Dr Rob Dempsey, Lecturer in Psychology & Course Leader of Staffordshire University’s BSc (Hons) Psychology degree, blogs about a new study published with his PhD Student Rebecca Owen on understanding the experiences of discussing suicidality from the perspective of people with Bipolar Disorder diagnoses:
As part of Rebecca’s PhD research we have been exploring the experiences of suicidal thoughts, feelings and behaviours by people with a Bipolar Disorder diagnosis, with a particular focus on understanding the role of social factors and appraisals of social interactions in suicidality. We have already conducted a qualitative study where we interviewed 20 people with bipolar disorder to explore the sorts of social factors that might enhance or reduce their feelings of suicidality. We published the first part of this study last year on the relationship between social factors and suicidality (click here) and have previously blogged about our findings (click here and here).
As part of these interviews we also asked our participants about their experiences of discussing suicidality with us to help us to better understand if there were any negative or positive effects of discussing suicidality on our participants and to obtain feedback about our research. We identified six themes in our analysis:
(1) talking about suicide was not distressing for the majority of our participants.
(2) negative interview expectations: whilst most participants did not find taking part in the interview to be distressing, many had negative expectations before the interview about how they would cope with talking about personal experiences of suicidality.
(3) personal benefits: discussing suicidality for some participants helped them understand and reflect on their own experiences and, for some, helped with their own personal recovery process.
(4) value of suicide research: most participants felt that research into suicidality was worthwhile and many participants mentioned that they took part as part of a desire to help other people in similar circumstances.
(5) interview advice: for future studies, participants emphasised the importance of having stable moods before discussing suicide-related experiences, and positively commented on our approach in the interviews to build towards discussing suicide in a gradual and careful manner, and ensuring regular breaks during the interview for the participant.
(6) talking about suicide was difficult: although most of our participants did not find the interview distressing, it is important to note that some did find talking about suicide and reflecting on past negative experiences to be difficult. A couple of our participants were also experiencing some ongoing difficult life circumstances at the time of the interview which appeared to explain why they felt talking about suicide was more difficult for themselves than other participants.
So what did we learn from these interviews? It was clear from conducting this study that many people with personal experience of bipolar disorder valued the opportunity to discuss their own experiences of suicidality, even though it was something difficult to discuss. Anecdotally, we were aware that many people with bipolar disorder experience significant periods of suicidality but may feel unable to discuss such experiences with friends, family or healthcare workers for a variety of reasons. We also found that a number of individuals with bipolar disorder, including those who didn’t end up taking part in our interviews, felt that suicidality in bipolar disorder was a poorly understood phenomenon – so there was a clear interest from individuals with lived experience bipolar disorder in better understanding suicidality. Whilst the majority of our participants did not find discussing suicidality to be distressing in our interviews, some participants did find reflecting on negative experiences to be difficult. The research team were careful to sample only those individuals whose moods were stable (based on a standardised screening interview) and only sampled those individuals who were willing to discuss their experiences with Rebecca.
Based on our analysis of the interviews, and our own experiences of conducting this study, we have made a number of recommendations for best practice when conducting similar interviews in the future. Examples include: (1) ensuring participants have a realistic overview of what the interview will involve during the pre-study consent process; (2) ensuring participants’ mood stability prior to the study and that the risk of suicidality is minimal; (3) providing extensive training in interviewing for the interviewer (including on-going support and training in discussing difficult topics during interviews); as well as appropriate after-study practices like liaising with the participant’s care team if the individual became distressed, follow-up phone-based support as well as post-interview brief mood-boosting techniques (see our paper via the link below for more details).
We are very grateful to our participants for their time and for their very valuable contributions to the study. We are in the process of completing a larger-scale project investigating which of the psychosocial factors identified in these interviews and a review of the past research literature are associated with increased suicidality over time or which help to buffer (reduce) feelings of suicidality. These quantitative studies will allow us to model the psychosocial pathways implicated in suicidality for people with bipolar disorder diagnoses, which may be crucial for developing theory-informed targeted psychological therapies.
Owen, R., Gooding, P., Dempsey, R., & Jones, S. (in press). The Experience of Participation in Suicide Research from the Perspective of Individuals with Bipolar Disorder. Journal of Nervous & Mental Disease.
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