Doctor of Philosophy, The Ohio State University, 2024, Educational Studies

Suicide is a growing concern in the United States and around the world. Approximately 50,000 people die by suicide each year and more than 15 million additional people struggle with thoughts of suicide in the U.S. As a result, there are very few people who have not been affected by suicide. Much of the work that has been performed around suicide places a focus on awareness and interventions, which is necessary for understanding the issue and critical in directing people to help. In recent years, the increases in suicide have been met with increases in social awareness. There is one obvious gap, which has been a lack of implemented solutions. Unfortunately, little has been done to provide actual treatment models that have proven effective. This study explored the work conducted at an outpatient treatment center utilizing a novel treatment model specifically developed for individuals actively struggling with thoughts of suicide. This model merges two evidence-based models with over 50 randomized controlled trials between them to bring both access and treatment to the public. The sample included 58 participants with a mean age of 20 years and which was 57% female and 43% male. Importantly, 31% of those in the study had no prior history of mental health diagnosis. The study found that the treatment was effective in reducing suicidality scores in the sample from pre-treatment scores to post-treatment scores, with a very large effect size [t(57) = 8.1, p < .001, d = 1.02]. There were also a significant decreases in scores on hopelessness [t(56) = 9.875, p < .001, d = 1.630], psychological pain [ t(57) = 9.768, p<.001, d = 1.294], stress [t(57) = 9.560, p < .001, d = 1.266], and self-hate [t(57) = 8.118, p < .001, d = 1.075], all with large effect sizes. The treatment and dosage data shows that the participants were able to appropriately address the issue of suicide and achieve resolution in an average of 7.52 sessions over an average of 5.6 weeks, with a 93% succe (open full item for complete abstract)

Committee: Darcy Haag Granello (Advisor); Paul Granello (Committee Member); David Jobes (Committee Member); Kaprea Johnson (Committee Member) Subjects: Behavioral Psychology; Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Cognitive Psychology; Cognitive Therapy; Counseling Education; Counseling Psychology; Developmental Psychology; Ethics; Experimental Psychology; Health Care; Mental Health; Psychology; Psychotherapy; Public Health; Social Work; Sociology

Master of Arts, Miami University, 2024, Psychology

There is evidence from literature that has identified the infiltration of racism within the school system in the United States. Consequently, Black girls are victims of bias and stereotypes perpetuated by school officials. The impact of this is notable in their academic performance and attitudes towards school, such that due to the pressure associated with these effects, Black girls are experiencing academic stress that has affected their academic performance and schooling experiences. Additionally, they are twice as likely as Black boys to attempt suicide. While all these reports were inferred from comparative studies that examined adolescent males and females from both minority and white backgrounds, there is little known of the relationship between academic stress and suicidal ideation of Black female adolescents. In this study, the effects of suicidal ideation on academic performance among Black female adolescents were studied. Spearman's rank correlation and Ordinal logistics regression were used to assess the relationship between academic performance and suicidal ideation. The results showed significant correlations across the variables that measured suicidal behavior with no association between the predictors and the dependent variable. Future research would explore other dimensions of academic stress and the trend of suicidal ideation across different age grades for Black girls.

Committee: Yvette Harris (Advisor); Veronica Barrios (Committee Member); Aaron Luebbe (Committee Member) Subjects: Psychology

Doctor of Philosophy, Case Western Reserve University, 2022, Psychology

Objective: The present study aimed to explore the relationships between Erik Erikson's adult stages of psychosocial development (intimacy/isolation, generativity/stagnation, ego integrity/despair) and suicidal ideation. It was hypothesized that more severe suicidal ideation would be significantly associated with poorer resolution of each of the three adult stages. It was also hypothesized that age would moderate the relationships between suicidal ideation and psychosocial development. Methods: Seventy-five Veterans (26-88 years old, Mage = 54.44 years) completed a diagnostic interview and met the inclusion criteria of a current depressive disorder. Self-report measures were administered to assess severity of suicidal thinking and degree of healthy psychosocial development. Results: More severe suicidal ideation was significantly associated with poorer psychosocial development across all three adult stages. Though age did not moderate this relationship for intimacy/isolation or generativity/stagnation, there was a small conditional effect of age on the relationship between integrity/despair and suicidal ideation. The strength of the integrity-ideation relationship was greatest for the youngest participants, tapering off after age 68. Conclusions: The significant associations between suicidal ideation and the adult psychosocial stages suggest that the developmental issues identified by Erikson are indeed important areas of mental health. Helping clients confront issues related to intimacy/isolation and generativity/stagnation may help reduce suicide risk across adulthood. Moreover, it may be useful to help clients resolve issues pertaining to dissatisfaction with life prior to entering older adulthood. Implications: The psychosocial issues identified by Erikson may help guide clinicians who work with suicidal clients. Results support current suicide prevention efforts to reduce loneliness and increase social supports. Findings also suggest that developing (open full item for complete abstract)

