Skip to main content

Advertisement

SpringerLink
Log in

Emotional distress and dysregulation as treatment targets to reduce suicide in psychosis: a scoping review

  • Invited Review
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

There is a pressing need for effective treatments that address the high rate of suicide observed among people with psychosis. In this scoping review we highlight two suicidogenic treatment targets that have been relatively neglected in people with psychotic disorders: emotional distress and emotion dysregulation. We review the research on these constructs in psychosis and their relationship to suicide in this population, and then make clinical recommendations based on research findings. Emotional distress and emotional dysregulation may be promising treatment targets for suicide among people with psychosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hor K, Taylor M (2010) Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 24:81–90

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bertolote JM, Fleischmann A (2002) Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry 1:181–185

    PubMed  PubMed Central  Google Scholar 

  3. Olfson M, Gerhard T, Huang C et al (2015) Premature mortality among adults with schizophrenia in the United States. JAMA Psychiat 72:1172–1181

    Article  Google Scholar 

  4. Saha S, Chant D, McGrath J (2007) A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 64:1123–1131

    Article  PubMed  Google Scholar 

  5. Beautrais AL (2001) Suicides and serious suicide attempts: two populations or one? Psychol Med 31:837–845

    Article  CAS  PubMed  Google Scholar 

  6. Baca-Garcia E, Perez-Rodriguez MM, Sastre CD et al (2005) Suicidal behavior in schizophrenia and depression: a comparison. Schizophr Res 75:77–81

    Article  PubMed  Google Scholar 

  7. Fedyszyn IE, Robinson J, Harris MG et al (2014) Suicidal behaviours during treatment for first-episode psychosis: towards a comprehensive approach to service-based prevention. Early Interv Psychiatry 8:387–395. https://doi.org/10.1111/eip.12084

    Article  PubMed  Google Scholar 

  8. Klonsky D, Kotov R, Bakst S et al (2012) Hopelessness as a predictor of attempted suicide among first admission patients with psychosis: a 10-year cohort study. Suicide Life Threat Behav 42:1–10

    Article  PubMed Central  Google Scholar 

  9. Villa J, Ehret BC, Depp CA (2020) Systematic review of the inclusion of psychosis in suicide-specific clinical trials. Crisis 41:233–236

    Article  PubMed  Google Scholar 

  10. Anderson KK, Norman R, MacDougall A et al (2018) Effectiveness of early psychosis intervention: comparison of service users and nonusers in population-based health administrative data. AJP 175:443–452. https://doi.org/10.1176/appi.ajp.2017.17050480

    Article  Google Scholar 

  11. Nosek BA, Ebersole CR, DeHaven AC, Mellor DT (2018) The preregistration revolution. Proc Natl Acad Sci USA 115:2600–2606. https://doi.org/10.1073/pnas.1708274114

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bertelsen M, Jeppesen P, Petersen L et al (2007) Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial. Br J Psychiatry 191:s140–s146. https://doi.org/10.1192/bjp.191.51.s140

    Article  Google Scholar 

  13. Chan SKW, Chan SWY, Pang HH et al (2018) Association of an early intervention service for psychosis with suicide rate among patients with first-episode schizophrenia-spectrum disorders. JAMA Psychiat 75:458–464. https://doi.org/10.1001/jamapsychiatry.2018.0185

    Article  Google Scholar 

  14. Power PJR, Bell RJ, Mills R et al (2003) Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Aust N Z J Psychiatry 37:414–420

    Article  CAS  PubMed  Google Scholar 

  15. Tarrier N, Kelly J, Maqsood S et al (2014) The cognitive behavioural prevention of suicide in psychosis: a clinical trial. Schizophr Res 156:204–210. https://doi.org/10.1016/j.schres.2014.04.029

    Article  PubMed  Google Scholar 

  16. Haddock G, Pratt D, Gooding PA et al (2019) Feasibility and acceptability of suicide prevention therapy on acute psychiatric wards: randomised controlled trial. BJPsych Open 5:e14. https://doi.org/10.1192/bjo.2018.85

