Risk Factors for Attempting Suicide in Prisoners

We wished to examine determinants of suicidal behavior in prisoners. 903 male prisoners had a psychiatric interview which included various psychometric tests. Suicide attempters were compared with prisoners who had never attempted suicide. Significantly more of the attempters had a history of psychiatric disorder, substance abuse, a family history of suicidal behavior, convictions for violent crime, had exhibited aggressive behavior in jail, and had higher BGLHA aggression scores. A similar pattern of risk factors was found for prisoners with suicidal ideation. A lifetime history of attempting suicide, or of having suicidal ideation, is frequent in prisoners. Risk factors include family, developmental, aggression, personality, psychiatric, and substance abuse factors.     

右美托咪啶施用于海洛因依赖者全身麻醉

海洛因吸食者的行为失控常会引起创伤.对此类患者实施全身麻醉时,毒品所至的病理生理学改变应给予综合评估,同时海洛因与全身麻醉药和阿片类镇痛药物的相互作用需要引起重视和动态调整.α2肾上腺素能受体激动剂对于此类麻醉具有良好的辅助作用.     

海洛因成瘾者的脑灰质密度下降

本研究对海洛因成瘾者（n=34）和无毒品依赖的正常被试（n=34）进行磁共振脑结构扫描,用基于体素的形态学测量（VBM）方法分析被试间灰质密度的差异,并考察了海洛因成瘾者用药时间与灰质密度之间的关系。结果表明,同正常对照组相比,海洛因成瘾者其额叶和颞叶下部的灰质密度显著下降。进一步分析显示,用药时间短于5年的成瘾者其灰质密度下降不明显,而用药时间5年以上的患者其灰质密度下降非常显著。本文讨论了上述结果的潜在临床价值和理论意义。     

Decreased Reception of Nonverbal Cues in Heroin Addicts

The ability to interpret nonverbal cues was tested in 15 young, white American male heroin addicts who were not intoxicated. When their responses were compared with those of age-matched controls, addicts were found to be significantly less accurate in reading nonverbal communications.     

Risk Factors Proximate to Suicide and Suicide Risk Assessment in the Context of Denied Suicide Ideation

Health care providers have significant opportunities to identify individuals at near‐term risk for suicide, but lack empirical data on near‐term risk factors. This study aimed to identify dynamic, state‐related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near‐term risk factors among patients who denied versus responded positively to having suicide ideation (SI ) when last asked by a clinical practitioner prior to their death. Risk factors charted for the majority of all decedents were a history of prior suicide ideation and/or suicide attempt, current anxiety/agitation and sleep problems, current interpersonal problems or job/financial strain, current comorbid diagnoses, current social isolation/withdrawal, and a family history of mental disorder. Two‐thirds of patients denied having SI when last asked and one‐half of these patients were dead by suicide within 2 days. Decedents who denied having SI were quite similar in charted diagnoses, symptoms, behaviors, and environmental circumstances to decedents who responded affirmatively to having SI . Reliance on verbalized or reported SI as a gateway to a suicide risk assessment is questioned and the need for better understanding near‐term risk for suicide, particularly in the absence of stated SI , is highlighted.     

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.     

Reasons for Attempting Suicide among a Community Sample of Adolescents

The motives of suicide attempts among a community sample of 99 U.S. high school students were explored. Participants completed an in‐depth computer‐assisted self interview about their most recent attempts as well as additional psychosocial measures. Results indicated that nearly 75% of the adolescents engaged in suicide attempts for reasons other than killing themselves and that depressive symptoms and premeditation prior to the attempt were significantly associated with increased risk for engaging in the attempts with death as a clear motive. Linking motive for an attempt (death, interpersonal communication, emotion regulation) and treatment approach may improve prevention of subsequent attempts and completed suicides.     

Factor Structure of the Reasons for Attempting Suicide Questionnaire (RASQ) with Suicide Attempters

A sample of 134 suicide attempters completed the Reasons for Attempting Suicide Questionnaire (RASQ). Maximum likelihood factor and principal components analyses confirmed the multidimensionality of the RASQ, with two-component and three-factor models each receiving support. Scales from these competing multidimensional RASQ models demonstrated adequate internal consistency reliability. For the two-component model, two previously developed scales demonstrated differential validity with suicide indices. It is concluded that the RASQ has at least two dimensions, and it is recommended that the RASQ be scored for two scales: Internal Perturbation-Based Reasons and Extrapunitive/Manipulative Motivations.     

Family Factors Predicting Categories of Suicide Risk

We compared family risk and protective factors among potential high school dropouts with and without suicide-risk behaviors (SRB) and examined the extent to which these factors predict categories of SRB. Subjects were randomly selected from among potential dropouts in 14 high schools. Based upon suicide-risk status, 1,083 potential high school dropouts were defined as belonging to one of four groups; 573 non-suicide risk, 242 low suicide risk, 137 moderate suicide risk and 131 high suicide risk. Results showed significant group differences in all youth self-reported family risk and protective factors. Increased levels of suicide risk were associated with perceived conflict with parents, unmet family goals, and family depression; decreased levels of risk were associated with perceived parental involvement and family support for school. Perceived conflict with parents, family depression, family support satisfaction, and availability of family support for school were the strongest predictors of adolescent SRB. Our findings suggest that suicide vulnerable youth differ from their non-suicidal peers along the dimensions of family risk and protective factors.     

