Certain Types of Coping Skills Lower Suicide Risk in Schizophrenia

Although suicide is a risk for people with schizophrenia, those who believe that they can cope with negative emotions or difficult situations may have some protection against suicide, a study reported in the September Behavior Research and Therapy suggested.

It was headed by Judith Johnson, a doctoral candidate in clinical psychology at the University of Manchester in England.

Seventy-seven people with schizophrenia or schizoaffective disorder living in northwest England were recruited to participate in the study. They had been ill for 18 years on average. Almost three-fourths of them had made one or more suicide attempts.

They filled out the Beck Hopelessness Questionnaire, Beck Scale for Suicidal Ideation, and Resilience Appraisals Scale (RAS). On the 12-item RAS, subjects were asked to rate their ability to cope with negative emotions or to cope with difficult situations and to provide information about the social support in their lives—for instance, “My family or friends are very supportive of me” and “If I were to have problems, I have people I could turn to.”

High RAS scores were inversely linked with suicidal ideation, the researchers found. Thus it looked as if believing that one can cope with negative emotions or difficult situations and that one can garner social support in tough times might protect against suicidal ideation.

But when the researchers looked at individual components of the RAS, they found an inverse correlation with suicide only for the items indicating a belief that one can cope with negative emotions and a belief that one can cope with difficult situations. The correlation was not evident in responses to questions about the strength and availability of social supports.

Yet how might such beliefs protect people with schizophrenia from suicidal ideas? By tempering feelings of hopelessness, the researchers believe, since no matter how hopeless they felt, subjects who scored high on such beliefs were significantly less likely to experience suicidal ideation than subjects who scored lower.

The study was funded by the U.K. National Institute for Health Research.

An abstract of “Resilience to Suicidal Ideation in Psychosis: Positive Self-Appraisals Buffer the Impact of Hopelessness” can be accessed at <www.sciencedirect.com/science/journal/00057967> by clicking on the September issue.