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ellis TE, Newman CF (1996) Choosing to live: How to defeat suicide through cognitive therapy. New Harbinger Publications, Inc., Oakland

    Google Scholar 

  18. Freeman A, Reinecke MA (1993) Cognitive therapy of suicidal behavior: A manual for treatment. Springer, New York

    Google Scholar 

  19. Tarrier N, Gooding P, Pratt D et al (2013) Cognitive behavioural prevention of suicide in psychosis: A treatment manual. Routledge, New York

    Book  Google Scholar 

  20. Bornheimer LA, Verdugo JL, Krasnick J et al (2023) A cognitive-behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health: preliminary findings of an open pilot study. Social Work Mental Health 311:114505. https://doi.org/10.1080/15332985.2023.2186736

    Article  Google Scholar 

  21. Depp CA, Parrish EM, Chalker SA et al (2023) Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness. Psychiatr Rehabil J 46:74–82. https://doi.org/10.1037/prj0000547

    Article  PubMed  Google Scholar 

  22. Stanley B, Brown G, Brent DA et al (2010) Cognitive-behavioral therapy for suicide prevention (CBT-SP): treatment model, feasibility, and acceptability. J Am Acad Child Adolesc Psychiatry 48:1005–1013

    Article  Google Scholar 

  23. Bryan CJ, Rozek DC (2018) Suicide prevention in the military: a mechanistic perspective. Curr Opin Psychol 22:27–32. https://doi.org/10.1016/j.copsyc.2017.07.022

    Article  PubMed  Google Scholar 

  24. Linehan MM (2014) DBT skills training manual: Second Edition. Guilford, New York

    Google Scholar 

  25. Morrison AP (2017) A manualised treatment protocol to guide delivery of evidence-based cognitive therapy for people with distressing psychosis: learning from clinical trials. Psychosis 9:271–281

    Article  Google Scholar 

  26. Garety PA, Kuipers E, Fowler D et al (2001) A cognitive model of the positive symptoms of psychosis. Psychol Med 31:189–195

    Article  CAS  PubMed  Google Scholar 

  27. Freeman D, Garety PA, Kuipers E et al (2002) A cognitive model of persecutory delusions. Br J Clin Psychol 41:331–347

    Article  PubMed  Google Scholar 

  28. Beck AT, Rector NA, Stolar N, Grant P (2008) Schizophrenia: Cognitive theory, research, and therapy. Guilford Press

    Google Scholar 

  29. Freeman D, Garety PA (2003) Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations. Behav Res Ther 41:923–947

    Article  PubMed  Google Scholar 

  30. Sanchez-Gistau V, Baeza I, Arango C et al (2015) The affective dimension of early-onset psychosis and its relationship with suicide. J Child Psychol Psychiatry 56:747–755. https://doi.org/10.1111/jcpp.12332

    Article  PubMed  Google Scholar 

  31. Livingstone K, Harper S, Gillanders D (2009) An exploration of emotion regulation in psychosis. Clin Psychol Psychother 16:418–430. https://doi.org/10.1002/cpp.635

    Article  PubMed  Google Scholar 

  32. Birchwood M, Iqbal Z, Chadwick P, Trower P (2000) Cognitive approach to depression and suicidal thinking in psychosis. 1. Ontogeny of post-psychotic depression. Br J Psychiatry 177:516–521

    Article  CAS  PubMed  Google Scholar 

  33. Strauss GP, Esfahlani FZ, Visser KF et al (2019) Mathematically modeling emotion regulation abnormalities during psychotic experiences in schizophrenia. Clin Psychol Sci 7:216–233

    Article  Google Scholar 

  34. Norman RMG, Malla AK (1991) Dysphoric mood and symptomatology in schizophrenia. Psychol Med 21:897–903. https://doi.org/10.1017/S0033291700029883

