ABSTRACT
Suicide rates are higher among older adults than any other age group and suicidal ideation is one of the best predictors of completed suicide in older adults. Despite this, few studies have evaluated predictors of suicidal ideation and other correlates of death by suicide (e.g. hopelessness) among older adults. Even fewer studies on this topic have been conducted among samples characterized as poor responders to treatments (e.g. depressed individuals with co-occurring personality disorder). The purpose of this study was to examine coping styles and thought suppression as predictors of a suicide risk composite score in a sample of depressed older adults with co-occurring personality disorders. Based on the extant literature, it was hypothesized that maladaptive coping (i.e. emotional and avoidance coping) and chronic thought suppression would significantly predict suicide risk. The results of this study indicated that elevated emotional coping and thought suppression were associated with increased suicide risk. Contrary to hypotheses, lower avoidance coping was associated with increased risk, although this finding is moderated by Axis II diagnosis Thus, treatments that focus on decreasing emotional coping and chronic thought suppression may result in decreased suicidal ideation and hopelessness for older adults with depression and Axis II pathology.
Subject(s)
Adaptation, Psychological , Depression/epidemiology , Personality Disorders/epidemiology , Suicide, Attempted/psychology , Activities of Daily Living , Aged , Comorbidity , Female , Humans , Incidence , Male , Psychiatric Status Rating Scales , Risk Factors , Surveys and Questionnaires , ThinkingABSTRACT
This study examined severity of depression, age of onset, and thought suppression as predictors of treatment outcome. Measures were taken pre-treatment, post-treatment, and at six-month follow-up in 34 depressed older adults receiving the treatment protocol described in Lynch, Morse, Mendelson & Robins (Dialectical behavior therapy for depressed older adults, American Journal of Geriatric Psychiatry, 11, 33-45, 2003). Severity and chronicity of depression and higher levels of thought suppression were associated with higher depressive symptoms six months after treatment. Findings are consistent with research suggesting that severity and chronicity of depression predict poor clinical outcome. In addition, these results provide preliminary evidence that the tendency to cope with unwanted thoughts by deliberate attempts to not experience such thoughts may be an important pre-treatment predictor of outcome among depressed older adults. Larger studies are needed to explore whether thought suppression mediates long-term recovery from depression.
Subject(s)
Cognition , Depression/psychology , Depression/therapy , Age of Onset , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prognosis , Psychiatric Status Rating Scales , Severity of Illness Index , Treatment OutcomeABSTRACT
The purpose of this study was to begin a preliminary examination of constructs theorized to be related to suicidal behavior by testing a model of the influence of both temperament and emotion regulation on suicidal ideation and hopelessness in a sample of depressed older adults. The model was evaluated using structural equation modeling procedures in a sample of depressed, older adults. Findings supported a temporally predictive model in which negative affect intensity and reactivity lead to emotion inhibition, operationalized as ambivalence over emotional expression and thought suppression, which in turn lead to increased presence of suicidal predictors, operationalized as hopelessness and suicidal ideation. These results suggest that suicide prevention efforts in older adults may be improved by targeting emotion inhibition in treatment, especially among affectively intense and reactive older adults.