Committee: James Overholser (Committee Chair); Norah Feeny (Committee Member); Josephine Ridley (Committee Member); Eva Kahana (Committee Member); Arin Connell (Committee Member) Subjects: Clinical Psychology; Mental Health; Psychology

Master of Arts, Case Western Reserve University, 2021, Psychology

Posttraumatic stress disorder (PTSD) is a significant risk factor for suicidal ideation (SI). Psychological and pharmacological interventions reduce PTSD and SI, but the trajectory of SI over time has not been examined. Understanding these trajectories and their predictors, including negative cognitions, guilt, and treatment choice, may assist clinicians in personalizing care to each individual. Participants (N = 200) were recruited for a larger randomized control trial comparing prolonged exposure and sertraline for PTSD. Growth mixture modeling was utilized to examine trajectories and predictors of SI change. A three-class solution was found to have optimal fit for SI: (1) absent, stable; (2) present, decreasing; and (3) present, stable. Greater negative cognitions were predictive of worse trajectories of SI, while other predictors were not significant. Clinically, this suggests that providers should pay special attention to negative cognitions when working with individuals seeking treatment for PTSD who experience mild to moderate SI.

Committee: Norah Feeny PhD (Committee Chair); James Overholser PhD (Committee Member); Julie Exline PhD (Committee Member) Subjects: Psychology; Psychotherapy

Master of Arts (MA), Bowling Green State University, 2020, Sociology

The aim of this study is to provide a comprehensive picture of younger adults and their risks with suicidal ideation, in order to develop more thoughtful interventions. Using Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health, I examined the association between intersectional statuses, discrimination, and suicidal ideation. In addition to using intersectional theory, I draw on minority stress theory to motivate my study. I incorporated a measure of discrimination to accurately examine how endorsing one or more intersectional statuses changes the variation in suicidal ideation of younger adults. I found that sexual minorities, those who are discriminated against, and those who are nonwhite and female report a higher odds of expressing suicidal ideation compared to sexual majorities, those who are not discriminated against, and those who are white and male. I found that discrimination did not moderate or mediate the relationship between intersectional statuses and suicidal ideation. This study underscores the challenges intersectional individuals face when it comes to how discrimination negatively impacts mental health, and specifically, suicidal ideation.

Committee: Danielle Kuhl Dr. (Advisor); John Boman Dr. (Committee Member); Jenjira Yahirun Dr. (Committee Member) Subjects: Gender Studies; Social Psychology; Sociology

Doctor of Philosophy, Case Western Reserve University, 2020, Psychology

More research is needed to evaluate turning points from suicidal ideation to suicide related behaviors, as well as (non-) recovery from non-fatal suicide attempts. The Fluid Vulnerability Theory suggests that suicide- specific cognitions modulate the transition from chronic to acute suicide risk. The present study analyzed the interacting effects of current suicidal ideation and prior suicide attempts on suicide risk factors in a sample of outpatient military veterans. Between-subjects analyses will evaluated the role of current suicidal ideation and prior non-fatal suicide attempts on cognitive, affective, and behavioral suicide risk factors. Non-fatal suicide attempts were associated with altered beliefs about suicide. Vulnerability to re-activation of suicide-specific beliefs may modulate recovery from non-fatal suicide attempts or chronic elevations in suicide risk in survivors of suicidal crises. Suicide-specific cognitions may also activate acute exacerbations in suicide risk in the context of general cognitive, affective, and behavioral dysfunction.

