How do individuals with psychosis develop resilience to suicidal thoughts and behaviours? A qualitative investigation

  • Natalie Berry

Student thesis: Doctor of Clinical Psychology

Abstract

The aim of this thesis was to understand psychological resilience to suicidal experiences in people with psychosis. Paper 1 is a systematic review prepared for the journal Clinical Psychology Review. The paper presents a thematic synthesis of the literature that reported qualitative studies regarding the views and experiences of individuals with psychosis on the factors contributing to resilience to suicidal thoughts, urges, behaviours, and attempts. Twenty studies were included, with 477 participants across studies. Findings showed several factors that were viewed as important by participants for combatting suicidal experiences. These included meaningful and supportive connections with others, fostering internal psychological resources, implementing behavioural strategies such as keeping occupied, religion and faith, a sense of competence in personal and professional life roles, and engaging with physical and practical responses such as medication and removal of means. Findings offer clinical implications and highlight a need for the adaption of suicide models and a person-centred approach to delivering psychological interventions for suicidal experiences and psychosis. Paper 2 presents the empirical study, which has been prepared for the journal BMC Psychiatry. The paper is a qualitative analysis of secondary data that aims to understand how individuals with psychosis develop and maintain resilience to suicidal experiences through psychological therapy and identify the psychological processes involved. As part of a wider project (Cognitive AppRoaches to coMbatting Suicidality (CARMS); Gooding et al., 2020), thirty-seven participants were purposively sampled, and subsequently, interviewed about their experiences of psychosis and suicidal thoughts and behaviours. Thirty-five of these participants had previous or current experience of psychological therapy and were included in the current study. Data were analysed using reflexive thematic analysis to gain an in-depth understanding of the psychological processes involved. Four themes were generated: 1) a sense of control; 2) a sense of hope for the future; 3) acceptance of suicidal thoughts; and 4) a sense of self-worth. Considering these findings, clinical implications and recommendations for future research are discussed. Finally, paper 3 presents a critical appraisal of the research process, including the rationale for methodological decisions and strengths and limitations of the work. Overall theoretical and clinical implications of the work are also discussed. The paper concludes with personal and professional reflections of conducting the thesis.
Date of Award31 Dec 2023
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorGillian Haddock (Supervisor), Patricia Gooding (Supervisor) & Sarah Peters (Supervisor)

Keywords

  • psychosis
  • suicide
  • qualitative

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