Item – Theses Canada

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OCLC number
664421320
Link(s) to full text
LAC copy
LAC copy
Author
Fazakas-DeHoog, Laura L.(Laura Lyn),1961-
Title
An integrated cognitive-affective model of suicidal thinking and behavior.
Degree
Ph. D. -- University of Western Ontario, 2008
Publisher
Ottawa : Library and Archives Canada = Bibliothèque et Archives Canada, [2009]
Description
3 microfiches
Notes
Includes bibliographical references.
Abstract
Despite a growing body of research, a comprehensive understanding of suicide remains elusive. The current dissertation involved the development of an integrated cognitive affective theory of suicidal thinking and behavior, and the initial assessment of components of this theoretical model in three separate, but related studies. In Study 1, the integrity of the model was assessed in a sample of 397 (83 mate and 314 female) undergraduate students. The resulting fit indices (CFI=.87; GFI=.90; RMSEA=.09) of the structural equation modeling (SEM) analysis indicated an adequate fit between the hypothesized model and the data in the sample, with the model accounting for 90% of the variance. The SEM results indicated that rumination and negative affect directly impacted both cognitive distortions and cognitive deficits. Cognitive distortions then had a direct impact on the development of suicide ideation, whereas cognitive deficits had an indirect impact on the development of ideation, through their reciprocal relationships with cognitive distortions, as well as with rumination and negative affect. In the interest of parsimony, a simplified model, in which cognitive distortions and cognitive deficits were included, but affect and rumination were omitted, was also assessed. The resulting fit indices (CFI = .98; GFI = .98; RMSEA = .05) indicated a better fitting model than the initial model, with the simplified model accounting for 98% of the variance. In Study 2, the relationships among the components in the model were further assessed in a community sample of 25 non-ideators, 25 ideators, and 11 recent suicide attempters. Patterns of correlations between the variables in the model paralleled those found in Study 1. Further, the components of the model varied across the suicide continuum as predicted by the model. Suicide ideation, cognitive distortions, and negative affect were significantly higher in ideators than in non-deators, and higher in recent attempters than in ideators. Positive affect, in contrast, decreased significantly across these 3 groups. Ideators reported significantly higher levels of rumination than did non-ideators, but no significant differences in ruminative tendencies were noted between ideators and attempters. Between group differences in cognitive deficits varied depending on the deficit in question. Avoidant problem-solving was significantly higher in ideators than non-ideators. Although avoidant problem-solving increased across the entire continuum, between-group differences for ideators and attempters were not significant, Cognitive rigidity also increased across the entire continuum, and was significantly higher in attempters than in non-ideators. Self-reported problem-solving ability did not differ appreciably between any of the groups. Overall, compared to cognitive deficits, cognitive distortions demonstrated much stronger and more consistent relationships with suicide ideation and the severity of recent suicide attempts. As such, the findings of Study 2 provided further support for the relationships in the proposed model. Study 3, which was exploratory in nature, involved conducting psychological autopsy interviews with the next of kin of 4 individuals who had died by suicide, and analyzing the content of their suicide notes for evidence of affect, rumination, cognitive distortions and cognitive deficits. The results of Study 3 indicated that high levels of negative affect and cognitive distortions were evident in the thinking and behavior of fatal suicide attempters in the month prior to the suicide. Perhaps due to the process-oriented nature of rumination and cognitive deficits, there was less evidence of these variables in both the interviews and the suicide note analysis. In general, the results of Study 3 indicated that affect, cognitive distortions and to a smaller degree, cognitive deficits may have utility for understanding fatal suicide attempts as well. A secondary goal of the current dissertation involved assessing the utility of the components in the model as predictors of suicide ideation. In Study 1, hopelessness was a significant predictor of suicide ideation, but ambivalence, rumination and negative affect exhibited predictive utility above and beyond hopelessness. These findings were replicated in Study 2. Specifically, hopelessness significantly predicted suicide ideation, but the addition of ambivalence and negative affect (self-directed anger) significantly enhanced the prediction. In Study 2, relative to the severity of intent in recent suicide attempters, the results of the regression analysis indicated that hopelessness was the only significant single predictor. These findings were discussed in terms of the cognitive-affective state that was associated with ideators and attempters in the current studies. Further, the limitations of the current studies were discussed, as were contributions, implications and future directions.
ISBN
9780494392669
0494392665