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Short Report

Optimistic Explanatory Style as a Moderator of the Association

Between Negative Life Events and Suicide Ideation

Jameson K. Hirsch1, Karen Wolford2, Steven M. LaLonde3, Lisa Brunk4, and Amanda Parker-Morris5

1Department of Psychology, East Tennessee State University, Johnson City, TN, 2Department of Psychology, SUNY College at Oswego, NY, 3John D. Hromi Center for Quality and Applied Statistics,

Rochester Institute of Technology, NY, 4Central Nassau Guidance and Counseling Services, NY, 5School of Professional Psychology, Pacific University, OR, all USA

Abstract. Background: Individuals experiencing negative and potentially traumatic life events are at increased risk for suicidal thoughts and behaviors; however, suicidal outcomes are not inevitable. Individuals who attribute negative life events to external, transient, and specific factors, rather than internal, stable, and global self-characteristics, may experience fewer deleterious outcomes, including suicidal behavior. Aims: This study examines the moderating effect of explanatory style on the relationship between negative life experiences and suicide ideation in a college student sample. Methods: A total of 138 participants (73% female) were recruited from a rural, Eastern college and completed a self-report psychosocial assessment. Results: Optimistic explanatory style mitigates the influence of negative and potentially traumatic life events on thoughts of suicide, above and beyond the effects of hopelessness and depression. Conclusions: Beliefs about the origin, pervasiveness, and potential recurrence of a negative life event may affect psychological outcomes. Optimistic explanatory style was associated with reduced suicide ideation, whereas pessimistic explanatory style was associated with increased thoughts of suicide. Optimistic reframing of negative life events for clients may have treatment implications for the prevention of suicidal activity.

Keywords: optimistic explanatory style, suicide ideation and attempts, negative life events

Suicide is a leading cause of death during late adolescence and early adulthood (National Center for Health Statistics, 2004), and of years of potential life lost before age 65 (Na- tional Center for Injury Prevention and Control, 2005), making it a critical public health problem among young people (US Public Health Service, 1999. Individuals who experience negative or potentially traumatic life events ap- pear to be at greater risk for suicide ideation (Dube et al., 2001; Kaplan, Pelcovitz, Salzinger, Mandel, & Weiner, 1997). Increased vulnerability for the development of sui- cidal thoughts may be a result of the influence of negative and chronic stressful events on social, emotional, and cog- nitive development (Sulik & Garfinkel, 1992). Individuals experiencing stressful and negative life events may also be unable to positively reframe or reappraise their negative life experiences (Carver, Pozo, Harris, Noriega, Scheier et al., 1993), resulting in hopelessness, depressive symptoms,

and suicidal activity. Such effects, however, may not be inevitable, and it is important to examine variables that might have a buffering effect on the impact of negative life events.

Research on negative and potentially traumatic life events has historically focused on resultant poor outcomes, with less emphasis placed on characteristics that might pro- tect against psychopathology or poor functioning (Violanti, 2001). For some individuals who experience trauma, psy- chopathology may not develop because of their use of sa- lubrious coping processes (Irwin, 1999; Tedeschi & Cal- houn, 1996). With regard to suicide, the ability to defend against the manifestation of suicidal thoughts and behav- iors may be partially the result of adaptive cognitive and emotional characteristics, such as an optimistic explanato- ry style, dispositional optimism, or future orientation (Hirsch & Conner, 2006; Hirsch et al., 2006; Scheier, Carv-

er, & Bridges, 2001). Optimistic explanatory style is de- fined as a tendency to make attributions about prior nega- tive events that are external, specific, and transient (Gill- ham, Shatte, Reivich, & Seligman, 2001), rather than mak- ing internal, global, and stable attributions, which is considered a pessimistic explanatory style. Optimistic ex- planatory style is associated with good health and longevity (Peterson, Seligman, & Vaillant, 1988), effective problem solving (Shatte, Gillham, & Reivich, 2000; Stark & Bos- well, 2000), decreased depression (Gillham et al., 2001; Seligman, Abramson, Semmel, & Von Baeyer, 1984), and faster recovery from depression (Seligman, Castellon, Cac- ciola, Schulman, Luborsky et al., 1988). Such benefits may occur via the use of active and adaptive coping strategies, a direct approach to solving problems, a belief in the attain- ability of future goals, and striving to overcome adversity (Miller, Manne, Taylor, Keates, & Dougherty, 1996; Pus- kar, Sereika, Lamb, Tusaie-Mumford, & McGuiness, 1999; Scheier & Carver, 1993; Scheier et al., 2001).

These findings reveal a trend toward better outcomes for optimists than pessimists across many situations; however, no studies specifically investigating optimistic explanatory style as a moderator of negative and potentially traumatic life events and suicide ideation were found in a review of the literature. This study examines the relationship between lifetime history of negative life events and suicide ideation in a college student sample and tests a moderator model of explanatory style as a buffering variable. It is hypothesized that optimistic explanatory style will moderate the influ- ence of negative life events on suicide ideation after con- trolling for covariates.

