Diagnosis of Youth At-Risk for Suicide,Pregnancy, and Drug and Alcohol Abuse

The intent of this paper is to overview three selected subgroups of at-risk youth. These subgroups are: suicidal adolescents, pregnant teenagers, and drug and alcohol abusers. Alternatives to traditional diagnostic procedures will be examined from the perspective of determining whether they can effectively and efficitently provide information necessary to develop a client management plan. A continuing diagnostic process providing the data base for a client information system is proposed. Such diagnostic practices can promote the early recognition of at-risk behaviors, thus increasing the general awareness, or early recognition, that may be crucial to preventive efforts. Discussion is provided for the use of the term at-risk. In this paper, the term is used to mean more than an adolescent who is simply at academic risk and prone to dropping out (being stopped or pushed out) of school. As used here, the at-risk group includes a number of students who are not only failing academically, but display unwanted social-personal behaviors, leading to possible adjudication or requiring community based support services, while some may even be in life-threatening circumstances.     

Correlates of Suicide Stigma and Suicide Literacy in the Community

Public knowledge and attitudes toward suicide may influence help‐seeking for suicidality. This study aimed to identify correlates of suicide attitudes and knowledge. Australian adults were invited to complete an online survey, with 1,286 responders. Less exposure to suicide, older age, male gender, less education, and culturally diverse backgrounds were associated with poorer knowledge; while younger age, male gender, and culturally diverse backgrounds were associated with more stigmatizing attitudes toward people who die by suicide. The results suggest suicide literacy and stigma reduction programs would benefit community members, particularly males and individuals from culturally diverse backgrounds.     

Drug Abuse in the Sales Force

Drug abuse in the workplace is a national problem of frightening proportions and there is no reason to suspect that the nations's sales forces should be immune. This study examines the problem of sales force drug abuse and reports the findings of a nationwide survey of field sales managers concerning the extent of drug abuse in the nation's sales forces, the methods of dealing with the problem, and factors related to drug abuse problems in the sales force. Implications for sales managers, sales management educators and trainers, and researchers in the field of sales and sales management are also discussed.     

Suicide Risk Factors In Alcohol Abuse

ABSTRACT: The “clinical model” approach to estimating suicide risk assumes that persons sharing specific attributes will also share certain indicators of vulnerability to suicide. This would warrant an empirically derived risk assessment scale applicable only to persons with those attributes. Nine hundred seventy eight persons at risk for suicide who met our criteria for alcohol abuse were interviewed at length and followed for two years, during which 53 (5.5 percent) committed suicide. Eleven variables which best differentiated those who suicided from those who did not in an index set were then applied to an independent validation set. Clinical implications of the findings are discussed.     

Gender Roles,Suicide Attempts,and Substance Abuse

In this article, the focus is on a comparison of suicide attempts and substance abuse in the United States. It is argued that suicide attempts and substance abuse may function as psychologically equivalent but gender-specialized forms of self-injurious behaviors. Possible explanations for the gender segregation of suicide attempts and substance abuse are reviewed, and the benefits of crossover theories and treatments are presented.     

Editorial: Drug Abuse and AIDS

Abstract

The present article presents an overview of the behavioral and psychological components which have been found to be associated with Type A behaviors in children and adolescents. Each component is discussed within the context of the assessment device used to measure it. with methodological concerns being addressed whenever appropriate. Using both observational methods and self-report questionnaires. the four major behavioral components of adult Type A behavior; competitive-achievement striving, time urgency, aggressiveness-hostility and impatience have been found in child/adolescent Type A subjects. Type A children have a lower self-esteem, a more external locus of control and higher anxiety level than their non-Type A counterpart. Coping mechanisms for stress and characteristic cognitions may differ in Type A subjects as they progress from childhood through adolescence. Recommendations for future research are presented.     

Case Studies in the Family Treatment of Drug Abuse

This article, with case illustrations, attempts to demonstrate that drug-abuse behavior can be understood more clearly in the light of family loyalties and unresolved family crises than from the perspective that drug abusers are social deviates.1 Drug abuse is viewed as symptomatic, as a signal that both drug abuser and his or her family are having difficulty in getting past a particular stage in the natural unfolding life cycle of a family. Treatment of drug abuse is seen primarily as helping the family to become "unstuck," thereby freeing the individual's and family's energy for the task of self-development and growth rather than expending it to maintain rigid patterns of interaction in an attempt to prevent change.     

The Family Dance Around Drug Abuse

The article describes the interactivity of relationships and dynamics of a family with a chemically abusive member.     

Roles of the Drug Abuse Counselor in a Correctional Facility

This article focuses on the variety of roles that counselors working with drug offenders are expected to undertake. The authority, counseling, and intercessor roles are discussed, as well as the unwritten roles that are assumed by drug abuse counselors. Potential role conflicts and their effects, both on drug abuse counselors and on their clients, are addressed.     

