Family Centered Brief Intensive Treatment: A Pilot Study of an Outpatient Treatment for Acute Suicidal Ideation

Family Centered Brief Intensive Treatment (FC BIT), a hospital diversion treatment program for individuals with acute suicidal ideation, was developed to treat suicidal clients and their families. Individuals who met criteria for hospitalization were treated as outpatients using FC BIT (n = 19) or an intensive outpatient treatment without the family component (IOP; n = 24). Clients receiving FC BIT identified family members or supportive others to participate in therapy. FC BIT clients had significantly greater improvement at the end of treatment compared to IOP clients on measures of depression, hopelessness, and suicidality. Further research is needed to test the efficacy of FC BIT.     

Suicidal Behavior and Problems with Emotion Regulation

We examined in two independent samples whether: (1) difficulties with emotion regulation predict suicide ideation and (2) depressed adults with a history of attempting suicide report and exhibit more emotion dysregulation compared to healthy and depressed controls. Difficulties with emotional clarity and relationship status were significant predictors of suicide ideation (Study 1). In Study 2, when compared to controls, depressed attempters reported significantly more difficulties with emotional clarity and emotional impulsivity. Attempters had significantly more difficulty than controls returning to heart rate baseline following a stressful task. Problems with emotions are therefore differentially connected to suicidal behaviors.     

Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis

Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self-directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non-suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d = -.324, 95% CI = -.471 to -.176), and reduced frequency of psychiatric crisis services (d = -.379, 95% CI = -.581 to -.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d = -.229, 95% CI = -.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.     

Self-Attitudes and Suicidal Behavior

Findings are reported concerning the hypothesized relationship between adoption of suicidal responses (ideation, threats, attempts) and antecedent negative self-attitudes. Data were provided by junior high school student (N = 3,148) responses to questionnaires administered three times at annual intervals. Antecedent negative self-attitudes were measured by a seven-item self-derogation scale at the first testing. Adoption of suicidal responses was indicated by earlier denial and subsequent affirmation of the response (self-reports). Findings indicate that suicidal behaviors are responses (whether or not subsequently continued) to experiences of negative self-attitudes in the more recent past. However, whether or not suicidal behaviors are related to self-derogating feelings in the more remote past can be seen as a function of a sex-social-class-mode of suicidal response interaction.     

Observations on Long-Term Group Therapy with Suicidal and Depressed Persons

ABSTRACT: A long-term, open-ended group for depressed and suicidal individuals who had made suicide attempts is described. Two hundred persons participated in the sample groups over a 46-month period, with only 10 suicide attempts and 1 suicide occurring in this high risk group during the period of the study. Our observations corroborated some findings and differed with others reported of experiences with groups of individuals who have manifested suicidal behavior. The paper includes recommendations for starting groups of suicidal persons and emphasizes that this method of therapy appears to be an effective mode of suicide prevention.     

Epidemiology of Suicidal Behavior

This paper presents the epidemiology of suicide and discusses the known risk factors for suicide within a framework designed to encourage a systematic approach to theory testing and prevention. Mental and addictive disorders are the most powerful of the multiple risk factors for suicide in all age groups. Since risk factors for suicide rarely occur in isolation, prevention efforts are more likely to succeed if multiple risk factors are targeted.     

Social Deviancy and Suicidal Behavior

Abstract

In this study lottery gambling behavior of 288 American college students was examined. Although most students were infrequent gamblers, we found that student lottery gambling was related to having parents and friends who were lottery gamblers. Students who were frequent lottery gamblers were more likely to participate in other forms of gambling and to have begun gambling at younger ages than less frequent gamblers. Locus of control was related to more frequent gambling among parents and only marginally related to more frequent lottery play among students. Discriminant analysis using parental gambling, peer gambling, games played, sex, and locus of control could predict frequency of lottery playing for 72% of gamblers and nongamblers.     

Problem Solving and Suicidal Behavior

Research on suicidal behavior falls into two main areas: studies that aim to identify demographic and social risk factors, and studies that aim to investigate the psychological processes mediating suicidal behavior. Within the latter approach, impaired problem-solving ability has been found to be an important variable. This paper reviews recent research focusing on problem-solving deficits and their relation to suicidal behavior and considers some of the methodological problems that arise. These findings are discussed in terms of active versus passive problem solving, state or trait factors, and the psychological processes underlying problem solving. Suggestions for further research are made, focusing on the links between suicidal behavior, problem solving, and autobiographical memory.     

