Suicidal Crises: The Clinical and Research Implications of Overlooking the Role of Suicidal Reactivity
Individuals differ in their likelihood of becoming suicidal in the presence of stressors. This “suicidal reactivity” (i.e. the ease with which suicide-relevant physiological, emotional or cognitive processes are activated by suicide-relevant cues) is explicitly or implicitly included as a component of several extant theories of suicide, but is not consistently emphasized in suicide risk assessment or management. In this chapter, we examine the construct of suicidal reactivity from the perspective of cognitive models of suicidal behaviour. We propose that the failure to adequately assess suicidal reactivity may be a large contributing factor to the lack of progress in suicide risk assessment, and we review assessment measures relevant to suicidal reactivity. We also describe ways in which suicidal reactivity can be treated and illustrate how better understanding, predicting and preparing for reactivity plays a crucial role in suicide risk assessment, management and treatment. Finally, we argue that a lack of attention to the impact of suicidal reactivity on behaviour during research participation likely impedes our ability to draw meaningful conclusions from suicide research. We propose that suicidal reactivity is in need of additional empirical scrutiny and identify avenues for future research.
KeywordsSuicidal reactivity Suicide risk assessment Cognitive model of suicidal behaviour Dispositional vulnerability factors Safety planning
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