    Article  CAS  PubMed  Google Scholar 

  35. Kimhy D, Wall MM, Hansen MC et al (2017) Autonomic regulation and auditory hallucinations in individuals with schizophrenia: an experience sampling study. Schizophr Bull 43:754–763. https://doi.org/10.1093/schbul/sbw219

    Article  PubMed  PubMed Central  Google Scholar 

  36. Myin-Germeys I, Delespaul PA, DeVries MW (2000) Schizophrenia patients are more emotionally active than is assumed based on their behavior. Schizophr Bull 26:847–854

    Article  CAS  PubMed  Google Scholar 

  37. O’Driscoll C, Laing J, Mason O (2014) Cognitive emotion regulation strategies, alexithymia and dissociation in schizophrenia, a review and meta-analysis. Clin Psychol Rev 34:482–495. https://doi.org/10.1016/j.cpr.2014.07.002

    Article  PubMed  Google Scholar 

  38. Kimhy D, Vakhrusheva J, Jobson-Ahmed L et al (2012) Emotion awareness and regulation in individuals with schizophrenia: Implications for social functioning. Psychiatry Res 200:193–201

    Article  PubMed  PubMed Central  Google Scholar 

  39. Bridges JF, Slawik L, Schmeding A et al (2013) A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia. Health Expect 16:164–176

    Article  PubMed  Google Scholar 

  40. Hawton K, Sutton L, Haw C et al (2005) Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry 187:9–20

    Article  PubMed  Google Scholar 

  41. Challis S, Nielssen O, Harris A, Large M (2013) Systematic meta-analysis of the risk factors for deliberate self-harm before and after treatment for first-episode psychosis. Acta Psychiatr Scand 127:442–454. https://doi.org/10.1111/acps.12074

    Article  CAS  PubMed  Google Scholar 

  42. Barrett EA, Sundet K, Faerden A et al (2010) Suicidality before and in the early phases of first episode psychosis. Schizophr Res 119:11–17. https://doi.org/10.1016/j.schres.2010.03.022

    Article  PubMed  Google Scholar 

  43. Bornheimer LA (2018) Suicidal ideation in first-episode psychosis (FEP): examination of symptoms of depression and psychosis among individuals in an early phase of treatment. Suicide Life Threat Behav. https://doi.org/10.1111/sltb.12440

    Article  PubMed  PubMed Central  Google Scholar 

  44. Upthegrove R, Birchwood M, Ross K et al (2009) The evolution of depression and suicidality in first episode psychosis: depression in first episode psychosis. Acta Psychiatr Scand 122:211–218. https://doi.org/10.1111/j.1600-0447.2009.01506.x

    Article  PubMed  Google Scholar 

  45. Robinson J, Harris MG, Harrigan SM et al (2010) Suicide attempt in first-episode psychosis: a 7.4 year follow-up study. Schizophr Res 116:1–8. https://doi.org/10.1016/j.schres.2009.10.009

    Article  CAS  PubMed  Google Scholar 

  46. Sanchez-Gistau V, Baeza I, Arango C et al (2013) Predictors of suicide attempt in early-onset, first-episode psychoses: a longitudinal 24-month follow-up study. J Clin Psychiatry 74:59–66. https://doi.org/10.4088/JCP.12m07632

    Article  PubMed  Google Scholar 

  47. Tarrier N, Haddock G, Lewis S et al (2006) Suicide behaviour over 18 months in recent onset schizophrenic patients: the effects of CBT. Schizophr Res 83:15–27

    Article  PubMed  Google Scholar 

  48. McGinty J, Sayeed Haque M, Upthegrove R (2018) Depression during first episode psychosis and subsequent suicide risk: a systematic review and meta-analysis of longitudinal studies. Schizophr Res 195:58–66. https://doi.org/10.1016/j.schres.2017.09.040