Methods

Participants

Participants were 138 volunteers (100 females, 73%) re- cruited from a rural, Eastern state college. A power analysis was conducted to determine the number of participants needed to achieve 80% power to detect a significant effect (p < .01), given the standard deviation of predictor vari- ables (xmean = 5) and correlation of residuals (r = .30), re- sulting in a necessary sample of 122 subjects. Parameter estimates were based on our previous research with college students (Hirsch & Conner, 2006). Informed consent was obtained. Participants ranged from 18–57 years old (xmean age = 22.5; median = 21; SD = 6.10). The sample was pri- marily white (79%), although several ethnic groups were represented, including black (4.5%), Native American (1.3%), Hispanic/Latin American (1.3%), and Asian (1%).

Measures

Expanded Attributional Style Questionnaire (EASQ; Peterson & Villanova, 1988)

The EASQ is a 120-item questionnaire involving 24 sce- narios of negative events that assess attributional style. Re- spondents are given a brief scenario (e.g., “You lose your job”) and are asked to describe why this event happened to them. Respondents rate each scenario on scales of internal- ity, globality, stability, and importance. The EASQ predict- ed depression in college students and outpatients (Luten, Ralph, & Mineka, 1997). This measure exhibits adequate internal consistency (Reivich, 1995); in the current study, Cronbach’s α = .91.

Lifetime Incidence of Traumatic Events (LITE; Greenwald & Rubin, 1999)

The LITE-Student form is a 16-item self-report checklist designed to measure the occurrence and emotional impact of traumatic events. The 16 items cover a broad range of potential trauma and loss events, including emotional, physical, and sexual abuse, and neglect, and ask for an es- timate of emotional impact at both the time of occurrence and the present. The LITE has been used to assess traumatic events in older adolescents and their parents and has been shown to correlate positively with assessments of PTSD symptoms (Greenwald & Rubin, 1999). The authors report good to excellent test-retest reliability and adequate crite- rion validity against a structured interview (Greenwald & Rubin, 1999).

Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996)

The BDI-II is a 21-item self-report measure of the presence and severity of cognitive, affective, somatic, and motivation- al symptoms of depression. The BDI-II predicted depression in a clinical college sample (Beck et al., 1996) and has exhib- ited adequate test-retest reliability (.93; Beck et al., 1996). In the current study, Cronbach’s α for the BDI-II = .92.

Beck Hopelessness Scale (BHS; Beck, Weissman, Lester, & Trexler, 1974)

This scale assesses level of hopelessness via 20 true-false statements. The scale has adequate internal reliability (KR20 coefficient = .93), and test-retest reliability of .69 over 1 week and .66 over 6 weeks for patients with mixed diagnoses. The BHS predicted suicide ideation (Bonner & Rich, 1987), suicide attempts (Minkoff, Bergman, & Beck, 1973) and suicide completion in psychiatric outpatients (Beck, Brown, Berchick, Stewart, & Steer, 1990) and inpa-

J.K. Hirsch et al.: Optimistic Explanatory Style 49

tients (Keller & Wolfersdorf, 1993), and differentiated be- tween suicide attempters and completers (Beck, Steer, Ko- vacs, & Garrison, 1985). In the current study, Cronbach’s α = .87.

Beck Scale for Suicide Ideation (BSS; Beck, Kovacs, & Weissman, 1979)

The BSS is a 21-item self-report assessment of thoughts, attitudes, and intentions regarding suicide. The BSS has adequate internal consistency (coefficient α = .90, outpa- tient sample α = .87), demonstrates high face, convergent, and construct validity (Beck et al., 1979), exhibits adequate test-retest reliability (Beck & Steer, 1991), and predicted suicidal ideation in university students (Miller, Segal & Coolidge, 2001). In the current study, Cronbach’s α = .83.

Statistical Analyses

Independence of study variables was assessed using two- tailed bivariate correlation analyses (see Table 1). Hierarchi- cal, multiple linear regressions were utilized to conduct mod- erator analyses predicting suicide ideation, scored as a con- tinuous measure, according to accepted guidelines (Baron & Kenny, 1986); variables and covariates were entered on the first step, and the interaction term was entered on the second step. By design, all analyses controlled for depressive symp- toms (BDI-II), hopelessness (BHS), age, and gender (females are the reference group); however, we also ran these analyses without controlling for depression and hopelessness, and re- port these results. Predictor variables of optimistic explana- tory style and negative life events were centered prior to anal- yses to reduce multicollinearity occurring as a result of the moderator interaction (Aiken & West, 1991). To illustrate the moderator interaction, participants were categorized into high (pessimistic), medium, and low (optimistic) explanatory style groups using the mean score and cutoffs either one standard deviation above or below the mean.

