Temporal self-appraisals associated with suicide-related thoughts and behaviors.

BACKGROUND: Temporal self-appraisal (TSA) is the trajectory of self-appraisal over time, including how a person views their past and future selves in relation to their present self. In this study, we examined the TSA of individuals with and without a history of suicide-related thoughts and behaviors (STBs). METHODS: Using Amazon Mechanical Turk for recruitment, we studied 397 participants on validated measures of TSA, STBs, and mood. RESULTS: The non-STB group (n = 291) had a TSA trajectory similar to that previously found for nonclinical populations, with perceived self-improvement over time. In contrast, the TSA of the STB group (n = 106) had two distinct qualities: their TSA profiles were more negative at all time points (past, present, and future) than the non-STB group, and they displayed similar anticipated present-to-future growth as the non-STB group but perceived minimal past-to-present change. These differences persisted when controlling for depression, anxiety, and stress, suggesting a distinct STB-related TSA profile independent of comorbid affective states. LIMITATIONS: This study is limited by the use of self-report measures and cross-sectional design. CONCLUSIONS: By investigating TSA, this study provides insights into the unique aspects of self-appraisal associated with having a history of STBs and emphasizes the need for therapeutic interventions that foster self-continuity and positive self-appraisal across time. Future research should focus on clarifying the mechanisms underlying this distinct self-appraisal pattern in the STB group and the effects of interventions that enhance temporal self-appraisal.

Long COVID coping and recovery (LCCR): Developing a novel recovery-oriented treatment for veterans with long COVID.

Background: Long COVID has affected 13.5% of Veterans Affairs (VA) Healthcare System users during the first pandemic year. With 700,000+ United States Veterans diagnosed with COVID-19, addressing the impact of Long COVID on this population is crucial. Since empirically-based mental health interventions for Long COVID are lacking, a vital need exists for a tailored recovery-oriented intervention for this population. This study intends to assess the feasibility and acceptability of a novel recovery-oriented intervention, Long COVID Coping and Recovery (LCCR), for Veterans with Long COVID, aiming to support symptom management and quality of life. LCCR is an adaptation of Continuous Identity Cognitive Therapy (CI-CT), a suicide recovery-oriented treatment for Veterans. Methods: In a two-year open-label pilot, three single-arm treatment trials will be conducted with 18 Veterans suffering from Long COVID. Each trial includes 16 weekly 60-min sessions delivered via VA Video Connect (VVC) and/or VA WebEx. Primary objectives include optimizing LCCR for Veterans with Long COVID and assessing the acceptability and feasibility of the intervention, using attendance and retention rates, drop-out statistics, and client satisfaction levels. Additionally, potential benefits of LCCR will be explored by evaluating alterations in quality of life, resilience, mental health status (anxiety, depression, suicide risk/behavior), and personal identity. The protocol has been tailored based on Veterans' needs assessment interviews and stakeholder feedback. Conclusion: If the LCCR intervention proves feasible and acceptable, a manualized version will be created and a randomized controlled trial planned to examine its efficacy in the broader Veteran population.

Recovery after a suicidal episode: Developing and validating the Recovery Evaluation and Suicide Support Tool (RESST).

The personal recovery movement advocates for shifting emphasis from clinical symptom reduction toward reclaiming personal agency and creating meaning-filled lives despite the presence of distressing experiences. Corresponding personal recovery measures have been developed; however, there is no established psychometric assessment of personal recovery following a suicidal episode. This study addressed this gap by developing the Recovery Evaluation and Suicide Support Tool (RESST) and assessing its test score reliability, test score interpretations' validity, and psychometric properties. Throughout RESST's development, input from diverse stakeholders-including clinicians, researchers, and individuals with lived experience-was gathered to ensure a meaningful and useful scale. Exploratory factor analysis techniques were used with adults with a suicidal episode history (N = 502) to select and refine items, culminating in a 21-item scale with four distinct subscales: Self-Worth, Life Worth, Social Worth, and Self-Understanding. Confirmatory factor analysis techniques demonstrated model fit across three samples of adults with a suicidal episode history (combined N = 1,523), and test-retest reliability was obtained (N = 204). The results revealed that RESST scores exhibit an internally consistent and replicable factor structure, consistent with personal recovery theory. Additionally, the interpretation of test scores exhibited both convergent and discriminant validity. Mental health indices related to recovery, negative mood states, suicidality, and meaning in life had significant moderate-to-strong correlations with the RESST, supporting the validity of the test score interpretations and clinical relevance. This measure should aid research into recovery processes and understanding how recovery following a suicidal episode may be enhanced clinically and personally. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Feasibility and acceptability of continuous identity cognitive therapy as a recovery-oriented suicide treatment for Veterans: A study protocol.