    Article  PubMed  Google Scholar 

  49. Fedyszyn IE, Harris MG, Robinson J et al (2011) Characteristics of suicide attempts in young people undergoing treatment for first episode psychosis. Aust N Z J Psychiatry 45:838–845. https://doi.org/10.3109/00048674.2011.595687

    Article  PubMed  Google Scholar 

  50. Tarrier N, Khan S, Cater J, Picken A (2007) The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour. Soc Psychiatry Psychiatr Epidemiol 42:29–35

    Article  PubMed  Google Scholar 

  51. Thompson RA (1994) Emotion regulation: a theme in search of definition. Monogr Soc Res Child Dev 59:25–52. https://doi.org/10.2307/1166137

    Article  CAS  PubMed  Google Scholar 

  52. Gross JJ (2008) Emotion regulation. Handbook of emotions, 3rd edn. Guilford Press, New York, pp 497–512

    Google Scholar 

  53. Khoury B, Lecomte T (2012) Emotion regulation and schizophrenia. Int J Cogn Ther 5:67–76

    Article  Google Scholar 

  54. Tully LM, Niendam TA (2014) Beyond “cold” cognition: exploring cognitive control of emotion as a risk factor for psychosis. Curr Behav Neurosci Rep 1:170–181

    Article  Google Scholar 

  55. Ludwig L, Werner D, Lincoln TM (2019) The relevance of cognitive emotion regulation to psychotic symptoms – a systematic review and meta-analysis. Clin Psychol Rev 72:101746. https://doi.org/10.1016/j.cpr.2019.101746

    Article  PubMed  Google Scholar 

  56. Kimhy D, Lister A, Liu Y et al (2020) The impact of emotion awareness and regulation on psychotic symptoms during daily functioning. NPJ Schizophr 6:1–7. https://doi.org/10.1038/s41537-020-0096-6

    Article  CAS  Google Scholar 

  57. Pinkham AE, Penn DL, Perkins DO et al (2007) Emotion perception and social skill over the course of psychosis: a comparison of individuals “at-risk” for psychosis and individuals with early and chronic schizophrenia spectrum illness. Cogn Neuropsychiatry 12:198–212

    Article  PubMed  Google Scholar 

  58. Tremeau F (2006) A review of emotion deficits in schizophrenia. Dialogues Clin Neurosci 8:59–70

    Article  PubMed  PubMed Central  Google Scholar 

  59. Kring AM, Caponigro JM (2010) Emotion in schizophrenia: where feeling meets thinking. Curr Dir Psychol Sci 19:255–259

    Article  PubMed  PubMed Central  Google Scholar 

  60. Henry JD, Green MJ, de Lucia A et al (2007) Emotion dysregulation in schizophrenia: reduced amplification of emotional expression is associated with emotional blunting. Schizophr Res 95:197–204

    Article  PubMed  Google Scholar 

  61. Mandal MK, Pandey R, Prasad AB (1998) Facial expressions of emotions and schizophrenia: a review. Schizophr Bull 24:399–412

    Article  CAS  PubMed  Google Scholar 

  62. Lincoln TM, Hartmann M, Köther U, Moritz S (2015) Do people with psychosis have specific difficulties regulating emotions? Clin Psychol Psychother 22:637–646

    Article  PubMed  Google Scholar 

  63. Horan WP, Hajcak G, Wynn JK, Green MF (2013) Impaired emotion regulation in schizophrenia: evidence from event-related potentials. Psychol Med 43:2377–2391

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Visser KF, Esfahlani FZ, Sayama H, Strauss GP (2018) An ecological momentary assessment evaluation of emotion regulation abnormalities in schizophrenia. Psychol Med 48:2337–2345

    Article  PubMed  Google Scholar 

  65. Myin-Germeys I, Peeters F, Havermans R et al (2003) Emotional reactivity to daily life stress in psychosis and affective disorder: an experience sampling study. Acta Psychiatr Scand 107:124–131. https://doi.org/10.1034/j.1600-0447.2003.02025.x

