Recovery after a suicidal episode affects over 5 million individuals recovering from a recent suicidal episode (referred to as Post-Acute Suicidal Episode or PASE) needing recovery paths. Modern recovery-oriented models extend beyond clinical symptoms and finding a cure, and center on living a fulfilling and rewarding life with positive changes in self-perception and self-experience, but there are no studies examining personal recovery trajectories after a suicidal episode. There is a need for information on the varying trajectories of PASE individuals regarding recovery, understanding the characteristics of those who recover, and determining how recovery and clinical symptoms interrelate. This is crucial for tailoring support programs and clinical interventions for PASE individuals.
The principal investigator has developed a suicide-specific theoretical model of personal recovery and a validated measure of personal recovery after a suicidal episode. This study extends that work to examine the trajectories and predictors of personal recovery of 550 individuals over 12 months. The results will have clinical implications for individual recovery by illustrating trajectories and nuances that may be addressed by treatment, is a step toward increased personalized medicine with tailored treatment based on an individual’s recovery trajectory, and will lead to studies exploring the effects of medical and psychological treatments, and social supports for enhancing recovery.
Aim 1: To determine the number and characteristics of groups with similar longitudinal patterns of personal recovery following a suicidal episode through a seven-assessment point, 12-month longitudinal cohort analysis, during which personal recovery from a suicidal episode will be tracked. These trajectories will be understood through an analysis of the initial characteristics, experiences, and the other factors assessed. The study will use the Recovery Evaluation Suicide Support Tool (RESST) a 21-item measure asking participants about multiple domains of personal recovery.
Aim 2: To identify factors predicting increasing personal recovery over the 12-month study. Factors examined include demographic characteristics, suicidal history, mental health treatments received, levels of personal recovery, suicidal ideation/behavior, interpersonal factors in suicide risk development, meaning in life, social network status, co-morbidities, quality of life, housing, identity stability, and expectation of self-growth. The study will utilize the following measures: Suicidal History Self-Rating Screening Scale; Interpersonal Questionnaire; Meaning in Life Questionnaire; Lubben Social Network Scale; Quality of Life Scale; Future Self Continuity Questionnaire; modified Temporal Self Appraisal task; and Working Alliance Inventory. It is expected that the initial characteristics and other factors assessed will be predictive of increasing personal recovery.
Aim 3: To determine the relationship between individual levels of personal recovery, including its internal factors, with changing suicidal ideation and behavior over time. The study will use the Suicide Behavior Questionnaire-Revised which evaluates suicidal ideation and suicide attempts, frequency of suicidal ideation, disclosure of suicidality, and self-reported suicidal likelihood. To assess suicide ideation, the study will use the Suicidal Ideation Attributes Scale. We hypothesize that those who have higher levels of personal recovery will have less suicidal ideation and behavior over time and that the internal factors of personal recovery will be individually predictive of decreasing suicidal ideation and behavior.