Background: Suicide is a leading cause of death among Veterans, with rates significantly higher than the general population. To address this issue, it is crucial to develop and implement more effective treatments for Veterans with suicidal thoughts and/or behaviors, particularly those in the post-acute suicidal episode (PASE) stage. The present study aims to establish the feasibility and acceptability of a novel, recovery-oriented treatment called Continuous Identity Cognitive Therapy (CI-CT) for PASE Veterans. Methods: This 3-year open-label pilot study will include three one-arm trials and a pilot randomized controlled trial (RCT). A total of 57 Veterans with a history of an acute suicidal episode within the previous year will be recruited. Primary outcome measures will include changes in personal recovery, suicidal thoughts, and behaviors. Secondary outcomes will include changes in self-identity, life satisfaction, and hopefulness. Feasibility and acceptability will be assessed through attendance and retention rates, drop-out rates, and client satisfaction. Conclusion: This study aims to develop and evaluate the feasibility and acceptability of a novel recovery-oriented intervention for Veterans experiencing PASE. If the intervention is found to be feasible and acceptable, a manualized version will be finalized and a large-scale multi-site RCT will be designed to assess its clinical efficacy on a broader Veteran population. The results of this trial will aid in the development of effective treatment and provide valuable insights into the preliminary feasibility, acceptability, and effectiveness of this approach in reducing suicidal thoughts and behaviors and promoting recovery and rehabilitation in this population.

Supporting servicemembers and veterans during their transition to civilian life using certified sponsors: A three-arm randomized controlled trial.

Transitioning servicemembers and veterans (TSMVs) face difficulties throughout their reintegration to civilian life, including challenges with employment, poor social connection, and elevated risk for suicide. To meet the needs of this high-risk population, national initiatives have leveraged community-based interventions. Authors conducted a three-arm randomized controlled trial (n = 200) to evaluate two community-based interventions. The first, Team Red, White, and Blue (RWB), connects TSMVs to their community through physical/social activities. The second, Expiration Term of Service Sponsorship Program (ETS-SP) provides one-on-one certified sponsors to TSMVs who provide support during the reintegration process. TSMVs were assessed at baseline, 3, 6, and 12 months. The primary hypothesis was not supported as reintegration difficulties and social support were not significantly different for participants randomly assigned to the two community-based interventions (Arm-2/RWB and Arm-3/RWB + ETS-SP), when the data from the separate arms were collapsed and combined, compared to the waitlist. The results did support the secondary hypothesis as Arm-3/RWB + ETS-SP had less reintegration difficulties over 12 months and initially had more social support compared to Arm-2/RWB, which suggest that augmenting interventions with sponsors outperforms participation in community-based interventions alone. Overall, the results show some limitations of the studied community-based interventions, as implemented and researched within this study. The authors identified factors that may have contributed to the null findings for the primary hypothesis, which can be addressed in future studies, such as addressing the unique needs of TSMVs, enrolling TSMVs into interventions prior to military discharge, measuring and improving participation levels, and providing stepped-care interventions based on risk levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How future self-continuity mediates the impact of job loss on negative mental health outcomes among transitioning veterans.

Veterans in the transition stage out of the military have an increased risk for negative mental health outcomes and suicide. Previous research has found that finding and retaining employment is the most challenging post-service adjustment for veterans. Job loss may have a greater impact on mental health for veterans than for civilians due to the myriad challenges often faced when transitioning to the civilian workplace, as well as preexisting vulnerabilities that are common among veterans such as trauma exposure or service-related injuries. Previous studies have demonstrated that low Future Self-Continuity (FSC), which refers to the sense of "psychological connectedness" that a person has between their present and future selves, has also been associated with the abovementioned mental health outcomes. 167 U.S. military veterans who exited the military 10 or fewer years prior to their participation in the study, of which 87 experienced subsequent job loss, completed a series of questionnaires to assess future self-continuity (FSC) and mental health outcomes. Results confirmed previous findings in that job loss, as well as low FSC, were individually associated with an increased risk for negative mental health outcomes. Findings suggest that FSC may act as a mediator, where levels of FSC mediate the effects of job loss on negative mental outcomes (depression, anxiety, stress, and suicidality) among veterans during their first 10 years out of the military. These findings may have implications for enhancing current clinical interventions for veterans experiencing job loss and mental health difficulties during the transition period.

