Psychological autopsies: methods and ethics

Essential knowledge on suicide is derived from studies that include interviews with survivors. In this paper, we discuss methodological and ethical issues pertaining to the interview method known as "psychological autopsy"; the discussion is based on our application of the method to three studies of suicides in Sweden and on a review of other investigations. Interviewing a survivor is a delicate matter, and the integrity of the deceased, the integrity and health of the informant, and the psychological strain on the interviewer must all be taken into consideration. The interviewer should have clinical experience in order to be prepared to deal with interviewees in grief. Contact by telephone, followed by an introductory letter, provides an opportunity to meet survivors in an empathic manner and has a low rejection rate. A 2- to 6-month interval between suicide and interview is recommended. The survivor's reactions to the interview should be evaluated in order to expand the empirical base for ethical considerations. Studies on the validity and reliability of the method are necessary.     

Client‐centred group therapy for survivors of interpersonal trauma: A pilot investigation

Group therapy for trauma survivors provides an opportunity to share experiences with others in a supportive environment. Client‐centred groups have received very little attention as a way of working with traumatised people. Such groups promise to promote psychological growth following trauma. In this paper we present pilot data from a client‐centred group of six survivors of interpersonal violence who were experiencing complex posttraumatic stress reactions. Results suggested that those who perceived the presence of empathic listening within the group therapy sessions benefited from the group, showing greater positive changes. Clinical implications for working with trauma survivors, methodological considerations and directions for future research are discussed.     

TWO FACES OF THE CULTURE OF DEATH: RELATIONSHIP BETWEEN GRIEF WORK AND HUNGARIAN PEASANT SOUL BELIEFS

This article aims to demonstrate that peasant death culture–as a part of the social construction of reality–does not only support the grief work of survivors, but sometimes also interferes with and encumbers it. This destructive aspect of death culture is rooted in its this-worldly normative and order preservative role. If the deceased pursued a norm-following life course, peasant culture offers him or her a positive otherworldly perspective of existence, and supports the reorganization of the survivors in various ways. On the other hand, certain infringements of norms (e .g., suicide) are associated with deterrent otherworldly perspectives and are penalized with sanctions falling on the survivors. These sanctions increase survivors' bitterness and shelterlessness and make more difficult the finding of meaning, as well as a comforting closing of the relation to the deceased and its transition into an inner representation.     

Some notes on conducting a psychological autopsy.

This paper outlines procedures for conducting interviews with relatives of suicide victims or survivors of equivocal deaths, by means of the "psychological autopsy." A number of methodological recommendations are made which deal with training interviewers, contacting survivors and using experimental controls.     

Doing Community Research Without a Community: Creating Safe Space for Rape Survivors

This paper describes how the values of a feminist research team influenced methodological decisions in a study of rape survivors. Building upon concepts from community psychology and urban sociology, the authors created a community-based research design that respected the emotional needs of rape survivors without sacrificing methodological rigor. We developed relationships with community members in diverse settings, such as nail and hair salons, child care centers, churches, and bookstores, to advertise the study and recruit participants. Consistent with feminist approaches to interviewing, our goal was to create a safe setting for survivors to tell their stories. Although the purpose of this study was research rather than intervention, most survivors reported that participating in these interviews was healing. Our experiences in this project suggest that allowing values to influence the process of research may have beneficial outcomes for both researchers and participants.     

The Effects of Sibling Death on the Surviving Child: A Family Perspective

The death of a child invariably affects the family, who in effect become survivors. Adaptations are made in order to secure a new family equilibrium attendant upon such a loss. Surviving siblings not infrequently become the focus of maneuvers unconsciously designed to alleviate guilt and control fate through silence and efforts to maintain silence, through substitution for the lost child, and through endowing the survivor-child with qualities of the deceased. Three types of clinically identifiable types of survivor-children are described. Families that emphasize silence and focus on guilt, families in which the child becomes incomparably precious, and families in which substitution and replacement provide the major theme lead respectively to the "haunted,""bound," and "resurrected" child.
These children share many features, as do their families, but there appears to be a connection between the family defensive maneuver and the specific consequences for a child of the bereaved family.     

“Nothing About Me, Without Me”: Participatory Action Research with Self-Help/Mutual Aid Organizations for Psychiatric Consumer/Survivors

Participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors is reviewed. We begin by tracing the origins of and defining both participatory action research and self-help/mutual aid. In so doing, the degree of correspondence between the assumptions/values of participatory action research and those of self-help/mutual aid for psychiatric consumer/survivors is examined. We argue that participatory action research and self-help/mutual aid share four values in common: (a) empowerment, (b) supportive relationships, (c) social change, and (d) learning as an ongoing process. Next, selected examples of participatory action research with psychiatric consumer/survivor-controlled self-help/mutual aid organizations which illustrate these shared values are provided. We conclude with recommendations of how the key values can be promoted in both the methodological and substantive aspects of future participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors.     