Classification of Co-occurring Depression and Substance Abuse Symptoms Predicts Suicide Attempts in Adolescents

Although both depression and substance use have been found to contribute to suicide attempts, the synergistic impact of these disorders has not been fully explored. Additionally, the impact of subthreshold presentations of these disorders has not been researched. We utilized the Quadrant Model of Classification (a matrix of severity of two disorders) to assess for suicide attempt risk among adolescents. Logistic regression was used to examine the impact of co-occurring disorder classification on suicide risk attempts. Results indicate that quadrant classification had a dramatic impact on suicide attempt risk, with individuals with high severity co-occurring disorders at greatest risk.     

Medical Conditions and Nearly Lethal Suicide Attempts

P hysical illness has been studied as a risk factor for suicidal behavior, but little is known about this relationship among younger persons. We conducted a population‐based, case‐control study in Houston, Texas, from November 1992 through September 1995. The final sample consisted of 153 case‐ and 513 control‐subjects aged 13 to 34 years. Case patients were identified at hospital emergency departments and met criteria for a nearly lethal suicide attempt. Control subjects were recruited via a random‐digit‐dial telephone survey. Case patients were more likely than controls to report having any serious medical conditions (crude OR = 3.23; 95% CI = 2.12–4.91). After controlling for age, race/ethnicity, alcoholism, depression, and hopelessness, the adjusted odds ratio for men was 4.76 (95% CI = 1.87–12.17), whereas the adjusted odds ratio for women was 1.60 (95% CI‐0.62–4.17), suggesting that young men with medical conditions are at increased risk for nearly lethal suicide attempts. Increased efforts to identify and appropriately refer these patients are needed.     

Suicide Protective Factors in Outpatient Substance Abuse Patients: Religious Faith and Family Support

The purpose of this study was to identify the protective roles of religious faith and family support in buffering against suicidal behavior in a sample of substance abuse outpatients seeking treatment. Data were collected from 112 clinical outpatients seeking treatment for substance abuse. We hypothesized that religious faith would be related to lower levels of suicidal behavior through a negative association with depressive symptoms. We expected this mediation effect would differ across varying levels of family support, providing support for a moderated mediation effect. The results indicate that religious faith exerts stronger direct and indirect effects on suicidal behavior at low levels of family support. Religious faith was significantly and negatively related to suicidal behavior only at low levels of family support. The findings suggest that in the absence of family support, religious faith may play a compensatory role in protecting against suicidal behavior.     

Moderating Factors in the Path from Physical Abuse to Attempted Suicide in Adolescents: Application of the Interpersonal‐Psychological Theory of Suicide

Childhood physical abuse is a major risk factor for suicide attempt, but factors that moderate this risk remain largely unexamined. Moderated mediation analysis was used with 186 adolescents who responded to the Profiles of Student Life: Attitudes and Behavior survey. Physical abuse increased risk directly and indirectly through reduced self‐esteem. Involvement in youth programs moderated the direct effect. Community service moderated the indirect effect. Results indicate 2 hours per week of involvement in youth programs and 2 hours per week of community service mitigated suicide attempt risk associated with abuse. Providing avenues for youth experiencing abuse to increase their community service and involvement is recommended.     

Suicide Intervention Skills and Related Factors in Community and Health Professionals

Health and community professionals have considerable exposure to suicidal people and need to be well skilled to deal with them. We assessed suicide intervention skills with a Dutch version of the SIRI in 980 health and community professionals and psychology students. Suicide intervention skills clearly differed among professional groups and were strongly related to experience, especially suicide‐specific experience. Some community professionals scored below acceptable levels on their ability to respond appropriately to suicidal people they encounter, and tended to overestimate their skills level. Training is therefore indicated for these groups, and may be useful to more highly experienced groups too.     

Family Therapy and Drug Abuse: A National Survey

The following report describes the results of a national study of the role of family therapy in the drug abuse field. Characteristics of agencies that work with families are described, as well as the demographic characteristics and psychological problems of the clients most apt to be treated in family therapy. The study also looks at the role and structure of family therapy in the ecological system of the treatment institutions. A profile of the family therapists who are responsible for providing services to families is presented. An attempt was made to assess agencies' level of development with regard to family therapy by using an instrument, The Progress Index for Family Therapy Programs. Generally, findings indicated that there is considerable variation in expertise. More extensive training in family therapy techniques was of major concern, particularly among clinics with a heroin addict population.     

Community Reactions to Attempted and Completed Child Suicide1

In order to assess community reactions to attempted and completed child suicide, 180 shoppers were asked to read a short newspaper article about a 10-year-old who either (a) attempted suicide, (b) completed suicide, (c) completed suicide after having previously attempted, (d) was psychiatrically hospitalized, (e) died of a viral illness, or (f) died of an accident. Subjects then completed a 9-item Likert scale designed to assess their reactions. A2 × 6 (Gender of Victim × Type of Incident) multivariate analysis of variance indicated a significant effect only for type of incident. Families of psychiatrically hospitalized adolescents received milder reactions than families of suicide attempters, in terms of (a) other's assessment of their psychological health, (b) how long they were expected to be sad and depressed after the incident, and (c) how tense respondents expected to feel while visiting them. Apparently, families of suicide attempters must face many of the same negative community reactions as families whose loved ones actually die by suicide, whereas families who have a loved one psychiatrically hospitalized face less problematic reactions from others in the community.