Feasibility and utility of positive psychology exercises for suicidal inpatients

Jeff C Huffman; Christina M DuBois; Brian C Healy; Julia K Boehm; Todd B Kashdan; Christopher M Celano; John W Denninger; Sonja Lyubomirsky

doi:10.1016/j.genhosppsych.2013.10.006

Feasibility and utility of positive psychology exercises for suicidal inpatients

Gen Hosp Psychiatry. 2014 Jan-Feb;36(1):88-94. doi: 10.1016/j.genhosppsych.2013.10.006. Epub 2013 Oct 14.

Authors

Jeff C Huffman¹, Christina M DuBois², Brian C Healy³, Julia K Boehm⁴, Todd B Kashdan⁵, Christopher M Celano⁶, John W Denninger⁷, Sonja Lyubomirsky⁸

Affiliations

¹ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: jhuffman@partners.org.
² Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA; Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
⁴ Department of Psychology, Chapman University, Orange, CA, USA.
⁵ Department of Psychology, George Mason University, Fairfax, VA, USA.
⁶ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
⁷ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Benson Henry Institute for Mind Body Medicine, BostonMA, USA.
⁸ Department of Psychology, University of California-Riverside, Riverside, CA, USA.

PMID: 24230461
DOI: 10.1016/j.genhosppsych.2013.10.006

Abstract

Objective: The objective was to assess the feasibility and acceptability of nine positive psychology exercises delivered to patients hospitalized for suicidal thoughts or behaviors, and to secondarily explore the relative impact of the exercises.

Method: Participants admitted to a psychiatric unit for suicidal ideation or behavior completed daily positive psychology exercises while hospitalized. Likert-scale ratings of efficacy (optimism, hopelessness, perceived utility) and ease of completion were consolidated and compared across exercises using mixed models accounting for age, missing data and exercise order. Overall effects of exercise on efficacy and ease were also examined using mixed models.

Results: Fifty-two (85.3%) of 61 participants completed at least one exercise, and 189/213 (88.7%) assigned exercises were completed. There were overall effects of exercise on efficacy (χ(2)=19.39; P=.013) but not ease of completion (χ(2)=11.64; P=.17), accounting for age, order and skipped exercises. Effect (Cohen's d) of exercise on both optimism and hopelessness was moderate for the majority of exercises. Exercises related to gratitude and personal strengths ranked highest. Both gratitude exercises had efficacy scores that were significantly (P=.001) greater than the lowest-ranked exercise (forgiveness).

Conclusion: In this exploratory project, positive psychology exercises delivered to suicidal inpatients were feasible and associated with short-term gains in clinically relevant outcomes.

Keywords: Gratitude; Hopelessness; Optimism; Positive psychology; Suicide.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adult
Attitude*
Feasibility Studies
Hope*
Humans
Inpatients / psychology*
Male
Middle Aged
Psychotherapy / methods*
Suicidal Ideation*
Suicide Prevention*
Treatment Outcome

Grants and funding

R01-DP00336/DP/NCCDPHP CDC HHS/United States