Category: Suicide and Self-Injury

PS13- #A16 - The Association of Hopelessness With Suicide Ideation is Driven by Absence of Optimism and Not Cynicism

Saturday, Nov 18
2:45 PM – 3:45 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Suicide | Self-Injury | Adolescents

Background


Hopelessness has been stated as one of the strongest predictors of suicide ideation (Beck et al., 2006). Measures of hopelessness typically include positively worded items, which correspond to lack of optimism and negatively worded items, which reflect cynicism. A recent study (Horwitz et al., 2016) found that lack of optimism (but not cynicism) predicted suicidal behavior longitudinally in a sample of outpatient high risk youth. This study examines whether lack of optimism and cynicism are a) differentially associated with concurrent suicide ideation in acutely distressed youth and b) contribute to suicide ideation independent of perceived burdensomeness (PB) and thwarted belongingness (TB) cognitions that are central to suicidal ideation in the Interpersonal Psychological Theory of Suicide (IPTS).


 


Method


Participants were 311 youth (M age = 14.73, SD = 1.42) on an inpatient psychiatric unit. The sample was mainly Caucasian (92%) and female (80%). Measures used were the Hopelessness Scale for Children (Kazdin et al., 1986) with subscale scores for lack of optimism and cynicism, the Interpersonal Needs Questionnaire-15 item short form (Van Orden et al., 2012), and the Quick Inventory of Depressive Symptomatology (Rush et al., 2006) with suicidal ideation measured on a 4-point self-reported scale.


 


Results


A multiple regression model containing lack of optimism and cynicism predicted suicide ideation [F (5, 310) = 43.52, p < .01, R2= .41]. Main effect of lack of optimism ( b = .21, p < .01) was significant. There was no main effect for cynicism. Additionally, a multiple regression model containing lack of optimism, cynicism, PB, TB and PBxTB predicted suicide ideation, [F(8, 308) =30.81, p < .01, R2 = .44]. Main effect for lack of optimism (b = .19, p < .01), PB (b = .16, p = .01) and PBxTB (b = -.11, p = .01) were significant, but main effects for cynicism and TB were not. Sex, age and depression were controlled in each of these regressions. 


 


Conclusions


The results suggest a more nuanced understanding of the relationship between hopelessness and suicide ideation. Lack of optimism might be the more salient component of hopelessness in comparison to cynicism for suicide ideation. Lack of optimism provides an additive value to other cognitions associated with suicide ideation. Limitations include an acutely distressed and demographically narrow sample and cross-sectional design. Assessment of lack of optimism in the management of high risk youth and the development of innovative programs to target optimism might be warranted.

Daniel K. Elledge

Clinical Psychology Doctoral Student
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Sarah Horton

Psychology Postdoctoral Fellow
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Lucas Zullo

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas

Michael Eaddy

Graduate Research Assistant
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Jessica King

Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center

Sunita Stewart

Licensed Psychologist, Professor of Psychiatry
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center