Comparing the Effects of Cognitive-Behavioral Therapy and Mindfulness Treatment on Depressive Symptoms in Students with Suicidal Ideation

Suicide occurs in all age groups and is among the causes of death in individuals, aged 15–29 years. Suicide is a complex and multi–causal behavior, i.e., among the preparations for suicide. Numerous attempts were made to identify the risk factors leading to suicidal ideation or suicide attempt for its understanding and prevention. Cognitive–Behavioral Therapy (CBT) is a suitable option to treat depression based on the information processing theory, which assumes that cognitions (including thoughts, images, & the perceptions of events, assumptions, & beliefs) have a direct causal relationship with emotional and behavioral responses. Considering the relative success of CBT in treating depression and the prevalence and consequences of this disorder, it is of high importance to find newer treatment options, especially in suicidal adolescents. The current study aimed to evaluate the effects of CBT and Mindfulness Treatment (MT) on depressive symptoms in students with suicidal ideation.

This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study included all students in Savojbolagh City, Iran, in 2019; among whom, 60 eligible volunteers were included in the study based on the cut–off point of Beck Scale for Suicide Ideation (SSI; Beck et al., 1979) (cut off scores: 5–10). They were randomly divided into the experimental groups of CBT and MT, and a control group (n=20/group). The inclusion criteria of the study were obtaining a score higher than the cutoff point in the SSI, no diagnosis of bipolar disorder, borderline personality disorder, and history of drug use, no concomitant use of psychological services, no chronic physical illness, including thyroid, diabetes, and cancer, and biopsychological defects. Exclusion criteria were absence from 2 training sessions. The study subjects completed Beck Depression Inventory (Beck et al., 1961) at pretest and posttest. Moreover, 6 CBT sessions were performed based on Leahy’s intervention protocol (2017) and 6 MT sessions based on Burdick intervention protocol (2014); these sessions were held for 90 minutes for 2 experimental groups. No intervention was provided to the control group. Descriptive statistics (frequency, percentage, mean, & standard deviation) as well as inferential statistics, including Chi–squared test, Kruskal–Wallis test, Analysis of Covariance (ANCOVA), and Bonferroni post hoc test were used to analyze the obtained data in SPSS at the significance level of 0.05.

The obtained results indicated that after removing the pretest effect for depression, there was a significant difference in the posttest between the study groups (p<0.001). Besides, CBT (p<0.001) and MT (p<0.001) for the experimental groups reduced depression, compared to the control group; however, there was no significant difference between the provided interventions (p=0.480).

According to the present study results, CBT and MT were effective in the treatment of depressive symptoms among students with suicidal ideation; there was no significant difference between these interventions.