Middle-aged and older adults constitute a high suicide-risk group. Among adults aged
50 years old and older, suicide rates increased and suicide deaths almost doubled
during the period from 2000 to 2015. Suicide rates are elevated for patients hospitalized
for suicidality (i.e., active suicidal ideation or suicide attempt) and the 3 months
post-hospitalization is the time of the highest suicide risk. Psychosocial interventions
for middle-aged and older adults hospitalized for suicidality are sparse. In this
article, we present the main aspects, stages, techniques and a clinical case study
of Cognitive Reappraisal Intervention for Suicide Prevention (CRISP), a psychosocial
intervention targeting cognitive reappraisal to reduce suicide risk in middle-aged
and older adults who have been recently hospitalized for suicidal ideation or a suicide
attempt. CRISP is based on the theory that hospitalization for suicidality is preceded
by an emotional crisis (“perfect storm”); this emotional crisis is related to personalized
(patient- and situation-specific) triggers; and identifying these personalized triggers
and the associated negative emotions and providing strategies for an adaptive response
to these triggers and negative emotions will reduce suicidal ideation and improve
suicide prevention. CRISP therapists identify these triggers of negative emotions
and use cognitive reappraisal techniques to reduce these negative emotions. The cognitive
reappraisal techniques have been selected from different psychosocial interventions
and the affective neuroscience literature and have been simplified for use with middle-aged
and older adults. CRISP may fill a treatment need for the post-discharge high-risk
period for middle-aged and older adults hospitalized for suicidality.
Key Words
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Article info
Publication history
Published online: December 27, 2017
Accepted:
November 12,
2017
Received in revised form:
October 31,
2017
Received:
June 13,
2017
Footnotes
Clinical Trials Registration: NCT03026127.
Identification
Copyright
© 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
