Immersive and reflective processing of a suicidal episode: implications for assessment and treatment of adolescents
Date
2021
Authors
Journal Title
Journal ISSN
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Publisher
University of Delaware
Abstract
The following studies assessed and tested individual differences in two modes
of processing, Recall Intensity (RI) and Meaning Making (MM), during the Suicide
Narrative Interview (SNI). RI was viewed as a vulnerability to become immersed in
suicidal thoughts and feelings, while MM was viewed as a protective capacity for
developing new perspectives and understandings by reflecting on suicidal thoughts
and feelings. Three studies tested the validity and clinical utility of RI and MM in a
sixteen-week randomized clinical trial (RCT) for depressed and suicidal adolescents.
Study 1 examined the convergent, divergent, and concurrent validity of pretreatment
MM and RI. Results generally supported expectations, with baseline MM associated
with protective factors that reduce suicidality and baseline RI associated with elevated
scores across several suicide risk factors and more pre-treatment suicidal ideation.
Study 2 used baseline MM and RI to predict adolescents’ treatment response. Findings
indicated that adolescents with higher levels of MM and lower levels of RI
experienced the greatest symptom reductions during treatment. Study 3 examined
whether MM and RI changed from the beginning to end of treatment and whether
initial gains in therapeutic alliance (TA) or reductions in suicidal ideation mediated
change in RI and MM. Initial improvements in TA predicted increases in both MM
and RI, while initial reductions in suicidal ideation predicted declines in RI but had no
effect on MM. These studies support MM and RI as two distinct modes of processing
suicidal thoughts and feelings and highlight RI as an indicator of risk and MM as a
potential protective factor in assessing and treating adolescent suicidality. ☐ Keywords: adolescence, suicide, meaning making, suicide narrative, treatment response
Description
Keywords
Adolescence, Meaning making, Suicide, Suicide narrative, Treatment response