    Article  CAS  PubMed  Google Scholar 

  66. Bonfils KA, Lysaker PH (2020) Levels of distress tolerance in schizophrenia appear equivalent to those found in borderline personality disorder. J Clin Psychol 76:1668–1676. https://doi.org/10.1002/jclp.22944

    Article  PubMed  PubMed Central  Google Scholar 

  67. Cohen AS, Minor KS (2008) Emotional experience in patients with schizophrenia revisited: meta-analysis of laboratory studies. Schizophr Bull 36:143–150

    Article  PubMed  PubMed Central  Google Scholar 

  68. Vakhrusheva J, Khan S, Chang R et al (2020) Lexical analysis of emotional responses to “real-world” experiences in individuals with schizophrenia. Schizophr Res 216:272–278. https://doi.org/10.1016/j.schres.2019.11.045

    Article  CAS  PubMed  Google Scholar 

  69. Grattan R, Tully L, Lesh T et al (2019) F64. Exploring the role of emotion dysregulation and impulsivity on suicidal ideation and behavior within an early psychosis population. Schizophr Bull 45:S279–S279

    Article  PubMed Central  Google Scholar 

  70. Palmier-Claus J, Shryane N, Taylor P et al (2013) Mood variability predicts the course of suicidal ideation in individuals with first and second episode psychosis. Psychiatry Res 206:240–245. https://doi.org/10.1016/j.psychres.2012.11.014

    Article  PubMed  Google Scholar 

  71. Palmier-Claus J, Taylor PJ, Gooding P et al (2012) Affective variability predicts suicidal ideation in individuals at ultra-high risk of developing psychosis: an experience sampling study. Br J Clin Psychol 51:72–83. https://doi.org/10.1111/j.2044-8260.2011.02013.x

    Article  CAS  PubMed  Google Scholar 

  72. Mork E, Mehlum L, Barrett EA et al (2012) Self-harm in patients with schizophrenia spectrum disorders. Arch Suicide Res 16:111–123. https://doi.org/10.1080/13811118.2012.667328

    Article  PubMed  Google Scholar 

  73. DeVylder JE, Hilimire MR (2015) Suicide risk, stress sensitivity, and self-esteem among young adults reporting auditory hallucinations. Health Soc Work 40:175–181

    Article  PubMed  Google Scholar 

  74. Palmier-Claus J, Ainsworth J, Machin M et al (2013) Affective instability prior to and after thoughts about self-injury in individuals with and at-risk of psychosis: a mobile phone based study. Arch Suicide Res 17:275–287. https://doi.org/10.1080/13811118.2013.805647

    Article  CAS  PubMed  Google Scholar 

  75. Tarrier N, Gooding P, Gregg L et al (2007) Suicide schema in schizophrenia: the effect of emotional reactivity, negative symptoms and schema elaboration. Behav Res Ther 45:2090–2097. https://doi.org/10.1016/j.brat.2007.03.007

    Article  PubMed  Google Scholar 

  76. Bellack AS, Mueser KT, Gingerich S, Agresta J (2004) Social skills training for schizophrenia: a step-by-step guide, 2nd edn. Guilford Press, New York

    Google Scholar 

  77. Barlati S, Deste G, De Peri L et al (2013) Cognitive remediation in schizophrenia: current status and future perspectives. Schizophr Res Treatment. https://doi.org/10.1155/2013/156084

    Article  PubMed  PubMed Central  Google Scholar 

  78. Thase ME, Kingdon D, Turkington D (2014) The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments. World Psychiatry 13:244–250. https://doi.org/10.1002/wps.20149

    Article  PubMed  PubMed Central  Google Scholar 

  79. Kane JM, Robinson DG, Schooler NR et al (2016) Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE Early Treatment Program. AJP 173:362–372. https://doi.org/10.1176/appi.ajp.2015.15050632