Committee: James Overholser PhD (Committee Chair); Arin Connell PhD (Committee Member); Amy Przeworski PhD (Committee Member); Thomas Swales PhD (Committee Member); Josephine Ridley PhD (Other) Subjects: Psychology

Doctor of Philosophy, University of Akron, 2019, Counseling Psychology

Suicide is the tenth leading cause of death in the United States (McIntosh & Drapeau, 2018). Mental illness is prevalent among suicide deaths (Cavanaugh et al., 2003) and psychologists can expect to have clients with increased suicide risk during their training or career (Dexter-Mazza & Freeman, 2003; Kleespies, Penk, & Forsyth, 1993), it is vital that students training to be health service psychologists, including clinical psychology, counseling psychology, and school psychology (APA, 2018), be competent in providing clinical care to individuals with increased suicide risk. Competency incorporates “knowledge, skills, attitudes, and personal qualities” essential to clinical practice (Albanese et al., 2008). Although suicide is an important topic, only two studies have directly examined clinical skill with suicidal clients by graduate students (Mackelprang et al., 2014; Neimeyer & Bonnelle, 1997). There have been many calls to further emphasize clinical preparation related to suicide assessment and management (SAM; Neimeyer, 2000; Rudd et al., 2008; Westefeld et al., 2000), particularly because many students receive little training related to suicide at the internship level or beyond (Schmitz et al., 2012). The current study examined the experience, training, and competency of 140 health service psychology graduate students prior to internship, using a measure of skill (Suicide Intervention Response Inventory [SIRI-2]; Neimeyer & Bonnelle, 1997), attitudes, knowledge (Attitudes Towards Suicide Scale [ATTS]; Salander Renberg & Jacobsson, 2003), and a self-rating of clinical suicide competency (Suicide Competency Assessment Form [SCAF]; Cramer et al., 2013). These measures were compared examining a number of personal qualities identified in previous research as potentially affecting skill, attitudes, or knowledge related to suicide. Findings indicate nearly all graduate students were providing clinical services to clients with suicidal thoughts or attempts prior to (open full item for complete abstract)

Committee: Ingrid Weigold Ph.D. (Advisor); Bernard Jesiolowski Ph.D. (Committee Member); Suzette Speight Ph.D. (Committee Member); Charles Waehler Ph.D. (Committee Member); Alan Kornspan Ed.D. (Committee Member) Subjects: Clinical Psychology; Counseling Psychology; Psychology

Master of Arts, Miami University, 2019, Psychology

There is an assumption that eating disorders (EDs) serve as a risk factor for – and therefore, precede – suicidal thoughts and behaviors (STBs). However, because most studies investigating the ED-STB link have been limited to cross-sectional or retrospective designs, this assumption has not been adequately tested. There are other limitations with previous work that must be addressed. First, the mean follow-up time for the few longitudinal studies that exist was nearly a decade. Moreover, only one study has examined whether an ED factor (i.e., diagnosis or symptom) longitudinally predicts suicidal ideation. Even within cross-sectional studies, suicidal ideation has been poorly measured, with most studies using only one item to assess suicidal ideation. Thus, the present study used autoregressive cross-lagged modeling to test if a bidirectional relationship exists between ED symptoms and suicidal ideation among an ED patient sample over five weekly time points. Results revealed that suicidal ideation and ED symptoms were associated with each other at each time point. Additionally, suicidal ideation at Week 3 predicted ED symptoms at Week 4, while controlling for Week 3 ED symptoms. Given that suicidal ideation may influence future engagement in ED symptoms, targeting suicidal thoughts in therapy may help to reduce eating pathology.

Committee: April Smith Dr. (Advisor); Elise Clerkin Dr. (Committee Member); Aaron Luebbe Dr. (Committee Member) Subjects: Clinical Psychology; Psychology

