Relationship of optimism and suicidal ideation in three groups of patients at varying levels of suicide risk

Abstract

Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N=319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. The meta-analysis of the three studies showed that higher levels of self-reported optimism were associated with a lower likelihood of suicidal ideation (odds ratio [OR]=.89, 95% confidence interval [CI]=.85–.95, z=3.94, p<.001), independent of age, gender, and depressive symptoms. This association held when using the subscales of the Life Orientation Test-Revised scale that measured higher optimism (OR=.84, 95% CI=.76–.92, z=3.57, p<.001) and lower pessimism (OR=.83, 95% CI= .75–.92], z=3.61, p<.001). These results also held when suicidal ideation was analyzed as an ordinal variable. Our findings suggest that optimism may be associated with a lower risk of suicidal ideation, above and beyond the effects of depressive symptoms, for a wide range of patients with clinical conditions that place them at elevated risk for suicide.

Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial

“…2006), which has been used in prior studies examining connections between optimism and suicidal ideation (Hirsch & Conner, 2006; Hirsch et al . 2007a; Huffman et al . 2016b).…”

Neurophysiological correlates of suicidal ideation in major depressive disorder: Hyperarousal during sleep

“…A single suicide item from self-reported depression rating scales has been shown to be related to well-validated measures of suicidal ideation (e.g., Scale for Suicide Ideation) and number of suicide attempts (Desseilles et al, 2012). Furthermore, item 12 from the QIDS has been previously used to assess suicidal ideation (Gao et al, 2015; Huffman et al, 2016; Laje et al, 2007). The group defined as “low suicidal ideation” included participants who reported “I do not think of suicide or death” (QIDS score =0) and “I feel that life is empty or wonder if it's worth living” (QIDS score =1).…”

“…Third, a single item was used for the assessment of suicidal ideation. While this approach has been utilized in prior studies (Desseilles et al, 2012; Gao et al, 2015; Huffman et al, 2016; Laje et al, 2007), future studies would benefit by including validated measures of suicide.…”

Population-based norms of the Life Orientation Test–Revised (LOT-R)

“…Optimism is associated with better adjustment to pain ( Ronaldson et al, 2014 ) and less pain sensitivity ( Hanssen, Peters, Vlaeyen, & Meevissen, 2013 ). Furthermore, optimism has been associated with reduced risk of coronary heart disease ( Kim, Smith, & Kubzansky, 2014 ), lower mortality ( Boehm & Kubzansky, 2012 ; Kim et al, 2017 , Tindle et al, 2009 ) and with a lower risk of suicidal ideation ( Huffmann et al, 2016 ).…”