Resilience Factors and Suicide Risk for a Sample of Transgender Clients

This study explored how individual- and community-based resilience factors operated together in order to reduce risk of suicide for a sample of transgender therapy clients. We collected cross-sectional survey data from 106 transgender therapy clients at a local community center, including demographic information, experiences of relational support, participants' emotional stability, and risk for suicide. Results from our mediation analysis indicated that high levels of perceived relational support are related to reduced risk for suicide and that this happens by way of a person's emotional stability. Clinical implications for family therapists are discussed based on the significant indirect effect found in this study.     

海洛因戒断者吸毒及情绪注意偏向的ERP研究

海洛因戒断组对吸毒、正、负性线索注意偏向是理解戒断者复吸脑机制的重要手段之一。研究采用dot-probe实验范式,海洛因戒断组及正常被试各10名,分别记录64个电极点脑电数据。结果表明,戒断者吸毒线索注意偏向P200振幅显著高于正负性情绪线索,也显著高于正常组,提示戒断者存在吸毒线索注意偏向;N300振幅显著低于正常组,说明戒断者具有较低的情绪评价;吸毒线索诱发P300振幅显著高于正常组,表明戒断组对吸毒线索可能附加情绪加工。     

Examining Proximal Risk Factors for Suicide in a Sample of Mexican Adults in Rehabilitation Centers

The cross‐cultural generalizability of the interpersonal theory of suicide was examined in this study. One hundred ninety‐nine adults in an inpatient setting in Mexico completed the Personal Resources Questionnaire, Beck Hopelessness Scale, Interpersonal Needs Questionnaire, Acquired Capability for Suicide Scale, and Suicide Behaviors Questionnaire‐Revised. Analyses revealed the interaction between perceived burdensomeness and thwarted belongingness did not predict suicide ideation. The interactions between perceived burdensomeness and thwarted belongingness and between perceived burdensomeness and acquired capacity significantly predicted suicidal behaviors, whereas the hypothesized three‐way interaction did not. These findings highlight the importance of perceived burdensomeness in the development of suicidal behaviors among Mexican‐origin adults.     

Suicide Clusters: A Review of Risk Factors and Mechanisms

Suicide clusters, although uncommon, cause great concern in the communities in which they occur. We searched the world literature on suicide clusters and describe the risk factors and proposed psychological mechanisms underlying the spatio‐temporal clustering of suicides (point clusters). Potential risk factors include male gender, being an adolescent or young adult, drug or alcohol abuse, and past history of self‐harm. However, the majority of studies lack methodological rigor. Many different psychological mechanisms are described, including contagion, imitation, suggestion, learning, and assortative relating, but supporting empirical evidence is generally lacking. More scientifically rigorous studies are needed to improve understanding of suicide clusters.     

Suicide Risk Assessment and Risk Formulation Part I: A Focus on Suicide Ideation in Assessing Suicide Risk

The main procedure used by clinicians to determine whether an individual may be at risk of suicidal behaviors is the suicide risk assessment (SRA). The purpose of the SRA is to identify risk and protective factors that then provide the data for the formulation of suicide risk. The suicide risk formulation (SRF) assigns a level of suicide risk that ideally leads to triage and treatment deemed appropriate for that level of risk. Some of the problems with the SRA are explored here, with an emphasis on addressing the over reliance on communicated suicide ideation, and recommendations are made for improvements. Part II of this article (Berman & Silverman, 2013, also appears in this issue of STLB) examines the process of an SRF and, similarly, makes recommendations to improve clinical practice toward the desired end of saving lives.     

海洛因依赖者抑制控制功能的损伤机制及其可逆性

抑制控制障碍是海洛因依赖者认知功能受损的核心问题, 是影响复吸的关键因素。大量研究证实了海洛因依赖者抑制控制功能的受损, 并且发现长期药物滥用者额叶、前扣带回皮层、中脑腹侧被盖区、伏隔核、脑岛等相关脑区活动存在异常。以往研究表明海洛因依赖者抑制控制功能受损是一种持久性的、不可逆的脑损伤, 但最近一些研究却提供了毒品戒断者抑制控制功能生物性恢复的证据。未来的研究应该更加关注多重冲突条件下海洛因依赖者抑制控制功能的研究, 并且在戒毒实践中根据海洛因戒断者自身特点进行区分性治疗。     

Suicidal Behavior in Relatives or Associates Moderates the Strength of Common Risk Factors for Suicide

The prevalence and odds ratios of different suicide risk factors were compared in three pairs of decedents: 80 suicides and 25 injury decedents with blood relatives with suicidal behavior history (biologically exposed); 259 suicides and 126 injury decedents with unrelated acquaintances with suicidal behavior history (socially exposed); and 471 suicides and 523 injury decedents with neither relatives nor acquaintances with suicidal behavior history (unexposed). Negative life events and high psychological stress were more common in socially exposed suicides than in other suicides. The adjusted odds ratios of most established suicide risk factors were higher in unexposed decedents than in biologically or socially exposed decedents, suggesting that the predictive value of established risk factors wanes in individuals who have been exposed to suicidal behavior in family or friends.