Master of Arts, University of Toledo, 2017, Psychology - Clinical

Posttraumatic Stress Disorder (PTSD) and suicidal ideation (SI) are both relatively common among people who have experienced traumatic events, including veterans, survivors from natural disasters and violent events, etc. Researchers have proposed and tested several hypotheses to explain the relationship between PTSD and both SI and suicide attempt (SA). Two other common mental disorders, alcohol use disorder (AUD) and major depressive disorder (MDD), are variables that may play an important role in the relationship between PTSD and SI/SA. Alcohol use disorder and major depressive disorder are variables that are common among people who have concurrent posttraumatic stress disorder (PTSD) and suicidal ideation (SI). This study aimed at examining the effect of depression severity and alcohol use symptoms can have on the relationship between PTSD and SI. A sample of 339 participants from Amazon's Mechanical Turk labor-market reporting previous trauma exposure were included in the study. Both direct and indirect relationships were assessed using PTSD total scores and cluster scores based on the DSM-5 four-factor model. Path analysis results revealed that severity of PTSD and SI was both directly and indirectly related through alcohol use. In addition, each PTSD cluster score was found both directly and indirectly related through alcohol use. Regarding depression, significant indirect relationships were also found between suicidal ideation and both PTSD total and cluster scores through depression severity. Reversed path analyses demonstrated both significant direct and indirect relationships between alcohol misuse and suicidal ideation through PTSD. However, a non-significant indirect relationship was found between depression and suicidal ideation when specifying PTSD as the mediator. After including both depression and alcohol misuse as mediators in the same model, significant indirect relationships for both mediators, but non-significant direct effects, were found betwe (open full item for complete abstract)

Committee: Jon D. Elhai (Committee Chair); Matthew T. Tull (Committee Member); Jason C. Levine (Committee Member) Subjects: Clinical Psychology

PHD, Kent State University, 2017, College of Nursing

Background: According to a Thai Public Health Ministry spokesman, more than 300 Thai individuals commit complete suicide per month, making Thailand the nation with the third-most suicides in the world. Despite the high rates of suicidal ideation in Thai adult women, the predictors associated with suicidal ideation rates are still unknown. Thus, the purpose of this study was to examine those predictors, specifically the extent to which quality of life, intimate partner violence, social support, employment status, partnership status, and parenthood status predict suicidal ideation in this population. Theoretical framework: The Interpersonal Theory of Suicidal Behaviors guided the study. Suicidal ideation is defined as a desire to die or a desire to engage in lethal behaviors. Methods: This is a secondary analysis study using data obtained from a previous convergent mixed method study. The data were collected using self-report instruments. The present study used a cross-sectional correlational design. All participants in the parent study (N=284), who were recruited from a large hospital in Northeast Thailand, were included in the present study. Results: The overall prevalence of suicidal ideation was 8% (22 participants out of 284 had SI). Logistic regression analyses indicated that the included predictors (Quality of life, perceived social support, intimate partner violence, partnership status, employment status, and parenthood status) as set were statistically related with suicidal ideation. However, the bivariate logistic regression analyses showed that quality of life was the only predictor in the model that negatively affected suicidal ideation with an Odds Ratio (OR) of .91. Discussion and Conclusion: The current study indicated that quality of life was uniquely associated with suicidal ideation in Thai women. High levels of quality of life correlated with lower odds of reporting suicidal ideation. The findings partially support previous studies and the Inte (open full item for complete abstract)

Committee: Patricia Vermeersch (Committee Chair); Dana Hanson (Committee Member); Lori Kidd (Committee Member); Ratchneewan Ross (Committee Member); Kele Ding (Committee Member) Subjects: Nursing

Master of Arts (M.A.), University of Dayton, 2017, Psychology, Clinical

Psychopathy is recognized as a heterogeneous condition with empirical support behind the subtypes primary and secondary (Skeem, Poythress, Edens, Lilienfeld, & Cale, 2003). Research indicates differential patterns of associations between psychopathy subtypes and suicide whereby secondary psychopathy is positively related to suicidal ideations and attempts, and primary psychopathy is either negatively or unrelated to suicidal ideations and attempts (Verona, Hicks, & Patrick, 2005; Verona, Patrick, & Joiner, 2001). In seeking to explain the differential pattern of associations between psychopathy subtypes and suicide, the present study drew upon two modern frameworks for understanding self-injury: the emotional cascade model (Selby, Anestis, & Joiner, 2008) and interpersonal theory of suicide (IPTS; Joiner, 2005). The emotional cascade model attempts to understand how emotional and cognitive dysfunction combine to predict behavioral dysregulation such as non-suicidal self-injury (NSSI). The IPTS hypothesizes that an attempt at suicide requires the presence of both the desire for death and the capability to act on said desire and that these processes operate independently of one another. A history of painful and provocative experiences, such as NSSI, is believed to incrementally contribute to an acquired capability for suicide, increasing a tolerance for pain and decreasing the fear of death. Likewise, research has found that a history of NSSI is elevated in individuals that act on their suicidal ideations versus those that do not (Klonsky, May, & Glenn, 2013). In the present study, specific cognitive, affective, and behavioral features integral to the emotional cascade model and IPTS, as well as present in secondary psychopathy, were hypothesized to contribute to a history of suicide attempts in a sample of 204 male and female offenders. A serial mediation analysis was conducted to test if the association between secondary psychopathy and suicide attempts was best exp (open full item for complete abstract)