Attitudes and Beliefs About Suicidal Behavior When Coming Out Is the Precipitant of the Suicidal Behavior

Young persons who identify as lesbian, gay, or bisexual (LGB) have higher rates of nonfatal suicidal behavior than their heterosexual peers. It has been suggested that suicidal behavior may be a painful but unavoidable rite of passage for LGB youths at the coming out stage. Could this mean that suicidal behavior is considered understandable and even permissible behavior for LGB youths at this stage? In this study we explored reactions to a suicidal decision when coming out was the precipitant of the suicidal act. Specifically, we compared attitudes toward a suicidal decision after coming out and being rejected by one's parents with attitudes toward a suicidal decision after experiencing other stressors (i.e., a physical illness, a relationship loss, or an academic failure). Contrary to expectation, the decision to engage in suicidal behavior following coming out was not viewed in relatively accepting terms. Rather, it was perceived as unsound and weak. As in previous studies, physical illness was singled out as a relatively understandable motivation for suicidal behavior. In addition, we found that androgynous persons viewed the suicidal decision as more unsound than other gender-identity types, independent of precipitant. Given similar evidence from other studies, future research might explore the role of androgyny in the protection against suicidal behavior.

     

Relationships Between Suicidal Behavior and Personality Types

This study examined the hypotheses that introversion in general and the introverted-intuitive-feeling-perceiving (INFP) type as measured by the Meyers-Briggs Type Indicator are related to suicidal ideation and behaviors. Analyses of data from 330 university students found four interactive suicidal behavior risk models: introverted-perceiving (IP) (females); introverted-sensing-feeling (ISF) (males); introverted-intuitive-perceiving (INP) (males); extraverted-intuitive-judging (ENJ) (males). Study findings were interpreted in terms of implications for risk assessment and intervention.     

Basic Psychological Needs,Suicidal Ideation,and Risk for Suicidal Behavior in Young Adults

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross‐sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), and the odds of being at risk for suicidal behavior by 50%, OR (95% CI) = 0.50 (0.37–0.69). Young adults whose basic psychological needs are met may be less likely to consider suicide and engage in suicidal behavior. Prospective research is needed to confirm these associations.     

Occupational Therapy Intervention in the Treatment of Alcoholics

The first section of this article will provide the rationale for all occupational therapists to learn extensively about the isease of alcoholism regardless of area of practice or type of agency where employed. It will offer su estions on how this learning can take place. The second section will take an historic look at occupational therapy literature documenting the use of occupational therapy in alcoholism rehabilitation from 1941 to the present. It will describe modalities currently being used by occupational therapists in alcoholism rehabilitation and discuss expansion of occupational therapy in this practice area.     

Correlates of Suicidal Behavior in a Juvenile Detention Population

The present study identifies the correlates of current suicidal ideation and past suicide attempt among 555 adolescents in a county juvenile detention center. Suicidal behavior in delinquent boys was generally associated with depression and decreased social connection, whereas suicidal behavior in delinquent girls was associated with impulsivity and instability. Current ideation was most significantly associated with current depression. In multivariate analyses, past attempts were associated with suicidal ideation and ineffective coping for males, with major life events and impulsivity for females, and with not residing with at least one biological parent prior to detention for both males and females.     

Mindfulness in the Treatment of Suicidal Individuals

Suicidal behavior is exhibited by a diverse population of individuals and spans many diagnostic categories. In order to develop effective prevention and treatment programs, it is important to identify transdiagnostic processes that impact the many pathways to suicidality, are amenable to intervention, and affect clinical outcomes when modified. A growing body of data suggests that experiential avoidance, or the tendency to escape or avoid unwanted psychological experiences, even when such efforts cause harm, may represent one such universal process. This article reviews theory and evidence that support mindfulness and psychological acceptance as a means to target experiential avoidance in suicidal clients and thereby reduce the risk of suicide. The article also provides two case examples of the application of mindfulness to suicidality and discusses how mindfulness may help clinicians in managing the stress associated with treating suicidal clients.