    Article  Google Scholar 

  80. Marino L, Nossel I, Choi JC et al (2015) The RAISE connection program for early psychosis: secondary outcomes and mediators and moderators of improvement. J Nerv Ment Dis 203:365–371. https://doi.org/10.1097/NMD.0000000000000293

    Article  PubMed  PubMed Central  Google Scholar 

  81. Meltzer HY, Alphs L, Green AI et al (2003) Clozapine treatment for suicidality in SchizophreniaInternational Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry 60:82. https://doi.org/10.1001/archpsyc.60.1.82

    Article  CAS  PubMed  Google Scholar 

  82. Laws KR, Darlington N, Kondel TK et al (2018) Cognitive behavioural therapy for schizophrenia - outcomes for functioning, distress and quality of life: a meta-analysis. BMC Psychol 6:32. https://doi.org/10.1186/s40359-018-0243-2

    Article  PubMed  PubMed Central  Google Scholar 

  83. Bateman K, Hansen L, Turkington D, Kingdon D (2007) Cognitive behavioral therapy reduces suicidal ideation in schizophrenia: results from a randomized controlled trial. Suicide Life Threat Behav 37:284–290

    Article  PubMed  Google Scholar 

  84. Khoury B, Lecomte T, Comtois G, Nicole L (2015) Third-wave strategies for emotion regulation in early psychosis: a pilot study. Early Interv Psychiatry 9:76–83. https://doi.org/10.1111/eip.12095

    Article  PubMed  Google Scholar 

  85. Lawlor C, Vitoratou S, Duffy J et al (2022) Managing emotions in psychosis: evaluation of a brief DBT-informed skills group for individuals with psychosis in routine community services. Br J Clin Psychol 61:735–756. https://doi.org/10.1111/bjc.12359

    Article  PubMed  PubMed Central  Google Scholar 

  86. Ryan A, Crehan E, Khondoker M et al (2021) An emotional regulation approach to psychosis recovery: The Living Through Psychosis group programme. J Behav Therapy Exp Psychiatry 72:101651. https://doi.org/10.1016/j.jbtep.2021.101651

    Article  Google Scholar 

  87. Ritschel LA, Lim NE, Stewart LM (2015) Transdiagnostic applications of DBT for adolescents and adults. Am J Psychother 69:111–128

    Article  PubMed  Google Scholar 

  88. Neacsiu AD, Eberle JW, Kramer R et al (2014) Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: a pilot randomized controlled trial. Behav Res Ther 59:40–51

    Article  PubMed  Google Scholar 

  89. Slee N, Spinhoven P, Garnefski N, Arensman E (2008) Emotion regulation as mediator of treatment outcome in therapy for deliberate self-harm. Clin Psychol Psychother 15:205–216. https://doi.org/10.1002/cpp.577

    Article  PubMed  Google Scholar 

  90. DeCou CR, Comtois KA, Landes SJ (2019) Dialectical behavior therapy is effective for the treatment of suicidal behavior: a meta-analysis. Behav Ther 50:60–72

    Article  PubMed  Google Scholar 

  91. Hill DM, Craighead LW, Safer DL (2011) Appetite-focused dialectical behavior therapy for the treatment of binge eating with purging: a preliminary trial. Int J Eat Disord 44:249–261

    Article  PubMed  Google Scholar 

  92. Rizvi SL, Steffel LM (2014) A pilot study of 2 brief forms of dialectical behavior therapy skills training for emotion dysregulation in college students. J Am Coll Health 62:434–439. https://doi.org/10.1080/07448481.2014.907298

    Article  PubMed  Google Scholar 

  93. Muhomba M, Chugani CD, Uliaszek AA, Kannan D (2017) Distress tolerance skills for college students: a pilot investigation of a brief DBT group skills training program. J Coll Stud Psychother 31:247–256

    Article  Google Scholar 

  94. Linehan MM, Shearin EN (1988) Lethal stress: a social-behavioral model of suicidal behavior. In: Coombs M, Fisher S (eds) Handbook of life stress, cognition and health. Wiley, Chichester, pp 265–285

