2.Beck's Cognitive Triad: o Beck proposed that people acquire a
psychological predisposition to depression through early life
experiences
o Three autonomic (uncontrollable and repetitive) negative thoughts
(triad) are responsible for development of depression
3.Three autonomic (uncontrollable and repetitive) negative thoughts (triad)
are responsible for development of depression: Negative, self-deprecating
view of self
•"I really never do anything well; everyone else seems
smarter." Pessimistic view of the world
•"Once you're down, you can't get up." • "Bad things everywhere
you look." Belief that negative reinforcement (no validation for
,the self) will continue
•"It doesn't matter what you do, nothing will get better."
•"I'll be at this stupid job for the rest of my life."
4.Risk for suicide; Questions: SADPERSONS scale
•S- sex- 1 male
•A- age- 1 if <19 or >45
•D- depression/hopelessness- 2
•P- previous attempts/psychiatric care- 1
•E- excessive alcohol or drug use- 1
•R- rational thinking loss (psychotic or organic illness- 1
•S- separated/widowed/divorced- 1
•O- organized plan or serious attempt- 2
•N- no social support- 1
•S- stated future intent- 1
•Guidelines
,o 0-5: may be safe to discharge- discharge with family or friend
o 6-8: probably requires psych consult
o >8: probably requires hospital admission, voluntary or involuntary
5.Overt statements- RISK FOR SUICIDE: • I can't take it anymore
•Life isn't worth living anymore
•I wish I were dead
•Everyone would be better off if I were dead
6.Covert statements- RISK FOR SUICIDE: • It's okay now. Everything will
be fine
• Things will never work out
•I won't be a problem much longer
•Nothing feels good to me anymore and probably never will
•How can I give my body to medical science?
, 7.Behaviors: RISK FOR SUICIDE: Giving away
possessions Writing farewell notes
Making out a will
Putting personal affairs in
order Having global
insomnia
Sudden improvements in mood after being depressed or
withdrawn Neglecting personal hygiene
8.Protective factors from suicide: Internal: • Ability to cope with stress
•Religious beliefs
•Frustration tolerance
9.Protective factors from suicide: External: • Responsibility to
children or beloved pets
•Positive therapeutic relationships
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