Results

Forty-three percent of the sample (n = 59) had experienced at least one traumatic experience in their lifetime, with a mean occurrence of six traumatic life events (see Table 1). Slightly over 10% of the sample (n = 14) had made a pre- vious suicide attempt, and 85% (n = 115) endorsed past suicide ideation. Bivariate correlations indicated that neg- ative life events were significantly positively associated with depression (.21, p < .05) and suicide ideation (.26, p < .01). Optimistic explanatory style was significantly neg- atively associated with hopelessness (–.45; p < .01), de- pressive symptoms (–.48; p < .01), and suicide ideation (–.47; p < .01) (see Table 1).

An uncontrolled moderator model predicting the influence

Table 1: Bivariate correlations of study variables

Gender Depressive symptoms

Hopelessness Optimistic explanatory style

Negative life events Suicide ideation

Age –.01 –.09 –.08 .08 .35** .15

Gender – .15 .07 .00 –.04 .01

Depressive symptoms – – .72** –.48** .21* .53**

Hopelessness – – – –.45** .02 .56**

Optimistic explanatory style – – – – –.08 –.47**

Negative life events – – – – – .26**

Note: Depressive symptoms = Beck Depression Inventory – Second Edition; Hopelessness = Beck Hopelessness Scale; Optimistic explanatory style = Expanded Attributional Style Questionnaire; Negative life events = Lifetime Incidence of Traumatic Events; Suicide ideation = Beck Scale of Suicide Ideation (BSS). Note: * = p < .05; ** = p < .01

Figure 1: Linear regression – plot of interaction between explanatory style and negative life events for suicide idea- tion. Note: Optimistic explanatory style = Expanded Attri- butional Style Questionnaire; Negative life events = Life- time Incidence of Traumatic Events; Suicide ideation = Beck Scale of Suicide Ideation (BSS).

50 J.K. Hirsch et al.: Optimistic Explanatory Style

of optimistic explanatory style and traumatic life events, and their interaction, on suicide ideation, was tested and found to be significant; t = 2.54, p < .05, β = .19 (see Table 2). This moderating effect remained in a controlled model, covarying hopelessness and depressive symptoms; t = 2.10, p < .05, β = .14 (see Table 2). Individuals with a more optimistic explan- atory style were less likely to express suicidal ideation as a result of potentially traumatic life events, over and above the influence of hopelessness and depressive symptoms (see Fig- ure 1). Age and hopelessness, although covariates, were also significant predictors of suicide ideation.

Discussion

The experience of negative and potentially traumatic life events may contribute to the development of suicidal thoughts and behaviors; however, this effect may be buf- fered by adaptive cognitive characteristics. After control- ling for the effects of age, gender, depressive symptoms, and hopelessness, explanatory style moderated the associ- ation between trauma and suicide ideation. Our findings suggest that the manner in which an individual interprets the negative life experiences they encounter influences their level of suicidal ideation. In the context of potentially traumatic life events, individuals with an optimistic explan-

atory style report having less suicide ideation than individ- uals with a pessimistic explanatory style. Attributing a neg- ative life event to personal characteristics, believing that a negative life event might recur, or that experiencing a neg- ative life event will affect all areas of ones’ life, may con- tribute to the development or maintenance of suicidal thoughts and behaviors. On the other hand, if an individual avoids self blaming and can acknowledge a traumatic ex- perience as an isolated event with limited ramifications for other areas of their life then, perhaps, they may be at de- creased risk for suicidal thoughts and behaviors.

Our findings may also have implications for the treat- ment of trauma-related suicidal thoughts and behaviors. In- dividuals who think positively about their future appear to be protected from some adverse medical and psychological outcomes (Achat, Kawachi, Spiro, DeMolles, & Sparrow, 2000), perhaps through the use of active adaptive strategies (Miller et al., 1996) or establishment of meaningful and supportive interpersonal relationships that foster optimism (Brissette, Scheier, & Carver, 2002). An individual who is able to explain his or her past in an optimistic manner and engender a positive outlook toward the future may reduce distress, thereby mitigating risk (Hawkins & Miller, 2003; Vaillant, 2003). Preliminary findings suggest that teaching individuals to think optimistically can increase hopefulness (Johnson, Crofton, & Feinstein, 1996) and reduce depres- sion in adolescents, college students, and outpatients being

Table 2: Explanatory style, negative life events and suicide ideation – multivariate linear regression

Model I – uncontrolled analysis Model II – controlled analysis

T-Value Un. β (SE) β CI (95%) T-Value Un. β (SE) β CI (95%) Step one Step one

Constant 0.86 1.15 (1.33) 0.00 –1.48, 3.78 Constant –0.91 –1.15 (1.27) 0.00 –3.67, 1.36