    Google Scholar 

  95. Neacsiu AD, Bohus M, Linehan MM (2014) Dialectical behavior therapy: an intervention for emotion dysregulation. Handbook of emotion regulation. Guilford Press, New York, pp 491–507

    Google Scholar 

  96. Valentine SE, Bankoff SM, Poulin RM et al (2015) The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. J Clin Psychol 71:1–20

    Article  PubMed  Google Scholar 

  97. Goodman M, Banthin D, Blair N et al (2016) A randomized trial of dialectical behavior therapy in high-risk suicidal veterans. J Clin Psychiatry 77:e1591–e1600. https://doi.org/10.4088/JCP.15m10235

    Article  PubMed  Google Scholar 

  98. Phalen P, Grossmann J, Bruder T et al (2022) Description of a dialectical behavior therapy program in a veterans affairs health care system. Eval Program Plan 92:102098. https://doi.org/10.1016/j.evalprogplan.2022.102098

    Article  Google Scholar 

  99. Jablensky A, McGrath J, Herrman H et al (2000) Psychotic disorders in urban areas: an overview of the study on low prevalence disorders. Aust N Z J Psychiatry 34:221–236. https://doi.org/10.1080/j.1440-1614.2000.00728.x

    Article  CAS  PubMed  Google Scholar 

  100. Linehan MM, Laffaw JA (1982) Suicidal behaviors among clients at an outpatient psychology clinic versus the general population. Suicide Life Threat Behav 12:234–239. https://doi.org/10.1111/j.1943-278X.1982.tb00711.x

    Article  CAS  PubMed  Google Scholar 

  101. Bora E, Murray RM (2013) Meta-analysis of cognitive deficits in ultra-high risk to psychosis and first-episode psychosis: do the cognitive deficits progress over, or after, the onset of psychosis? Schizophr Bull 40:744–755

    Article  PubMed  PubMed Central  Google Scholar 

  102. Bora E, Yücel M, Pantelis C (2009) Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study. Br J Psychiatry 195:475–482

    Article  PubMed  Google Scholar 

  103. Seidman LJ, Cherkerzian S, Goldstein JM et al (2013) Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies. Psychol Med 43:119–131

    Article  CAS  PubMed  Google Scholar 

  104. Lyne J, O’Donoghue B, Owens E et al (2012) Prevalence of item level negative symptoms in first episode psychosis diagnoses. Schizophr Res 135:128–133. https://doi.org/10.1016/j.schres.2012.01.004

    Article  PubMed  Google Scholar 

  105. Sauvé G, Brodeur MB, Shah JL, Lepage M (2019) The prevalence of negative symptoms across the stages of the psychosis continuum. Harv Rev Psychiatry 27:15–32. https://doi.org/10.1097/HRP.0000000000000184

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, USA

    Peter Phalen & Melanie Bennett

  2. Department of Psychiatry, Icahn School of Medicine, New York, NY, USA

    David Kimhy

  3. Education and Clinical Center, James J. Peters VA Medical Center, Mental Illness Research, New York, NY, USA

    David Kimhy

  4. Department of Psychology, The Catholic University of America, Washington, DC, USA

    David Jobes

Authors
  1. Peter Phalen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Kimhy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Jobes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melanie Bennett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Phalen.

Ethics declarations

Conflict of interest

DJ receives royalties from American Psychological Association Press and Guilford Press; he is also co-owner of CAMS-care, LLC (a professional training and consultation company). The authors report no relationships with commercial interests.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Phalen, P., Kimhy, D., Jobes, D. et al. Emotional distress and dysregulation as treatment targets to reduce suicide in psychosis: a scoping review. Eur Arch Psychiatry Clin Neurosci (2023). https://doi.org/10.1007/s00406-023-01675-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00406-023-01675-x

Keywords

Search

Navigation