Temporal self and reflected appraisals in euthymic and depressed individuals.

BACKGROUND: Temporal self-appraisal (TSA) theory, reflected appraisal theory, and their clinical applications have previously been explored as independent constructs. This study investigates how TSA corresponds to temporal reflected appraisal (TRA), and how the relationship between them differs in the presence of depression. METHODS: 273 adults (57 % female), recruited using Amazon Mechanical Turk, filled out a series of measures of mood and self-appraisal assessments (TSA and TRA versions of the Me/Not Me task). Repeated measures MANOVAs were used to assess between group differences. RESULTS: The TSA trajectory of depressed individuals replicated the 'V' shape found in previous research, whereas the TRA of depressed individuals did not decline from past to present. There was little difference between TSA and TRA "past" and "future" appraisals, though there was a significant difference in appraisal of the "present." Individuals with depression believe that others perceive them as doing much better currently than the way they view themselves. By contrast, euthymic individuals had no significant differences between the TSA and TRA appraisals of their present selves, indicating they think their self-perception matches how others view them. LIMITATIONS: We assessed depression using online self-reports. Cross-sectional data limits causality determination but suffices for studying mood-related self-perceptions over time. CONCLUSIONS: Temporal self-appraisal and temporal reflected appraisal have varying relationships among euthymic and depressed individuals. This more precise characterization of depressed individuals' identity can further aid clinicians in understanding the nature of identity development and treating identity disruption among depressed individuals.

Struggles in the Orthodox Jewish shidduch dating system-A large-scale qualitative analysis.

Marriage is an important life goal and is highly valued among Orthodox Jews. Shidduch dating refers to the arranged dating system that is typically used within the community. Previous research and anecdotal evidence suggest that the shidduch system has become difficult and challenging for many individuals, yet there is a dearth of evidence on the subject. This study set out to explore issues related to dating and marriage within the Orthodox Jewish community using a large sample size. Participants included 889 Orthodox individuals across diverse demographic groups who responded to an optional question within a larger survey inquiring about their thoughts and experiences on the subject. An inductive qualitative analysis was conducted, and this paper focuses on the seven most prevalent themes that emerged. These themes include issues related to superficial criteria in mate selection, gender segregation, perceived surplus of females, pressure to marry before feeling ready, the formal structure of shidduch dating, the exclusion of specific groups from the process and lack of education in areas of intimacy and sexuality. This study is important in promoting clinical awareness regarding the struggles that many Orthodox Jewish daters face and underscores the need for communal change addressing these issues.

Theoretical model of recovery following a suicidal episode (COURAGE): scoping review and narrative synthesis.

BACKGROUND: Despite a significant need, there are currently no rigorously developed empirically based models for what personal recovery from a suicidal episode looks like. AIMS: To develop a theoretical model of personal recovery after a suicidal episode, based on a comprehensive literature review and stakeholder feedback. METHOD: A scoping review of all empirical studies on this topic was conducted, followed by a thematic analysis to create a preliminary framework. Consultation-based revisions were then made based on feedback from a stakeholder panel to develop the final theoretical model. RESULTS: The final model comprised seven themes: choosing life, optimising identity, understanding oneself, rediscovering meaning, acceptance, growing connectedness and empowerment (acronym 'COURAGE'). Although there are some similarities between COURAGE and other models of personal recovery, there are components, such as 'choosing life' and 'understanding oneself', that are specific to recovery after an acute suicidal episode. CONCLUSIONS: To our knowledge, this is the first study to use a comprehensive literature review with stakeholder feedback to develop a conceptual model of personal recovery after an acute suicidal episode. This model has important implications for both researchers and clinicians to consider. Looking ahead, COURAGE can inform the reconceptualisation of assessment, research and clinical care of individuals who have experienced a suicidal episode.

Anxiety and temporal self-appraisal: How people with anxiety evaluate themselves over time.

