This study was supported in part by National Institute of Mental Health grant MH44801 (E. J. Bromet) and a grant from the American Foundation for Suicide Prevention (E. D. Klonsky). We thank Dr. Charles Rich for assistance in the design of this study. We are indebted to the project psychiatrists, interviewers, data team, and mental health professionals in Suffolk County for their outstanding support. We are particularly indebted to the study participants for contributing their time and valuable input throughout the course of the study.
Hopelessness as a Predictor of Attempted Suicide among First Admission Patients with Psychosis: A 10-year Cohort Study
Article first published online: 9 FEB 2012
© 2012 The American Association of Suicidology
Suicide and Life-Threatening Behavior
Volume 42, Issue 1, pages 1–10, February 2012
How to Cite
David Klonsky , E. , Kotov, R., Bakst, S., Rabinowitz, J. and Bromet, . E. J. (2012), Hopelessness as a Predictor of Attempted Suicide among First Admission Patients with Psychosis: A 10-year Cohort Study. Suicide and Life-Threat Behavi, 42: 1–10. doi: 10.1111/j.1943-278X.2011.00066.x
- Issue published online: 9 FEB 2012
- Article first published online: 9 FEB 2012
- Manuscript Received: November 7, 2011 Revision Accepted: November 10, 2011
Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during the 10-year follow-up, and those who attempted suicide scored significantly higher at baseline on the Beck Hopelessness Scale. In general, a given assessment of hopelessness (i.e., baseline, 6, 24, and 48 months) reliably predicted attempted suicide up to 4 to 6 years later, but not beyond. Structural equation modeling indicated that hopelessness prospectively predicted attempted suicide even when controlling for previous attempts. Notably, a cut-point of 3 or greater on the Beck Hopelessness Scale yielded sensitivity and specificity values similar to those found in nonpsychotic populations using a cut-point of 9. Results suggest that hopelessness in individuals with psychotic disorders confers information about suicide risk above and beyond history of attempted suicide. Moreover, in comparison with nonpsychotic populations, even relatively modest levels of hopelessness appear to confer risk for suicide in psychotic disorders.