TY - JOUR
T1 - Deaths of Despair
T2 - Conceptual and Clinical Implications
AU - Rehder, Kristoffer
AU - Lusk, Jaimie
AU - Chen, Jason I.
N1 - Publisher Copyright:
© 2021
PY - 2021/2
Y1 - 2021/2
N2 - Since the late 1990s, mortality rates for middle-aged (45-55), White non-Hispanic (WNH) Americans began to rise while rates declined for all other demographic and age groups. Coinciding with the rise in mortality, rates of death due to suicide, drug- and alcohol-related overdoses, and alcohol-related liver diseases increased as well for this demographic. Research suggests these causes of death (i.e., suicide, poisoning, alcohol-related liver disease) are driving the overall mortality rate for middle-aged WNHs and have been described as “deaths of despair” in the literature. In the current paper, we describe the social and clinical features of “deaths of despair,” explore theoretical models of psychopathology (e.g., depression, posttraumatic stress disorder) that may inform our understanding of mechanisms of risk for negative mental health outcomes, and propose an initial conceptual model of “deaths of despair” to identify intervention targets. We then review an applied case example demonstrating how this model could be used for clinical application. We conclude our paper by describing how current cognitive-behavioral interventions may address these mechanisms of “despair.”
AB - Since the late 1990s, mortality rates for middle-aged (45-55), White non-Hispanic (WNH) Americans began to rise while rates declined for all other demographic and age groups. Coinciding with the rise in mortality, rates of death due to suicide, drug- and alcohol-related overdoses, and alcohol-related liver diseases increased as well for this demographic. Research suggests these causes of death (i.e., suicide, poisoning, alcohol-related liver disease) are driving the overall mortality rate for middle-aged WNHs and have been described as “deaths of despair” in the literature. In the current paper, we describe the social and clinical features of “deaths of despair,” explore theoretical models of psychopathology (e.g., depression, posttraumatic stress disorder) that may inform our understanding of mechanisms of risk for negative mental health outcomes, and propose an initial conceptual model of “deaths of despair” to identify intervention targets. We then review an applied case example demonstrating how this model could be used for clinical application. We conclude our paper by describing how current cognitive-behavioral interventions may address these mechanisms of “despair.”
KW - mortality rate
KW - overdose
KW - rural
KW - substance use
KW - suicide
UR - http://www.scopus.com/inward/record.url?scp=85077705760&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077705760&partnerID=8YFLogxK
U2 - 10.1016/j.cbpra.2019.10.002
DO - 10.1016/j.cbpra.2019.10.002
M3 - Article
AN - SCOPUS:85077705760
SN - 1077-7229
VL - 28
SP - 40
EP - 52
JO - Cognitive and Behavioral Practice
JF - Cognitive and Behavioral Practice
IS - 1
ER -