Possessions and Self in the Identity Work of Survivors of Domestic Violence

Domestic violence has serious consequences for survivors, including severe effects on psychological well‐being and identity. This article reveals the previously hidden possession experiences and identity work of domestic violence survivors. Using a novel visual research method that features material objects as visual stimuli to elicit data, we found possessions were critical in the complex identity work undertaken by survivors. Emergent themes detailing the role of possessions in coping with ongoing self‐threats by an intimate partner provide empirical support for the conceptualization of diametrically opposed selves, the Prescribed Self and Agentic Self. These opposite and compartmentalized selves enabled survivors to cope with extreme disintegration and destabilization of self by the abuser. As well as the conceptual and methodological contributions we make to the possessions‐self literature in consumer research and psychology, this research is valuable for designing social service programs to help survivors cope with the effects of domestic violence on identity.     

Broken hearts or broken bonds. Love and death in historical perspective.

Psychological theories and practices frequently neglect the extent to which their subject matter is historically and culturally defined. This issue is explored in the context of theories and therapies related to bereavement. Contemporary orientations emphasize the importance of breaking bonds with the deceased and the return of survivors to autonomous lifestyles. Placing the orientation in cultural and historical context reveals that it is largely a product of a modernist worldview. Within the romanticist ethos of the preceding century, such breaking of bonds would destroy one's identity and the meaning of life. In light of contemporary variations in subcultural meanings and values, a postmodern view is suggested in which reflexive responsibility is focal.     

A Call for Research: The Need to Better Understand the Impact of Support Groups for Suicide Survivors

Support groups for suicide survivors (those individuals bereaved following a suicide) are widely used, but little research evidence is available to determine their efficacy. This paper outlines the pressing public health need to conduct research and determine effective ways to identify and meet the needs of suicide survivors, particularly through survivor support groups. After describing the various approaches to survivor support groups, we explain the need for further research, despite the inherent challenges. Finally, we pose several questions for researchers to consider as they work with survivors to develop a research agenda that sheds more light on the experiences of survivors and the help provided by survivor support groups.     

Appropriate Control Groups in Feminist Research

Control groups in psychological research reveal the outlines of the investigator's theoretical framework. They identify variables which are assumed to affect the causal relationship between independent and dependent variable and by implication, those which are not. This role of control groups is implicitly denied when they are discussed simply as a methodological issue. Feminist psychologists can use the inevitable interpenetration of methodological and theoretical issues to promote new theoretical perspectives under the guise of sounder methodology. One result may be to move the psychology of women outside (beyond-?) a conceptualization of science in which the notions of experimentation and control are central.     

Development of the Grief Experience Questionnaire

The development of the Grief Experience Questionnaire (GEQ) is reported. This questionnaire is an instrument for measuring various components of grief, including somatic reactions, general grief reactions, search for explanation, loss of social support, stigmatization, guilt, responsibility, shame, rejection, self-destructive behavior, and reactions to a unique form of death. Initial results with the GEQ suggest its potential to differentiate grief reactions experienced by suicide survivors from those experienced by survivors of accidental death, unexpected natural death, and expected natural death. Conclusions support its use in redressing common methodological criticisms of suicide survivor research. Six additional benefits derived from use of this instrument are discussed.     

Testing alleged mediumship: Methods and results

Mediums claim to be able to communicate with the deceased. Such claims attract a considerable amount of public interest and, if valid, have important implications for many areas of psychology. For over 100 years, researchers have tested alleged mediums. This work has obtained mixed results and provoked a considerable amount of methodological debate. This paper reviews the key issues in this debate, describes how the authors devised a method of testing that aimed to prevent the many problems that have hindered past research, and how they then used this method to test several professional mediums. The results of this work did not support the existence of genuine mediumistic ability. Competing interpretations of these results are discussed, along with ways in which the methodology presented in the paper could be used to assess conceptually similar, but non‐paranormal, claims made in clinical, occupational and forensic contexts.     

