Traumatic Brain Injury and Suicide

Group cognitive behavioral therapy (CBT) may help reduce hopelessness and prevent increases in suicidal ideation among persons suffering from traumatic brain injury (TBI), according to the results of a randomized controlled trial of Windows to Hope, a ten-session group program designed specifically to apply the principles of CBT to hopelessness associated with TBI.

The authors of this study point out that the hopelessness found among many people suffering from severe TBI may result “from the valid appraisal that life has changed profoundly in ways that cannot be viewed positively” rather than from the cognitive distortions characteristic of people suffering from depression. Thus, the authors recommend that although depression should be treated, it is also essential to create interventions that target specific risk factors that have been shown to be associated with suicide regardless of the presence of depression – in this case, the hopelessness associated with TBI.

Participants in Windows of Hope were more likely to show reductions in hopelessness than members of a control group. These positive outcomes were maintained or improved for 75 percent of the treatment group at a three-month follow-up. Treatment group members were also less likely to experience the increases in suicidal ideation found among control group members. The research also confirmed the importance of “booster sessions” to sustain progress made by patients after the initial treatment period.

The study involved 17 participants with long-term TBI who experienced posttraumatic amnesia and moderate to severe hopelessness and/or suicidal ideation. Members of the control group were provided with treatment after the data collection period.

Simpson, G., Tate, R., Whiting, D., & Cotter, R. (2011). Suicide prevention after traumatic brain injury: A randomized controlled trial of a program for the psychological treatment of hopelessness. Journal of Head Trauma Rehabilitation, 26(4), 290-300.