The LSARS-II: Lethality of Suicide Attempt Rating Scale-Updated

The concept of lethality is essential to the assessment of suicide risk; yet operational definitions of lethality for purposes of its measurement have been loose and varied. A number of scaling measures have been published in the literature, with no relative consensus on the best of these. In addition, only a few of these scales have published data on their psychometric properties. Of these, we argue that the best is the Lethality of Suicide Attempt Rating Scale (LSARS; Smith, Conroy, & Ehler, 1984). Presented here is a significantly revised and redesigned listing of drugs and chemicals and lethal ranges of ingestion (in caps, tabs, or ounces) by body weight to update that scale.     

Dimensions of Suicide: Perceptions of Lethality,Time, and Agony

Two hundred ninety-one lay persons and 10 forensic pathologists rated the lethality, time, and agony for 28 methods of suicide for 4117 cases of completed suicide in Los Angeles County in the period 1988–1991. Whereas pathologists provided consistent ratings, lay persons demonstrated extreme variability and a tendency to inflate ratings of all three dimensions. Significant gender differences emerged, with females rating frequently used suicide methods more similarly to pathologists than the males did. Males who suicided used the most lethal and quickest methods whereas females selected methods varying in lethality, duration, and agony. African Americans were overrepresented in the use of the most lethal and quickest methods.     

Female Suicide: The Trend Toward Increased Lethality in Method of Choice and Its Implications

Results of recent analyses of statistics on suicide in the United States have documented a trend toward increased lethality in the method of choice in female suicides. A brief review of this research is presented, and its implications for female suicidal risk assessment are discussed.     

Suicide in Group Therapy: Trauma and Possibility

Abstract

This paper compares and contrasts the experiences of two different long term psychodynamic psychotherapy groups in which a patient suicided. The acute reactions and longer term process of each group is described in detail and discussed. The reactions of the two leaders, married to each other and in a shared supervisory group with the late Anne Alonso, and their own working through of the traumatic losses are explored. Their experiences highlight the importance of open discussion of the suicides in the groups, consultation with senior colleagues, and continual processing of their own reactions as a means of fostering posttraumatic growth. The authors discuss their experience in light of the literature on trauma in groups and the emerging literature on posttraumatic growth and they reflect on implications for the community of group therapists.     

Suicide in Adolescence as a Compromise Formation

No abstract available for this article.     

Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Autocastration as a Counterphobic Focal Suicide

ABSTRACT: A case of autocastration is presented and a psychodynamic formulation is proposed. Implications for treatment are discussed.     

Hope as a Predictor of Interpersonal Suicide Risk

The current study hypothesized that (1) hope would negatively predict burdensomeness, thwarted belongingness, and acquired capability to enact lethal injury; (2) hope would negatively predict suicidal ideation; and (3) the interpersonal suicide risk factors would predict suicidal ideation. Results indicated that hope negatively predicted burdensomeness and thwarted belongingness, but positively predicted acquired capability to enact suicide. Contrary to our second hypothesis, hope did not predict suicidal ideation, but interpersonal risk factors for suicide predicted suicidal ideation. Results are discussed in terms of implications for hope theory and Joiner's (2005) interpersonal risk factors for suicide, and for clinical practice.     

Body Investment as a Protective Factor in the Relationship Between Acquired Capability for Suicide and Suicide Attempts

Acquired capability for suicide is associated with increased suicide risk and behaviors, but little research has examined factors that may qualify this relationship. Body investment is proposed as one such factor, as it may engage self-preservation instincts and serve as a buffer to capability for suicide. It was expected that facets of body investment (body feelings, body care, comfort with touch, and body protection) would moderate the relationship between acquired capability for suicide and suicide attempts. The current study included a sample of 1,150 undergraduate students with a mean age of 19.74 (3.44). The majority of the sample identified as female (71%) and White/Caucasian (78%). Participants completed self-report measures of body investment (Body Investment Scale [BIS]), acquired capability (Acquired Capability for Suicide Scale [ACSS]), suicide thoughts and attempt history (Self-Harm Behavior Questionnaire [SHBQ]), and demographic information. Four moderation analyses were run using the PROCESS macro; one for each body investment subscale. All facets of body investment showed significant moderation except for body care. Acquired capability was significantly associated with suicide attempts when body feelings, comfort with touch, and body protection were low, but not when they were high. Results indicate that fostering aspects of body investment may be important for suicide prevention.     