BACKGROUND: Previous studies found that psychopathology is associated with distinct self-perceptions over time. Euthymic individuals report experiencing a self-enhancement bias, with self-appraisal increasing over time. In contrast, depressed individuals report viewing a personal decline from past to present and anticipated self-improvement from present to future. This study examined the association between the singular presence of anxiety and temporal self-appraisal. METHODS: Using the Depression Anxiety and Stress Scale, this study examined a depressed (n = 142), anxious (n = 95), comorbid depressed and anxious (n = 335), and euthymic group (non-depressed and non-anxious, n = 535), on a validated task of temporal self-appraisal. RESULTS: Anxiety has a unique association with temporal self-appraisal that differs from the other disorders examined in this study. Specifically, individuals with anxiety had a similar positive trend of self-view to the euthymic group; however, their overall trend was lower at each temporal point. Individuals with depression had a stable past-to-present self-view and an improving present-to-future self-view. LIMITATIONS: The use of an online self-report sample without longitudinal assessment of variables, while sufficient for the intent of the present study, limits the potential extrapolation from this sample, as well as prevents the determination of the direction of causality. CONCLUSIONS: While individuals with anxiety demonstrate a positive sense of improvement over time, their psychopathology is associated with a negative bias in their perception of their past, present, and future selves. These findings have important implications for clinicians regarding potential interventions and treatment for anxiety and depression.

The deadly gap: Understanding suicide among veterans transitioning out of the military.

In the period following separation from the military, service members face the challenge of transitioning to a post-military civilian life. Some evidence suggests these transitioning Veterans are at higher risk for suicide compared with both the broader Veteran population and the United States public, yet they often do not receive adequate support and resources. In this review, we use the Three-Step Theory of suicide to outline characteristics of transitioning Veterans and the transition process that may affect suicide risk. We then highlight relevant services available to this specific subgroup of Veterans and make recommendations that address barriers to care. Cumulatively, this literature suggests transitioning Veterans fall within a "deadly gap" between the end of their military service and transition into civilian life. This "deadly gap" consists of limited psychiatric services and increased suicide risk factors which together may explain the increase in suicide during this transition period.

Continuous Identity Cognitive Therapy: Feasibility and Acceptability of a Novel Intervention for Suicidal Symptoms.

We introduce continuous identity cognitive therapy (CI-CT), a novel suicide intervention. CI-CT was developed based on evidence that suicidal individuals have difficulty viewing and experiencing continuity with their perceived future self, and having meaningful and achievable personal goals. CI-CT integrates aspects of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) with modality-specific techniques focusing on the individual's perceived present-to-future life story. The intervention guides the development of a meaningful life story with a vivid and positive future self. The results of an open-label pilot/feasibility trial (N = 17) for U.S. Veterans with a serious mental illness indicate that CI-CT is feasible, acceptable to Veterans, and may help with suicidality, depression, hopelessness, and future self-continuity. Reductions in clinical symptoms were associated with improvement in future self-continuity and were largely maintained at the 1-month follow-up. These results, along with high retention rates and positive Veteran feedback, support further exploration of the utility of CI-CT.

An Open Trial of a Suicide Safety Planning Group Treatment: "Project Life Force".

In 2008, the Department of Veterans Affairs mandated that clinicians oversee the construction of a Suicide Safety Plan for every patient who is identified as "high risk" for suicide. While the Suicide Safety Plan is a mandated "best practice," there are currently no recommended guidelines for its augmentation in a group setting. To address this gap, a novel group intervention, "Project Life Force," (PLF; a 10-session manualized psychotherapy), was developed and piloted. Results indicate high feasibility and acceptability. Exploratory analysis revealed statistically significant decreases in suicidal thoughts/behaviors, depression, and hopelessness. Feedback from Veterans and PLF therapists is also discussed. Despite some limitations (e.g. small sample size) exploratory results suggest that PLF may be a promising treatment for Veterans with suicidal symptomology.

Expanded Roles and Recommendations for Stakeholders to Successfully Reintegrate Modern Warriors and Mitigate Suicide Risk.

This article draws upon the legends of warriors from ancient Greece and other traditions to illuminate the journey of Modern Warriors (MWs) who have served in the United States military over the last century. It then turns to stakeholders that can assist current MWs in their reintegration to civilian life and mitigate suicide risk. Until this point, without an existing and coordinated local, federal, non-profit, and private system, rates of suicide for post-9/11 MWs after leaving the military have greatly increased, especially for young and women MWs. This is due in part to the military satisfying many of MWs' needs by providing units, leaders, and a mission during the Departure and Initiation stages of the MW journey. However, as MWs exit the military and face the difficult task of reintegration, the absence of units, leaders, and mission leads to deteriorating psychological health and increasing suicide risk. Written primarily by post-9/11 MWs, this article proposes recommendations for stakeholders to better reintegrate MWs and mitigate suicide risk. The authors strive to develop a system that satisfies MWs' reintegration needs and enables MWs to be well positioned to continue their next 'mission' - to serve and improve society.

