Is Exposure to Suicide Beyond Kin Associated with Risk for Suicidal Behavior? A Systematic Review of the Evidence

Suicide bereavement and postvention literature often espouses risk for subsequent suicidal behavior among those previously exposed to a suicide death. Most often risk is discussed in relation to kin; however, many more individuals are exposed to suicide, and the impact of this exposure is important to understand in relation to targeting postvention. This review examined the research literature (1990–2014) to determine the evidence base for risk among those exposed to suicide. The findings demonstrate that risk of suicidal behaviors among those exposed to the suicide is significantly higher than those unexposed. These results are discussed within the context of current research in the field of postvention, and suggestions for future research are suggested.     

Suicide Exposure and Posttraumatic Stress Disorder: Is Marriage a Protective Factor for Veterans?

Alarming numbers of military veterans end their lives each day which has a profound effect on the military population. This study examines a sample (N?=?434) of suicide-exposed (i.e., personally knowing someone who has died by suicide) veterans to determine whether the proportion of individuals who report high impact from suicide exposure and those who have clinically-significant posttraumatic stress disorder symptoms is related to marital status. Using Hill’s (Social Casework 49: 139–150, 1958) ABC-X model for conceptualizing the relationships between variables, mean scores for posttraumatic stress disorder were significantly different between groups, and the odds of a married veteran reporting high-impact suicide exposure were 2.19 times lower than the odds of a single veteran reporting high-impact. Likewise, the odds of a veteran with high-impact suicide exposure having clinically-significant posttraumatic stress disorder symptoms were 10.04 times higher than veterans with low-impact suicide exposure. Findings indicate that veterans who are married are less likely to be highly-affected by another individual’s suicide. Thus, marriage is a protective factor for suicide-exposed veterans.     

Loneliness and Suicidal Risk in Young Adults: Does Believing in a Changeable Future Help Minimize Suicidal Risk Among the Lonely?

This study examined loneliness and future orientation as predictors of suicidal risk, namely, depressive symptoms and suicide ideation, in a sample of 228 college students (54 males and 174 females). Results of regression analyses indicated that loneliness was a significant predictor of both indices of suicidal risk. The inclusion of future orientation was found to significantly augment the prediction model of both depressive symptoms and suicide ideation, even after accounting for loneliness. Noteworthy, beyond loneliness and future orientation, the Loneliness × Future Orientation interaction term was found to further augment both prediction models of suicidal risk. Consistent with the notion that future orientation is an important buffer of suicidal risk, among lonely students, those with high future orientation, compared to low future orientation, were found to report significantly lower levels of depressive symptoms and suicide ideation. Some implications of the present findings for studying both risk and protective factors associated with suicidal risk in young adults are discussed.     

Is Acoustic Startle a Viable Exposure Protocol for Posttraumatic Stress Disorder? A Clinical Case Study

Exaggerated startle is a common symptom (based on Diagnostic and Statistical Manual of Mental Disorders [fourth edition] Criterion D) for many patients with posttraumatic stress disorder (PTSD). Findings from previous studies suggest that exaggerated startle may be due to trauma exposure or pretrauma vulnerability factors for PTSD development. The present clinical case study reports on a patient with PTSD characterized by a very prominent startle response and preference against standard trauma-related exposure strategies. On the basis of recent findings that interoceptive exposure exercises (e.g. shaking head side to side, hyperventilation) elicit trauma-related memories (Wald & Taylor, 2008), the authors sought to determine whether repeated application of an acoustic startle stimulus would serve to diminish the prominent startle response and facilitate exposure and overall symptom reduction by eliciting trauma-related memories. The protocol was successful in eliciting vivid and distressing trauma-related memories. Over the course of seven exposure trials, the patient demonstrated a decrease in distress elicited during the protocol, improved mood, and reduced general anxiety and trauma-related distress. He also reported significantly decreased startle response to loud noises encountered during activities of daily living. Although preliminary, these finding suggest that the acoustic startle protocol may be a viable (interoceptive) exposure strategy for individuals with PTSD, particularly those with exaggerated startle responses and those who are not amenable to standard trauma-related exposure strategies.     

Is Heightened Disgust Propensity Truly a Risk Factor for Contamination-Related Obsessive-Compulsive Disorder?

Disgust propensity (DP) has been conceptualized as a stable personality trait that confers risk for contamination-related OCD (C-OCD). However, the extent to which DP leads to the subsequent development of C-OCD is unclear. In fact, the presence of C-OCD might lead to an increase in DP rather than the inverse. The present study was aimed to test this hypothesis in a large clinical sample of OCD patients (≥ 21 years of age) with (C-OCD; n = 56) and without (NC-OCD; n = 103) contamination-related symptoms that completed measures of OCD symptoms, depression, anxiety, and DP. DP was assessed twice, in reference to the present situation (T1) and to when the participant was 18 years old (T0). The two groups did not significantly differ in DP at T0. However, C-OCD participants reported higher DP scores than NC-OCD at T1. Furthermore, the T1 vs T0 difference in DP was significant only in the C-OCD group. Subsequent analyses also showed that T1 DP levels, but not T0 levels, significantly predicted contamination-related symptoms. Despite study limitations, these findings question the role of DP as a risk factor for C-OCD.     