Suicide as a resolution of separation-individuation among adolescent girls

The purpose of this study was to discover if there is a relationship between suicidal adolescent girls and borderline phenomena, and to examine separation anxiety in suicidal girls. Hansburg's Separation Anxiety Test and Gunderson's Diagnostic Interview for Borderline Disorder were administered to 40 adolescent girls. Only those girls that had attempted suicide were included in this study. The findings of this research suggested that adolescent suicide is a borderline phenomena that has its roots in the early separation-individuation phase of development, resulting in separation anxiety. The adolescent girl gets relief from the abandonment depression and feelings of separateness by using suicide as a vehicle for regression to a symbiotic state where she earlier had experienced safety.     

Support Groups for Suicide Survivors: Results of a Survey of Group Leaders

To update and expand Rubey and McIntosh's (1996) survivors of suicide support groups report, SPAN USA completed a survey of U.S. support group leaders (n = 100; 24% completion). There are now more survivor groups (from 280 to 417), and the majority of groups now have a survivor leader (78% vs. 25%). Groups continue to be small (88% < 10 members per session) and meet on a monthly basis (55%). Sharing continues to be a universal experience in groups, which tend to be open‐ended (85%). Current groups are newer, and more operate without a sponsor. Further research is needed to examine group member perspectives and effectiveness of groups.     

Inadequate Response to Therapy as a Predictor of Suicide

The role of response to cognitive therapy as a predictor of suicide was investigated by comparing 17 outpatients with mood disorders who committed suicide with 17 matched patients who did not commit suicide. The suiciders attended significantly fewer sessions of cognitive therapy and dropped out of therapy more frequently: 88% of the suiciders, compared to 53% of the controls, were rated by their therapists as requiring more treatment at termination. They also had higher levels of hopelessness at the termination of therapy. The results suggest that premature termination of therapy and inadequate response to treatment have unfavorable prognostic significance for eventual suicide.     

Testing the Work Environment Hypothesis of Bullying on a Group Level of Analysis: Psychosocial Factors as Precursors of Observed Workplace Bullying

The present paper scrutinises the work environment hypothesis of bullying by examining relationships between psychosocial factors at work and bullying within departments on a group level of analysis, as compared to the many studies executed on an individual level of analysis. Relationships between quantitative demands, job control, role demands, leadership behaviour and social climate, and observed bullying were studied in a convenience sample consisting of 276 departments with a total of 4,064 respondents. Between‐group bivariate correlations showed relatively strong relationships (r > .52) between the predictors social climate, leadership behaviour, and role demands, respectively, and observed bullying in the department. A two‐factor higher‐level model was formulated for the independent variables yielding two latent factors reflecting an interpersonal domain and a task‐oriented domain, where the former was strongly associated with observed bullying at a group level of analysis (Beta =?.73), while the last factor yielded an insignificant contribution. The results confirm that a poor social work environment exists within departments in which bullying takes place, hence, yielding further support to the work environment hypothesis. In line with the present results, future studies on workplace bullying should include a group level of analysis.     

Resistances Encountered in Starting a Group Therapy Program for Suicide Attempters in Varied Administrative Settings

ABSTRACT: This paper reports the predictable areas of difficulty—funding issues, management and personal bias issues, theoretical issues—which emerged in the development of five treatment groups composed entirely of depressed and suicidal patients. These groups represent a coordinated effort between the city/county mental health system and the authors' funding agencies. Effective strategies for overcoming these difficulties are discussed.