An exploratory randomised trial of a simple, brief psychological intervention to reduce subsequent suicidal ideation and behaviour in patients admitted to hospital for self-harm.
Open accessAbstract
BACKGROUND: Implementation intentions link triggers for self-harm with coping skills and appear to create an automatic tendency to invoke coping responses when faced with a triggering situation. AIMS: To test the effectiveness of implementation intentions in reducing suicidal ideation and behaviour in a high-risk group. METHOD: Two hundred and twenty-six patients who had self-harmed were randomised to: (a) forming implementation intentions with a 'volitional help sheet'; (b) self-generating implementation intentions without help; or (c) thinking about triggers and coping, but not forming implementation intentions. We measured self-reported suicidal ideation and behaviour, threats of suicide and likelihood of future suicide attempt at baseline and then again at the 3-month follow-up. RESULTS: All suicide-related outcome measures were significantly lower at follow-up among patients forming implementation intentions compared with those in the control condition (ds>0.35). The volitional help sheet resulted in fewer suicide threats (d = 0.59) and lowered the likelihood of future suicide attempts (d = 0.29) compared with patients who self-generated implementation intentions. CONCLUSIONS: Implementation intention-based interventions, particularly when supported by a volitional help sheet, show promise in reducing future suicidal ideation and behaviour.
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- Authors
- Armitage, C. J., Rahim, W. A., Rowe, R., & O'Connor, R. C.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Corresponding author
- Armitage, Christopher J.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-05
- Volume
- 208
- Issue
- 5
- Pages
- 470-476
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2238667578
- Cited by
- 63
- References
- 21
- Citations by year
- 2026: 4 · 2025: 9 · 2023: 10 · 2022: 4 · 2021: 8 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 2
- FWCI
- 9.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- implementation intentions, self-harm, suicidal ideation, suicide attempts, suicide prevention, psychological intervention, coping strategies, hospitalized patients
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Female, Follow-Up Studies, Humans, Inpatients, Male, Middle Aged, Psychotherapy, Brief, Suicide, Attempted, Outcome Assessment, Health Care, Intention, Young Adult, Suicidal Ideation
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