Committee: Catherine Lutz-Zois (Advisor); Jackson Goodnight (Committee Member); Lee Dixon (Committee Member) Subjects: Clinical Psychology; Personality

Doctor of Philosophy, University of Toledo, 2017, Psychology - Clinical

The purpose of the present study was to examine the moderating effects of moral injury between posttraumatic stress symptoms (PTSS) and two externalizing constructs: potential harm to self (i.e., suicidal ideation) and to others (i.e., hostility). Moral injury is a relatively new construct that broadly encompasses feelings of guilt associated with engaging in a potentially amoral or unethical combative situation. In addition to experiencing a moral injury, military veterans are vulnerable to developing additional pathology, most notably posttraumatic stress disorder (PTSD). Other complaints reported by combat veterans are suicidal ideation and hostility. PTSD is associated with its own set of complications such as high comorbidity, difficulty with diagnosis due to comorbidity and overlapping symptoms and poor treatment outcomes and thus examining additional moderators and constructs is critical. Moral injury has demonstrated relations in the extant literature with PTSD, suicidality and hostility. These existing relations prompted the present study to examine moral injury as a potential moderator between PTSD symptom clusters (i.e., reexperiencing, avoidance, negative alterations in mood and cognitions (NAMC) and alterations in arousal and reactivity (AAR)) and hostility and suicidal ideation, independently. i The present study utilized a subsample of combat-exposed male veterans (n = 377) selected from a larger sample of veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). Five moderations were analyzed such that moral injury-perceived transgressions (MIES-PT) was hypothesized to moderate the relationship between 1) reexperiencing and suicidal ideation, 2) avoidance and suicidal ideation, 3) NAMC and suicidal ideation, 4) NAMC and hostility, and 5) AAR and hostility. Results demonstrated that MIES-PT significantly contributed to the relationships between reexperiencing, avoidance and NAMC and suicidal ideation, consistent with (open full item for complete abstract)

Committee: Jon Elhai (Committee Chair); Jason Levine (Committee Member); Sarah Francis (Committee Member); Amy Bixler (Committee Member); Kamala London (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2015, Psychology

Emotion dysregulation and frequent suicidal behaviors are defining features of borderline personality disorder (BPD). In fact, emotion dysregulation is critical to the utilization and maintenance of suicide attempts (Gross, 1998a; Gross, 1998b; Linehan, 1993; McMain et al., 2001). Traditionally, clinicians have utilized explicit self-report measures to determine suicidality despite findings that 78% of patients explicitly deny suicidal ideation before completing suicide (Busch, Fawcett, & Jacobs, 2003). Nock et al. (2010) developed and evaluated a version of the implicit association test (IAT) that measures implicit associations of self with death/suicide: The Death/Suicide IAT (DS-IAT). Research is needed to test if the DS-IAT can predict implicit suicidality of individuals with symptoms of BPD and if emotion dysregulation mediates this relationship. Analyses were conducted using data gathered from 83 male and female undergraduate students at a private Midwestern university who completed the DS-IAT, a measure of specific subjective impairments typically experienced by individuals with BPD, and a measure of difficulties in emotion regulation. Results demonstrated a significant relationship between BPD symptoms and implicit suicidality as well as BPD symptoms and emotion dysregulation. However, results indicated no significant relationship between emotion dysregulation and implicit suicidality. Post hoc analyses examining specific domains of emotion dysregulation demonstrated that nonacceptance of emotional responses was a mediator of the relationship between BPD symptoms and implicit suicidality.

