Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.

OBJECTIVE: Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in b...

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Main Authors: Hales, S, Deeprose, C, Goodwin, G, Holmes, E
Format: Journal article
Language:English
Published: 2011
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author Hales, S
Deeprose, C
Goodwin, G
Holmes, E
author_facet Hales, S
Deeprose, C
Goodwin, G
Holmes, E
author_sort Hales, S
collection OXFORD
description OBJECTIVE: Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in bipolar disorder. Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20). METHODS: The study used a quasi-experimental comparative design. The Structured Clinical Interview for DSM-IV was used to confirm diagnoses. Quantitative and qualitative data were gathered through questionnaire measures (e.g., mood and trait imagery use). Individual interviews assessed suicidal cognitions in the form of (i) mental images and (ii) verbal thoughts. RESULTS: All participants reported imagining flashforwards to suicide. Both groups reported greater preoccupation with these suicide-related images than with verbal thoughts about suicide. However, compared to the unipolar group, the bipolar group were significantly more preoccupied with flashforward imagery, rated this imagery as more compelling, and were more than twice as likely to report that the images made them want to take action to complete suicide. In addition, the bipolar group reported a greater trait propensity to use mental imagery in general. CONCLUSIONS: Suicidal ideation needs to be better characterized, and mental imagery of suicide has been a neglected but potentially critical feature of suicidal ideation, particularly in bipolar disorder. Our findings suggest that flashforward imagery warrants further investigation for formal universal clinical assessment procedures.
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spelling oxford-uuid:0a245a76-e8d6-4d4d-b62f-92505fca6bda2022-03-26T09:22:07ZCognitions in bipolar affective disorder and unipolar depression: imagining suicide.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0a245a76-e8d6-4d4d-b62f-92505fca6bdaEnglishSymplectic Elements at Oxford2011Hales, SDeeprose, CGoodwin, GHolmes, E OBJECTIVE: Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in bipolar disorder. Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20). METHODS: The study used a quasi-experimental comparative design. The Structured Clinical Interview for DSM-IV was used to confirm diagnoses. Quantitative and qualitative data were gathered through questionnaire measures (e.g., mood and trait imagery use). Individual interviews assessed suicidal cognitions in the form of (i) mental images and (ii) verbal thoughts. RESULTS: All participants reported imagining flashforwards to suicide. Both groups reported greater preoccupation with these suicide-related images than with verbal thoughts about suicide. However, compared to the unipolar group, the bipolar group were significantly more preoccupied with flashforward imagery, rated this imagery as more compelling, and were more than twice as likely to report that the images made them want to take action to complete suicide. In addition, the bipolar group reported a greater trait propensity to use mental imagery in general. CONCLUSIONS: Suicidal ideation needs to be better characterized, and mental imagery of suicide has been a neglected but potentially critical feature of suicidal ideation, particularly in bipolar disorder. Our findings suggest that flashforward imagery warrants further investigation for formal universal clinical assessment procedures.
spellingShingle Hales, S
Deeprose, C
Goodwin, G
Holmes, E
Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title_full Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title_fullStr Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title_full_unstemmed Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title_short Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.
title_sort cognitions in bipolar affective disorder and unipolar depression imagining suicide
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