No abstract

The cognitive processes underlying suicidal thinking and behavior are not well-understood. The present study examined brooding and reflection, two dimensions of rumination, as predictors of suicidal ideation among a community sample of 1,134 adults. Participants completed self-report measures of rumination and depression, and a semi-structured clinical interview that included an assessment of suicidal ideation, at baseline and one-year follow up. Brooding was more strongly related to degree of ideation at baseline than was reflection. However, both brooding and reflection predicted whether an individual thought about suicide at one-year follow up, even after adjusting for baseline suicidal ideation. Symptoms of depression mediated the relationship between brooding and ideation but not between reflection and ideation. Implications for the nature of thought processes that result in suicidal thinking are discussed.

This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic memories. Hierarchical regression analyses indicated the strength of the therapeutic alliance established early in treatment reliably predicted improvement in PTSD symptoms at posttreatment. Furthermore, this relationship was mediated by participants' improved capacity to regulate negative mood states in the context of Phase 2 exposure therapy. In the treatment of childhood abuse-related PTSD, the therapeutic alliance and the mediating influence of emotion regulation capacity appear to have significant roles in successful outcome.