was also effective in reducing the disorder. Based on the results we conclude that CT and Logo therapy can be effective non-pharmacological treatment options for reducing negative spontaneous thoughts and depression, and increase quality of life and psychosocial functioning.
.................................................................................................... more ......................................................................................................................... ii Acknowledgments ...........................................................................................................v Vita ............................................................................................................................... vi Table of
ObjectiveSuicidal ideation and suicidal behaviors are major public health concerns in the United ... more ObjectiveSuicidal ideation and suicidal behaviors are major public health concerns in the United States and are difficult to treat and predict. Risk factors that are incrementally informative are needed to improve prediction and inform prevention of suicidal thoughts and behaviors. Uncontrollability of suicidal ideation, one parameter of suicidal ideation, is one such candidate.MethodIn the current study, we assessed the predictive power of uncontrollability of suicidal ideation, over and above overall suicidal ideation, for future suicidal ideation in a large sample of active‐duty service members. A total of 1044 suicidal military service members completed baseline assessments, of whom 664 (63.6%) completed 3‐month follow‐up assessments.ResultsWhile baseline overall suicidal ideation itself was the strongest predictor of future suicidal ideation, uncontrollability of suicidal ideation added some incremental explanatory power.ConclusionFurther study of uncontrollability of suicidal ...
Cognitive therapy for depression is based on an assumption that depressed individuals have inaccu... more Cognitive therapy for depression is based on an assumption that depressed individuals have inaccurate, negative biases. Whether this assumption is accurate remains unresolved. Thus, this study sought to examine the relationship between depressive symptoms and bias in three sets of predictions (i.e., predictions of future life events, how one would be rated by a significant other, and performance on a vocabulary test). Following study announcements made to a subset of people pre-screened for depressive symptoms, 85 participants with widely varying depressive symptoms (17 of whom met diagnostic criteria for depression) made predictions on three judgment tasks and the outcomes for these tasks were assessed. Optimistic/pessimistic biases were related to depressive symptoms for each of the three tasks. Participants with high levels of depressive symptoms and depressed participants exhibited substantial pessimistic bias. Those high in depressive symptoms exhibited significant pessimistic bias on all three tasks. Participants meeting diagnostic criteria for depression exhibited pessimistic bias on two of three tasks. There was no evidence that depressive symptoms were associated with greater accuracy in judgments. Results are largely consistent with cognitive models of depression which postulate that depression is associated with pessimistic biases.
This study examined effortful cognitive skills and underlying maladaptive beliefs among patients ... more This study examined effortful cognitive skills and underlying maladaptive beliefs among patients treated with Cognitive Therapy for depression (CT). Depressed patients (n = 44) completed cognitive measures before and after 16 weeks of CT. Measures included: an assessment of CT skills (Ways of Responding Scale, WOR), an implicit test of maladaptive beliefs (Implicit Association Test, IAT), and a self-report questionnaire of maladaptive beliefs (Dysfunctional Attitude Scale, DAS). A matched sample of never-depressed participants (n = 44) also completed study measures. Prior to treatment, depressed patients endorsed significantly more undesirable cognitions on the WOR, IAT, and DAS compared to never-depressed participants. Patients displayed improvement on the WOR and DAS over the course of treatment, but showed no change on the IAT. Additionally, improvements on the WOR and DAS were each related to greater reductions in depressive symptoms. Results suggest that the degree of symptom reduction among patients participating in CT is related to changes in patients' acquisition of coping skills requiring deliberate efforts and reflective thought, but not related to reduced endorsement of implicitlyassessed maladaptive beliefs.
This study used a mixed methods approach to examine pathways to suicidal behavior by identifying ... more This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within one day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.
Attentional fixation is a cognitive process characterized by a narrowing of attention on and preo... more Attentional fixation is a cognitive process characterized by a narrowing of attention on and preoccupation with suicide as the only solution to one's problems. The present study sought to investigate the experience of attentional fixation on suicide by establishing the psychometric properties of the Attentional Fixation on Suicide Experiences Questionnaire (AFSEQ) in a sample of 64 patients who recently attempted suicide. The AFSEQ evidenced strong psychometric properties, including good internal consistency and construct validity through moderate correlations with measures of suicidal ideation, depressive symptoms, and suicide-relevant cognitive distortions. In addition, an exploratory factor analysis of the AFSEQ identified two factors: Cognitive Dysfunction and Cognitive Stuckness. Results suggest the AFSEQ is a reliable method for assessing the experience of attentional fixation in relation to suicide. We propose future research to further examine attentional fixation as a proximal risk factor for suicidal behavior.