Committee: Nicholas Salsman Ph.D (Committee Chair); Cynthia Dulaney Ph.D (Committee Member); Christian End Ph.D (Committee Member) Subjects: Clinical Psychology; Cognitive Psychology; Psychology

Psy. D., Antioch University, 2014, Antioch New England: Clinical Psychology

Approximately 36,000 people commit suicide in the U.S. each year, making it the fourth leading cause of death for adults between 18 and 65-years-old. Clients participating in psychotherapeutic treatment are at elevated risk for suicide, due to the emotional distress that drives their entry into psychotherapy. Therapists cannot know the full extent of their clients' risk for suicide if clients do not fully confide their thoughts and intentions. The current study sought to discover factors that inhibit and promote client disclosure of these thoughts and behaviors. The study utilized the Suicidal Ideation in Psychotherapy Questionnaire (SIPQ), a questionnaire developed for this study that assesses attitudes and behaviors regarding suicidal ideation during psychotherapy. The Working Alliance Inventory-Short Version Revised (WAI-SR) was also used to assess therapeutic alliance. These questionnaires were administered online to a sample of 85 participants who were over 18-years-old, currently involved in psychotherapy, and had thoughts of suicide during treatment. A hierarchical linear regression was conducted to identify which factors are most predictive of suicidal ideation disclosure. Specifically, this study assessed the degree to which the following are predictive of client disclosure of suicidal ideation: working alliance, the degree to which the therapist asked interpersonal theory of suicide assessment questions from the perspective of the client, how the therapists asks about suicidal ideation, and client fear of negative consequences for disclosure. Results suggested that the strength of the working alliance, the degree to which interpersonal theory of suicide assessment questions were asked, and lower levels of biased or awkward therapist questions about suicidal ideation all significantly predicted client disclosure of suicidal ideation. Implications explored include the utility of these identified factors in promoting a psychotherapeutic environment that optim (open full item for complete abstract)

Committee: George Tremblay PhD (Committee Chair); Lorraine Mangione PhD (Committee Member); David Arbeitman PhD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, The Ohio State University, 2005, Psychology

One promising area for intervention with suicidal youth relates to coping skills. The cognitive, behavioral and affective limitations invoked in the face of problem situations may inhibit appropriate behavior and encourage suicidal ideation. The current study aimed to further assess the role of problem-solving deficits among suicidal ideators as well as assessing the benefits of a brief prevention intervention based on the PST model. The current study found little direct support for the role of problem-solving deficits in predicting suicidal ideation. More specifically, the influence of problem-solving deficits was mediated by depression and likely exerts an influence on suicide through its influence on mood. Despite this, ideating individuals clearly experience greater psychopathology and problem-solving deficits relative to their non-ideating peers. Exposure to a brief video intervention regarding problem-solving and coping skills was sufficient to elicit significant decreases in suicidal ideation and depression. Though both time limited and of modest clinical impact, this confirms the importance of incorporating problem-solving and coping skills modules into suicide treatment programs. Despite the effectiveness of the problem-solving video on decreasing targeted measures of psychopathology, the intervention had no appreciable impact on problem-solving skills and behaviors themselves. Assessment of the course of suicidal ideation and its correlates of depression and hopelessness suggest that these are not stable variables, but may evidence considerable fluctuation over the short-term. A variable pattern, indicative of emotional lability, is suggestive of greater pathology and associated with greater risk, particularly when combined with a history of previous suicide attempts. In contrast, high mean scores of depression and ideation did not significantly predict changes in course or risk, nor did they interact with attempt status. However, an interaction of mean le (open full item for complete abstract)

Committee: Steven Beck (Advisor) Subjects: Psychology, Clinical

Doctor of Philosophy, Case Western Reserve University, 2011, Psychology

Psychological risk factors for depression and suicide have been identified, but the impact of life meaning on symptoms of depression and suicide has not been adequately examined in empirical investigations. The present study examined life meaning in depressed patients at the VA Medical Center in Cleveland, Ohio, during an initial assessment consisting of a diagnostic interview and self-report questionnaires. Patients were re-evaluated at an 18 week follow-up visit. Two measures of life meaning were completed, the Life Regard Index – framework subscale and the Personal Meaning Profile. Among depressed veterans, less life meaning was significantly related to more severe depression, more intense hopelessness, and more frequent thoughts of suicide. Furthermore, life meaning contributed to the understanding of suicidal ideation above and beyond known risk factors. Follow-up analyses revealed that an increase in life meaning during the 18 week follow-up was significantly related to a decrease in depressive symptoms and hopelessness. Researchers and clinicians are encouraged to address the impact of a lack of life meaning on the development and course of depressive symptoms, hopeless thoughts, and suicidal behaviors.

Committee: James Overholser PhD (Committee Chair); Julie Exline PhD (Committee Member); Arin Connell PhD (Committee Member); Abraham Wolf PhD (Committee Member) Subjects: Clinical Psychology