Can Religious Beliefs be a Protective Factor for Suicidal Behavior? A Decision Tree Analysis in a Mid-Sized City in Iran, 2013

This study aimed to assess using tree-based models the impact of different dimensions of religion and other risk factors on suicide attempts in the Islamic Republic of Iran. Three hundred patients who attempted suicide and 300 age- and sex-matched patient attendants with other types of disease who referred to Kerman Afzalipour Hospital were recruited for this study following a convenience sampling. Religiosity was assessed by the Duke University Religion Index. A tree-based model was constructed using the Gini Index as the homogeneity criterion. A complementary discrimination analysis was also applied. Variables contributing to the construction of the tree were stressful life events, mental disorder, family support, and religious belief. Strong religious belief was a protective factor for those with a low number of stressful life events and those with a high mental disorder score; 72 % of those who formed these two groups had not attempted suicide. Moreover, 63 % of those with a high number of stressful life events, strong family support, strong problem-solving skills, and a low mental disorder score were less likely to attempt suicide. The significance of four other variables, GHQ, problem-coping skills, friend support, and neuroticism, was revealed in the discrimination analysis. Religious beliefs seem to be an independent factor that can predict risk for suicidal behavior. Based on the decision tree, religious beliefs among people with a high number of stressful life events might not be a dissuading factor. Such subjects need more family support and problem-solving skills.     

Structure of the Dospert: Is There Evidence for a General Risk Factor?

The Domain‐specific Risk‐taking scale was designed to assess risk taking in specific domains. This approach is unconventional in personality assessment but reflects conventional wisdom in the decision community that cross‐situational consistency in risk taking is more myth than reality. We applied bifactor analysis to a large sample (n = 921) of responses to the Domain‐specific Risk Taking. Results showed that, in addition to domain‐specific facets, there does appear to be evidence for a general risk‐taking disposition. And this general appetite for risk appears to be useful for predicting real‐world outcomes. Copyright © 2016 John Wiley & Sons, Ltd.     

Is Expressed Emotion a Specific Risk Factor for Depression or a Nonspecific Correlate of Psychopathology?

Five Minute Speech Sample Expressed Emotion (FMSS-EE) was examined in families of youth with depressive disorders, nondepressed youth with attention deficit/hyperactivity disorder (ADHD), and community controls screened for the absence of depression and ADHD. Consistent with the hypothesis that FMSS-EE shows some specificity as a risk factor for depression, rates of critical EE were significantly higher among mothers of youth with depression as compared to mothers of nondepressed youth with ADHD, or mothers of controls. When both mothers' and fathers' scores were used to generate family EE ratings, rates of overall EE and critical EE were significantly higher for the depressed group than the control group, but the nondepressed ADHD group did not differ significantly from the other groups. Results support the hypothesis that critical EE in mothers shows some specificity as a risk factor or correlate of depression in youth.     

Is Clinical Anxiety a Risk or a Protective Factor for Executive Functioning in Youth with ADHD? A Meta-regression Analysis

Comorbidity rates between ADHD and anxiety disorders (AD) are high, but little is known about the nature of this co-occurrence. A dominant idea is that AD may intensify some (i.e., attention and working memory) and attenuate other (i.e., inhibition) ADHD symptoms. Results are mixed, potentially because of between-study differences. To investigate this further we performed a meta-regression analysis on 11 studies (n ‘ADHD-only’ = 695; n ‘ADHD + AD’ = 608), containing 35 effect sizes on attention, inhibition and working memory. Main results were: (1) no evidence of a negative effect of AD on attention and working memory; (2) better response inhibition in children with ADHD with AD than those with only ADHD (medium ES g = ? .40); (3) medication moderated this association: the effect seemed limited to studies that included medication-naïve participants; (4) the difference between the two groups increased with age for attention and with proportion of boys for working memory ability. There was no effect of comorbid disruptive behavior disorder. In conclusion, AD seems to be a protective factor for inhibition problems as assessed with laboratory tasks in ADHD, especially in children who are medication naïve. Further, AD may have a protective function for attention in older children, and for working memory in boys with ADHD. It is therefore important to screen for AD when diagnosing ADHD, and to educate those with comorbid AD about the possible positive function of feeling anxious. Potential negative effects of ADHD medication on inhibition in children with comorbid AD should be considered.     

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta‐analysis

This meta‐analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research.     

Uterine Transplant: A Risk to Life or a Chance for Life?

Science and Engineering Ethics - Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to...     

Cumulative culture and future thinking: Is mental time travel a prerequisite to cumulative cultural evolution?

Cumulative culture denotes the, arguably, human capacity to build on the cultural behaviors of one's predecessors, allowing increases in cultural complexity to occur such that many of our cultural artifacts, products and technologies have progressed beyond what a single individual could invent alone. This process of cumulative cultural evolution underlies human cultural success and has enabled us to reach and inhabit some of the most inhospitable environments on this planet. Why humans, but not other animals, have exhibited a cultural explosion has caused much deliberation. The human propensity to imitate, teach, “mind-read” and cooperate have all featured prominently in accounts of the prerequisites for cumulative culture. However, this may not represent the complete picture. In this article we consider whether there exists a link between future thinking, specifically prospective mental time travel, and the observed distribution of cumulative culture.     