This study aimed to identify barriers to treatment seeking and service utilization among previous... more This study aimed to identify barriers to treatment seeking and service utilization among previously deployed Army soldiers who recently experienced a suicidal crisis. Methods: Confidential interviews were conducted on a psychiatric inpatient unit with 12 Army soldiers with a deployment history following a suicidal crisis. Qualitative analysis focused on statements coded as "barriers to seeking help" and "explicit recommendations." Results: Suicidal Army soldiers with a deployment history experienced different barriers to seeking help, including stigma and logistical challenges (e.g., long wait times for appointments). Negative and positive perceptions of support were reported for various resourcesfor example, family, crisis hotlines, chaplains, and command. Conclusions: Suicidal Army soldiers, interviewed in this study, experienced a number of challenges and frustrations associated with various helping resources. This study highlights the need for greater attention toward understanding these challenges and subsequently addressing them through appropriate resource allocation and additional training for those working directly with Army soldiers at risk for suicide.
The evidence for combat experience per se as a risk factor for suicide is reviewed in this chapte... more The evidence for combat experience per se as a risk factor for suicide is reviewed in this chapter. The chapter discusses assessing the risk of suicide with combat veterans with a particular emphasis on suicide risk factors associated with combat-related PTSD. A controversy about whether combat-related PTSD actually is a risk factor for suicide is reviewed. In conducting a risk assessment with veterans, clinicians are encouraged to be sensitive to issues of particular relevance to veterans who have experienced combat. Finally, the chapter offers suggestions for the management of suicide risk, including comments on when and how suicidal patients can be managed on an outpatient basis and when an emergency intervention might be needed.
In this paper, we compare the effectiveness of logo therapy (LT) and cognitive therapy (CT) in al... more In this paper, we compare the effectiveness of logo therapy (LT) and cognitive therapy (CT) in alleviating symptoms of depression. For this purpose 45 elderly men aged between 65 to 85 years who inhabit in nursing houses were randomly put into two experimental and one control group (n = 45). The experimental groups received techniques of cognitive and logo therapies for 10 treatment sessions, 75 min for each sessions per week. All depressed participants were assessed using the 15-question Geriatric depression scale (GDS-15) before and after the treatment and the results were analyzed by two sample t-test, ANOVA and Tukey test. The results indicated that there were significant differences between the experimental groups and the control group. Both CT and Logo therapy reduced symptoms of depression. Analysis of the results of Tukey test showed that CT had the most and the control group had the least depression and logo therapy was also effective in reducing the disorder. Based on the results we conclude that CT and Logo therapy can be effective non-pharmacological treatment options for reducing negative spontaneous thoughts and depression, and increase quality of life and psychosocial functioning.
.................................................................................................... more ......................................................................................................................... ii Acknowledgments ...........................................................................................................v Vita ............................................................................................................................... vi Table of
ObjectiveSuicidal ideation and suicidal behaviors are major public health concerns in the United ... more ObjectiveSuicidal ideation and suicidal behaviors are major public health concerns in the United States and are difficult to treat and predict. Risk factors that are incrementally informative are needed to improve prediction and inform prevention of suicidal thoughts and behaviors. Uncontrollability of suicidal ideation, one parameter of suicidal ideation, is one such candidate.MethodIn the current study, we assessed the predictive power of uncontrollability of suicidal ideation, over and above overall suicidal ideation, for future suicidal ideation in a large sample of active‐duty service members. A total of 1044 suicidal military service members completed baseline assessments, of whom 664 (63.6%) completed 3‐month follow‐up assessments.ResultsWhile baseline overall suicidal ideation itself was the strongest predictor of future suicidal ideation, uncontrollability of suicidal ideation added some incremental explanatory power.ConclusionFurther study of uncontrollability of suicidal ...
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