Testing the Efficacy of Two Prevention Interventions for Individuals at Risk for Suicide and Depression

Suicide and depression are serious and growing public health problems. Despite their substantial global health burden, relatively few interventions have been found to be efficacious at preventing these conditions. The aims of the current study were to (a) determine whether two brief, cost-effective, and easy-to-disseminate prevention interventions (gratitude and priorities) were efficacious at preventing suicidality and depressive symptoms among individuals at risk for these conditions based on their psychological histories; (b) compare the efficacy of a gratitude intervention to a stringent active control condition (priorities) and an inactive control condition; and (c) address why the two prevention interventions might be efficacious by testing possible mechanisms (e.g., belongingness, sleep quality, optimism, gratitude) through which the interventions operate. In the current study, participants (N = 192) who were currently asymptomatic but who endorsed a history of suicidality and/or depression were randomly assigned to one of three intervention conditions (gratitude, priorities, control). These at-risk participants were followed for two months following the intervention period to determine if the interventions were efficacious at preventing future symptoms of suicidality and depression. Testing the efficacy of these interventions in an at-risk sample is crucial, as it is important to know whether such interventions are efficacious, have no effect, or are potentially harmful to a subgroup of individuals. Results provided evidence that participants in the gratitude condition experienced a poorer trajectory of depressive symptoms over time, a shorter length of time to suicidal ideation, and equivalent trajectories of life satisfaction and subjective happiness compared to participants in the control condition. Results also provided evidence that participants in the priorities condition experienced a poorer trajectory of satisfaction with life, and equivalent trajectories of depressive symptoms, suicidal ideation, and subjective happiness compared to participants in the control condition. None of the proposed mediators were found to mediate the relationship between condition and outcome. Overall, results suggest that participating in a gratitude or priorities intervention may not be an efficacious means of improving well-being and preventing suicidality and depressive symptoms among individuals with a history of suicidality and/or depression. Future research should continue to test the efficacy of positive psychology interventions among vulnerable individuals before techniques and interventions are endorsed to the public via self-help campaigns.