Can a Connection to Culture Reduce Mental Illness Symptoms and Risk for Future Violence?

Recent policy initiatives and service provider strategic frameworks from the state of Victoria have highlighted intentions to invest in culturally safe practices for justice-involved Indigenous individuals. However, the culturally themed frameworks and protocols presented by health and justice organisations appear to be largely underpinned by theoretical and/or anecdotal evidence. This commentary summarises findings from the first Australian program of research to investigate the influence of cultural identity and cultural engagement on mental health symptoms and violence for Indigenous people in custody. Implications for correctional policy and forensic clinical practice are discussed in this article.     

Is Television a Health and Safety Hazard? A Cross‐Sectional Analysis of At‐Risk Behavior on Primetime Television1

Twenty‐four top‐rated primetime television shows were observed weekly during 1997 and 1998 (242 episodes). The study examined behaviors of vehicle occupants; violence and risky sex; and use of drugs, alcohol, and tobacco. Findings were compared to studies conducted in the mid‐1980s and 1994. Characters in vehicles were unrestrained 74% of the time in 1998, compared to 73% and 78% in 1994 and 1986, respectively. Violence, risky sex, and substance use were shown in 47%, 29%, and 55%, respectively, of 30‐min intervals observed in 1998. Similar data were recorded in 1994, with some negligible improvements. Results indicated that risky behaviors were rarely followed by punishing consequences, and irresponsible behaviors were modeled on primetime television. The relevance to social modeling and public health is discussed.     

Is Disciplinary Culture a Moderator Between Materialism and Subjective Well-being? A Three-Wave Longitudinal Study

To clarify the influence of disciplinary culture on the materialism–subjective well-being (SWB) relationship, as well as the relationship between changes in materialism and changes in SWB, the current longitudinal study tracked the levels of materialism and SWB among first-year undergraduates for 12 months. A total of 218 participants from a congruent disciplinary culture (i.e., business school) and 210 participants from an incongruent disciplinary culture (i.e., engineering school) provided ratings on the Material Values Scale, the Satisfaction with Life Scale, and the Positive and Negative Affect Schedule in three waves. The following results were obtained: (1) the interaction effect of disciplinary culture and time was significant. In Wave 3, the level of materialism in business school was significantly higher than that in engineering school, but this difference was not found in Waves 1 and 2; (2) the negative relationship between materialism and SWB remained stable over time and was not moderated by disciplinary culture. Moreover, disciplinary culture did not moderate the relationship between changes in materialism and changes in SWB. The above findings indicate that disciplinary culture influences the development of materialism but not the materialism–SWB relationship in the long term.     

Is Religious Coping Associated with Cumulative Health Risk? An Examination of Religious Coping Styles and Health Behavior Patterns in Alzheimer’s Dementia Caregivers

The current study explored the relationship between religious coping and cumulative health risk associated with health behavior patterns in a sample of 256 Latina and Caucasian female caregivers of elderly relatives with dementia. Primary analyses examined the relationship between religious coping (both positive and negative) and an overall index of cumulative health risk. Secondary analyses were conducted on the individual health behaviors subsumed in the broader index. Findings revealed that negative religious coping was significantly associated with increased cumulative health risk. Positive religious coping was predictive of decreased cumulative health risk among Latina caregivers but not among Caucasians. Negative religious coping was significantly associated with both an increased likelihood for weight gain and increased dietary restriction. Positive religious coping was associated with decreased likelihood for weight gain in Latinas. Implications for both caregivers and clinicians are discussed.     

Is there a common pathway to maladjustment for internationally adopted and non-adopted adolescents?

The main purpose of the research was to test whether cumulative effects represent a common pathway to behavioral maladjustment for internationally adopted adolescents and controls. The findings of previous comparison and follow-up studies have been contradictory. The hypothesis was tested in an original multi-informant study with 74 adolescents: 40 adoptees and 34 controls. The analyses of the data provided arguments in favor of the existence of a common pathway for adoptees and controls. The accumulation of risk factors in the current characteristics of the adolescents and their family was significantly associated with behavioral outcomes of both adoptees and controls. Implications for research, policy and practice are discussed.     

The Course of Post‐Crisis Suicidal Symptoms: How and for Whom Is Suicide “Cathartic”?

We investigated suicide "catharsis" as evidenced by decreased suicidality following a suicide attempt. Past research has examined this issue with mixed results (Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985). In the present study, we examined Modified Scale for Suicide Ideation (MSSI) scores for 198 suicidal men during suicidal crisis, prior to entry into a treatment study, and again at 1-month and 12-month follow-ups. Patients were divided into ideators, single attempters, and multiple attempters. We found evidence for decreased suicidality, but interpreted it as the gradual action of interpersonal support, rather than as emotional catharsis. Also, multiple attempt status affected the long-term course of post-crisis suicidality.