Dr. Kayce Hyde Brott

When people feel hopeless, they are more likely to think about suicide. Prior work has shown that both hopelessness and suicidal ideation fluctuate over time; however, there are likely other contextual factors underlying increased hopelessness and suicidal ideation in moments of time.

In two studies using retrospective recall of a real event (Study 1, n = 268) and an experimental imaginal vignette design (Study 2, n = 356), we examined self-criticism and self-efficacy for self-regulation as crucial factors underlying hopelessness in people vulnerable to suicidal ideation.

In both studies, greater state self-criticism and lower state self-efficacy were associated with greater hopelessness. In Study 2, we also measured suicidal ideation, and found that higher self-criticism and lower self-efficacy for self-regulation scores were associated with greater suicidal ideation, even when controlling for negative affect. Evidence of an interaction between self-criticism and self-efficacy was found with scores in Study 2 but not in Study 1; specifically, lower self-efficacy was associated with greater ideation when self-criticism was high but not when self-criticism was low.

Overall, results support self-criticism and self-efficacy as important contextual factors underlying hopelessness and suicidal ideation and attending to the potential interactive effect between self-criticism and self-efficacy.

Cognitive reappraisal is an emotion regulation strategy with significant empirical support. However, it is also true that many people have difficultly using cognitive reappraisal—and any cognitive strategy that requires significant mental effort—while experiencing intense emotions. Per the tenants of emotion-regulation flexibility, we provide information on a therapeutic concept we call the “thinking threshold” that helps clients identify the level of emotional distress at which their thinking becomes impaired. When clients are above the thinking threshold they are guided to use behavioral and bodily focused emotion regulation strategies, and to use cognitive reappraisal and problem solving when below the thinking threshold. In this article, we outline the rationale for considering emotion-regulation flexibility with clients, identify why level of emotional intensity is an important context to consider when helping clients identify effective emotion regulation strategies, and review research supporting the notion that effortful cognitive strategies are less effective at high levels of emotional distress. We also describe how we teach clients to use the thinking threshold concept and provide a brief case study demonstrating the utility of the concept with a client. Finally, we review ways in which the thinking threshold could be tailored and adapted alongside acceptance-based approaches, and we describe future directions for both empirical examination of the thinking threshold as well as expansion within clinical practice.

Although distress tolerance is usually studied as a trait, people also vary in their momentary distress tolerance over time and across contexts. In the current study, we evaluated perceptions of distress tolerance changeability (n = 317) and qualitatively coded narrative responses to questions asking about contexts in which distress tolerance is impaired as well as strengthened.

We found that 82% of people believe that their distress tolerance changes over time. Qualitative analyses revealed that people believe their distress tolerance is impaired under stress, when in a negative mood, when lacking in social support, or when physically drained (i.e., hungry, tired, sick). Similarly, people reported greater distress tolerance when in a positive mood, when feeling supported or with others, when experiencing fewer obligations or recent life successes, and when feeling clear-headed. Results provide avenues for the future study of distress tolerance changeability and confirm the utility of considering distress tolerance as a state, not just a trait.