Age 1.60 0.09 (0.05) 0.13 –0.02, 0.19 Age 2.25* 0.11 (.04) 0.16 0.01, 0.20

Gender 0.23 0.16 (0.68) 0.02 –1.19, 1.50 Gender –0.44 –0.27 (.61) –0.03 –1.48, 0.94

Life events 2.14* 0.26 (0.12) 0.17 0.01, 0.50 Life Events 1.90 0.22 (.11) 0.13 –0.03, 0.14

Optimism 6.25*** 3.85 (0.61) 0.47 2.63, 5.06 Optimism 3.25** 2.04 (.62) 0.36 0.17, 0.58

Depressive symptoms 1.25 0.05 (.04) 0.14 –0.00, 0.44

Hopelessness 3.67*** 0.38 (.10) 0.25 0.79, 3.27

Step two Step two

Constant 0.68 0.90 (1.30) 0.00 –1.69, 3.48 Constant –1.00 –1.26 (1.25) 0.00 –3.74, 1.23

Age 1.53 0.08 (0.05) 0.12 –0.02, 0.18 Age 2.18* 0.10 (.04) 0.15 0.00, 0.19

Gender 0.81 0.56 (0.68) 0.06 –0.80, 1.91 Gender 0.07 0.04 (.62) 0.00 –1.19, 1.27

Life events 1.70 0.21 (0.12) 0.14 –0.03, 0.44 Life events 1.55 0.18 (.11) 0.12 –0.04, 0.40

Optimism 6.59*** 3.99 (0.60) 0.49 2.79, 5.18 Optimism 3.54*** 2.21 (.62) 0.27 0.97, 3.44

Optimism × Life events interaction

2.54* 0.72 (0.28) 0.19 0.15, 1.28 Optimism × Life events interaction

2.09* 0.53 (.25) 0.14 0.02, 1.04

Depressive symptoms 1.24 0.05 (.04) 0.13 –0.03, 0.13

Hopelessness 3.52*** 0.36 (.10) 0.35 0.15, 0.56

Note: Controlled analyses covary depressive symptoms and hopelessness. Depressive symptoms = Beck Depression Inventory – Second Edition; Hopelessness = Beck Hopelessness Scale; Optimistic explanatory style = Expanded Attributional Style Questionnaire; Negative life events = Lifetime Incidence of Traumatic Events; Suicide ideation = Beck Scale of Suicide Ideation (BSS). Model I – Step One – R2 = .29, AdjR2 = .26, Step Two – R2 = .32, AdjR2 = .29 (p < .05). Model II – Step One – R2 = .45, AdjR2 = .42, Step Two – R2 = .47, AdjR2 = .44 (p < .05).

J.K. Hirsch et al.: Optimistic Explanatory Style 51

treated for depression (Barber & Derubeis, 2001; Gillham & Reivich, 2004; Puskar et al., 1999). Perhaps similar tech- niques could be used to decrease suicide ideation in patients who have experienced a traumatic life event.

Our novel findings must be interpreted within the con- text of several limitations. Cross-sectional data preclude the ability to examine causal effects of future orientation on the initiation or maintenance of suicidal ideation and behavior. Prospective research with diverse clinical and community samples is needed to determine whether the risk of suicidal behavior is lower in traumatized individuals who are able to construct a positive perspective on their past negative life events. Such an optimistic explanatory style may be advantageous in the prevention of suicide, and prospective investigation of the mechanisms by which fu- ture-oriented and optimistic cognitive characteristics might exert a protective effect in individuals who have experi- enced trauma is warranted. Further, potential detrimental effects of future orientation on psychological functioning should be explored (Segerstrom, 2001, 2005). Increased understanding of adaptive and future-oriented characteris- tics that might mitigate the development and expression of suicidal thoughts and behaviors may lead to the develop- ment of improved treatments.

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About the authors

Jameson K. Hirsch is an Assistant Professor and Director of the Laboratory of Rural Psychological and Physical Health, Depart- ment of Psychology, East Tennessee State University in Johnson City, TN, USA.

Karen Wolford is a professor of psychology and an expert on trauma and PTSD at SUNY College at Oswego, NY, USA.

Steven M. LaLonde is an associate professor and an expert in multivariate modeling and survey research at the Rochester Insti- tute of Technology, NY, USA.

Lisa Brunk is a practicing counselor in the Central Nassau Guid- ance and Counseling Services, NY, USA.

Amanda Parker-Morris is currently completing her graduate train- ing at the School of Professional Psychology, Pacific University, OR, USA.

Jameson K. Hirsch

Department of Psychology East Tennessee State University P.O. Box 70649 Johnson City, TN 37614 USA Tel. +1 423 439-4463 E-mail [email protected]

J.K. Hirsch et al.: Optimistic Explanatory Style 53