What survivors see: Creative condemnations of total institutionalization

This paper presents a 2013–2016 research project that documented the history of the Huronia Regional Centre from the perspectives of survivors. Located in Ontario Canada, Huronia housed children with intellectual disabilities until its closure in 2009, and is now notorious for its violent history. Our research collective visited Huronia in 2014 to take pictures of the space, and used those photographs in scrapbook art created in monthly workshops. This paper presents pages selected from survivors' scrapbooks to illustrate key spatial conditions and affective experiences of a total institution. Analysis of these images shows that models of institutionalization are designed to produce violence against the institutionalized. Given the collective's commitment to an arts-informed methodology, this paper serves as a clear condemnation of every version of institutionalization. First, this paper situates its argument in geographic and sociological research that has taken up Goffman's concept of the total institution. Next, it lays out a methodological approach that included photovoice adapted for intellectually disabled institutional survivors. Finally, it presents and analyzes key images of art that survivors produced with support in workshop settings—with a focus on photography taken in facility buildings and on facility grounds.     

The 2004 Indian Ocean Tsunami Catastrophe,its Survivors,Job and the Universal Features of Suffering: A Theoretical Study

The purpose of this theoretical article is to discuss the existential and universal feature of suffering—as illustrated by Job’s suffering in the Book of Job in the Bible and by the survivors of the 2004 Asian tsunami catastrophe—and to highlight its significance for health care. Further, the study is aiming at contributing to health professionals’ understanding of patients’ suffering. The sources are narratives, comprising Job’s book, TV interviews 1 year after the tsunami catastrophe and the survivors’ autobiographies. The methodological approach is a philosophical analysis. The existential, universal, ontological and epistemological aspects of suffering are carefully scrutinized to unveil the universal and existential versus culture-specific features of suffering. Based on the results, the authors’ recommendations are (1) a holistic concept of the patient and health care has to seriously consider suffering in all its complexity because when a person is in pain, it is not his/her body but the whole person as a unity of body, psyche and spirit that suffers and (2) suffering should be seen as the most central concept of health care, which should provide treatment for physical pain and all dimensions of suffering: physical, social, mental and spiritual aspects.     

“It Happens to Girls All the Time”: Examining Sexual Assault Survivors’ Reasons for Not Using Campus Supports

Sexual assault is a prevalent problem in higher education, and despite the increasing availability of formal supports on college campuses, few sexual assault survivors use them. Experiencing sexual assault can have devastating consequences on survivors’ psychological and educational wellbeing, which may intensify if survivors do not receive adequate care. Drawing from existing theoretical frameworks and empirical research, this study used a mixed methodological approach to examine why survivors did not use three key campus supports—the Title IX Office, the sexual assault center, and housing staff—and if these reasons differed across the three supports. Using data from 284 women who experienced sexual assault in college, our qualitative findings identified four overarching themes, including logistical issues (e.g., lacking time and knowledge), feelings, beliefs, and responses that made it seem unacceptable to use campus supports, judgments about the appropriateness of the support, and alternative methods of coping. Quantitative findings revealed that survivors’ reasons for not seeking help differed across supports. Collectively, our findings suggest that community norms and institutional policies can make it challenging for survivors to use campus supports. We propose several suggestions for institutional change (e.g., taking a stronger stance against “less serious” forms of sexual assault, reducing a quasi‐criminal justice approach to investigation and adjudication, limiting mandated reporting).     

Methodological individualism: Singular causal systems and their population manifestations

The purpose of this essay is to investigate the properties of singular causal systems and their population manifestations, with special concern for the thesis of methodological individualism, which claims that there are no properties of social groups that cannot be adequately explained exclusively by reference to properties of individual members of those groups, i.e., at the level of individuals. Individuals, however, may be viewed as singular causal systems, i.e., as instantiations of (arrangements of) dispositional properties. From this perspective, methodological individualism appears to be an ambiguous thesis: some properties of collections of (independent) systems of the same kind are reducible, but other properties of collections of (dependent) systems of the same kind are not. In cases of the first kind, therefore, methodological individualism is true, but trivial; while in cases of the second kind, it is significant, but false. Hence, if the arguments that follow are correct, at least some of the properties of social groups should qualify as emergent.     

A substantive and methodological review of couples group therapy outcome research

Outcome research on couples' group therapy is reviewed and discussed in terms of substantive findings and relevant methodological components. Research to date has found couples group therapy to be as effective as either individual, conjoint, or non-spouse group formats. These results, however, are based on the findings of only five studies, all of which displayed methodological limitations. Suggestions for future research involving couples groups are discussed.     

A Current Perspective on Short-term Groups for Incest Survivors

Short-term groups are a vital resource for adult women who were incestuously abused in childhood or adolescence. The authors describe a model developed by a hospital-based Rape Crises Program. The groups are designed to help members focus on specific goals and experience growth through identifying with other incest survivors. The group format addresses many aspects of the recovery process for survivors. Group heterogeneity, designation of groups for younger and older women respectively, and individual follow-up meetings with members are therapeutically valuable.