The modern-day Odysseus: How mental health providers can better reintegrate modern warriors and mitigate suicide risk.

During their return from combat, warriors from Greek mythology and Native American traditions received the support of "helpers" to guide the reintegration back into their communities or tribes. While the military provides our modern warriors (MWs), similar helpers, during their departure from their hometown and during their initiation into the military, there is a dearth of comparable help when MWs reintegrate back into their hometowns. We strive to assist mental health providers to serve as such helpers for MWs to shape their reintegration environment, enable MWs to meet their unique needs after exiting the military, ameliorate the MW suicide epidemic, and facilitate MWs to continue their next "mission" to serve and improve society with a newly forged MW identity, wisdom, and sense of purpose.

Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis.

Importance: Dimensional definitions of transdiagnostic mental health problems have been suggested as an alternative to categorical diagnoses, having the advantage of capturing heterogeneity within diagnostic categories and similarity across them and bridging more naturally psychological and neural substrates. Objective: To examine whether a self-reported compulsivity dimension has a stronger association with goal-directed and related higher-order cognitive deficits compared with a diagnosis of obsessive-compulsive disorder (OCD). Design, Setting, and Participants: In this cross-sectional study, patients with OCD and/or generalized anxiety disorder (GAD) from across the United States completed a telephone-based diagnostic interview by a trained rater, internet-based cognitive testing, and self-reported clinical assessments from October 8, 2015, to October 1, 2017. Follow-up data were collected to test for replicability. Main Outcomes and Measures: Performance was measured on a test of goal-directed planning and cognitive flexibility (Wisconsin Card Sorting Test [WCST]) and a test of abstract reasoning. Clinical variables included DSM-5 diagnosis of OCD and GAD and 3 psychiatric symptom dimensions (general distress, compulsivity, and obsessionality) derived from a factor analysis. Results: Of 285 individuals in the analysis (mean [SD] age, 32 [12] years; age range, 18-77 years; 219 [76.8%] female), 111 had OCD; 82, GAD; and 92, OCD and GAD. A diagnosis of OCD was not associated with goal-directed performance compared with GAD at baseline (ß [SE], -0.02 [0.02]; P = .18). In contrast, a compulsivity dimension was negatively associated with goal-directed performance (ß [SE], -0.05 [0.02]; P = .003). Results for abstract reasoning task and WCST mirrored this pattern; the compulsivity dimension was associated with abstract reasoning (ß [SE], 2.99 [0.63]; P < .001) and several indicators of WCST performance (eg, categories completed: ß [SE], -0.57 [0.09]; P < .001), whereas OCD diagnosis was not (abstract reasoning: ß [SE], 0.39 [0.66]; P = .56; categories completed: ß [SE], -0.09 [0.10]; P = .38). Other symptom dimensions relevant to OCD, obsessionality, and general distress had no reliable association with goal-directed performance, WCST, or abstract reasoning. Obsessionality had a positive association with requiring more trials to reach the first category on the WCST at baseline (ß [SE], 2.92 [1.39]; P = .04), and general distress was associated with impaired goal-directed performance at baseline (ß [SE],-0.04 [0.02]; P = .01). However, unlike the key results of this study, neither survived correction for multiple comparisons or was replicated at follow-up testing. Conclusions and Relevance: Deficits in goal-directed planning in OCD may be more strongly associated with a compulsivity dimension than with OCD diagnosis. This result may have implications for research assessing the association between brain mechanisms and clinical manifestations and for understanding the structure of mental illness.

Development and Validation of a Future Self-Continuity Questionnaire: A Preliminary Report.

