Recovery of positive future thinking within a high-risk parasuicide group:Results from a pilot randomized controlled trial

Objectives. The research examined: (i) whether high risk parasuicide patien ts showed a deficit in positive future thinking but no increase in negative future thinking; and (ii) whether such a deficit could be remedied by a br ief, manual-assisted psychological intervention (manual assisted cognitive- behaviour therapy; MACT). Design. A cross-sectional, mixed model design was used to assess difference s between a sample of high risk parasuicide patients and matched controls o n future thinking. A longitudinal mixed model design was used to assess cha nges in future thinking in the different groups over time. Methods. Parasuicide patients with a history of previous suicidal behaviour and personality disturbance were compared with a matched group of communit y controls on an adapted fluency measure of future thinking, which measured both quantitative and qualitative aspects of anticipated experiences. Pati ents were then randomly allocated to either the specific intervention (MACT ) or treatment as usual (TAU) and assessed again at 6 month follow-up. Results. Parasuicide patients showed reduced positive future thinking but n o increased negative future thinking. Patients who received MACT showed a s ignificant improvement in positive future thinking over the follow-up perio d whereas the TAU group showed no such improvement. However, interpretation of this finding was made more difficult by the control group also showing a significant improvement in positive future thinking. Conclusion. The results confirm that parasuicide patients exhibit a relativ e deficit in positive future thinking and suggest that this lack of positiv e future thinking may be remedied, at least partly, by a brief intervention .