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Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide

  • M. Ghahramanlou-Holloway (a1), S. S. Bhar (a2), G. K. Brown (a3), C. Olsen (a4) and A. T. Beck (a3)
  • DOI:
  • Published online: 19 October 2011

Cognitive therapy has been found to be effective in decreasing the recurrence of suicide attempts. A theoretical aim of cognitive therapy is to improve problem-solving skills so that suicide no longer remains the only available option. This study examined the differential rate of change in problem-solving appraisal following suicide attempts among individuals who participated in a randomized controlled trial for the prevention of suicide.


Changes in problem-solving appraisal from pre- to 6-months post-treatment in individuals with a recent suicide attempt, randomized to either cognitive therapy (n=60) or a control condition (n=60), were assessed by using the Social Problem-Solving Inventory-Revised, Short Form.


Improvements in problem-solving appraisal were similarly observed for both groups within the 6-month follow-up. However, during this period, individuals assigned to the cognitive therapy condition demonstrated a significantly faster rate of improvement in negative problem orientation and impulsivity/carelessness. More specifically, individuals receiving cognitive therapy were significantly less likely to report a negative view toward life problems and impulsive/carelessness problem-solving style.


Cognitive therapy for the prevention of suicide provides rapid changes within 6 months on negative problem orientation and impulsivity/carelessness problem-solving style. Given that individuals are at the greatest risk for suicide within 6 months of their last suicide attempt, the current study demonstrates that a brief cognitive intervention produces a rapid rate of improvement in two important domains of problem-solving appraisal during this sensitive period.

Corresponding author
*Address for correspondence: M. Ghahramanlou-Holloway, Ph.D., Departments of Medical & Clinical Psychology and Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room B3050, Bethesda, MD 20814-4799, USA. (Email:
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Psychological Medicine
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