Future self-continuity, the sense of persistence of selfhood from the present to the future, is a fundamental feature of personal identity. Decreased self-continuity between the present and future self is associated with disadvantageous behaviors and increased psychopathology. The primary aim of the series of studies reported in this article was to develop and assess the psychometric properties and validity of an instrument designed to measure present to future self-continuity, the Future Self-Continuity Questionnaire (FSCQ). Exploratory factor analysis techniques were used to select items for removal and inclusion and to develop a potential factor model. Confirmatory factor analysis techniques were then employed to demonstrate model fit across 4 independent samples of adults (N = 1,481). Data are also presented demonstrating convergent, discriminant, and nomological validity. Findings support the coherence of the FSCQ, indicating the scale has adequate test-retest reliability, concurrent and discriminant validity, and an internally consistent replicable factor structure related to the construct of future self-continuity and relevant indexes including levels of consideration of future consequences, temporal discounting, depression, hopelessness, suicidality, anhedonia, and subjective quality of life.

Temporal Self, Psychopathology, and Adaptive Functioning Deficits: An Examination of Acute Psychiatric Patients.

Individuals with psychiatric illness have difficulty remembering specific events from their personal past and imagining their future. We examined psychotic psychiatric inpatients' sense of self-continuity over time, predicting that low levels of temporal continuity would predict increased psychopathology and lower functionality. Inpatients (n = 60) were compared with healthy controls (n = 60) on a validated measure of self-continuity, psychiatric symptoms, insight, and adaptive functioning capacity. Results revealed that patients had significant difficulty perceiving their past, present, and future selves as unified over time compared with controls. Within the inpatient group, deficits in present to future self-continuity was associated with patients' severity of positive, negative, and mood symptoms, degree of insight, and adaptive capacity. It may be the case that temporal self-unity provides a context for deriving reinforcement from daily life experiences in the moment and in anticipating the future as well as a worthwhile goal for treatment exploration.

Temporal self appraisal and continuous identity: Associations with depression and hopelessness.

BACKGROUND: While depression is associated with decreased self-worth, less is known about how depression relates to the degree of perceived unity of the self over time (CI; continuous identity) and appraisal of past and future selves (temporal self-appraisal). In Study 1, we examined the relationship between depression severity and temporal self-appraisal. In Study 2, we examined depression and hopelessness severity as it relates to temporal self-appraisal and continuous identity. It was hypothesized that individuals with significant levels of depressed mood would report lower self appraisals of current and future selves and that hopelessness about the future would be associated with disturbances in perception of self over time (CI; continuous identity) and temporal self-appraisal. METHODS: Study 1 examined depressed mood (n=75) and non-depressed mood (n=144) individuals to determine their self-rated personal attributes for their past, present and future selves using a validated task of temporal self-appraisal. Study 2 examined an independent sample of subjects. Based on cutoff scores for clinically significant depression and hopelessness, Depressed/Hopeless (n=63) and Non-Depressed /Non-Hopeless (n=168) subjects were asked complete the validated task of temporal self-appraisal and also complete a validated task to assess their continuous identity. RESULTS: In Study 1, a significant difference was found between the depressed mood group and the non-depressed mood group in how they see themselves changing over time. The non-depressed group perceived themselves increasing in positive personal attributes from past, to present, to future self. The depressed mood group perceived themselves as deteriorating from the past to the present in terms of positive attributes about their self-identity. However, contrary to expectations, the depressed group perceived their future self as improved from their present self. Subjects' past and future selves were at a similar level and both were significantly higher than perception of their present self-worth. Study 2 replicated these findings and also found severity of depression was significantly related to lower levels of CI. Additionally, it was found that the severity of hopelessness was minimally associated with continuous identity and temporal self-appraisal ratings. CONCLUSION: These results suggests that even people with depressed mood have an instinctive grasp of the possibility to an improved future self-worth despite the negative cognitions associated with present self-worth and hopeless expectations about the future. While depressed and hopeless individuals may view the world negatively and feel hopeless about their general future, these results suggest that depressed individuals distinguish between hopelessness about future external success and future self-improvement. Despite perceiving their past and future selves to be more positive, depression severity was associated with less continuous identity. Since depressed individuals perceive a future self as a return to or a recovery of a past self, therapeutic strategies may focus on improving a sense of continuous identity with past and future selves and focusing on deriving meaning from current life difficulties to improve beyond a past self, growing to a superior future self. LIMITATIONS AND FUTURE RESEARCH: Limitations include using self-report measures of depression and hopelessness. Future studies may wish to use individuals who were diagnosed with depression to explore further how depressed people see themselves changing from the present to the future. Additionally, future studies could determine if depressed individuals who do not perceive their future self to be improved are at higher risk for adverse outcomes.