Is Suicide Ideation a Surrogate Endpoint for Geriatric Suicide?

The present study explored the validity of treating suicide ideation as a surrogate endpoint that can serve as a proxy for suicide in clinical intervention research with suicidal seniors. Two criteria; that suicide ideation is modulated by the proposed intervention and that modulation of suicide ideation leads to a quantitative reduction in suicide rates, were the focus of this review. A series of literature searches of the PsychINFO and Medline databases were conducted on the terms geriatric, elderly, seniors, suicide, self-destruction, clinical, randomized, trial, treatment, intervention , and ideation . Articles were analyzed if they provided sufficient information to examine whether an intervention effectively led to a reduction in suicide ideation among seniors. Two hundred and eight articles were considered for potential inclusion in this study, with 19 articles meeting final inclusion criteria. The articles reviewed were divided into three broad categories: articles supporting suicide ideation as a surrogate endpoint for geriatric suicide ( n = 6); those not supporting this hypothesis ( n = 1); and those providing insufficient information to test the hypothesis ( n = 12). The present analysis provided modest evidence for suicide ideation as a surrogate endpoint for geriatric suicide, due, in part, to a paucity of randomized controlled trials of treatment interventions for suicidal seniors, thus demonstrating a clear need for research in this area. Implications of utilizing surrogate endpoints in suicide research are discussed.     

BRITISH ORTHODOX JEWRY 1945–1990: SWING TO THE RIGHT OR SHIFT TO THE CENTRE?

For almost two decades Jewish historians and sociologists have been tracing and debating the “swing to the right” among American Orthodox Jews. This phenomenon has no precise definition, but can be summarized as the contention that since the 1970s there has been a move within centrist Orthodoxy toward stricter halakhic positions, based more on text than tradition, and that there has also been a tightening of philosophical and theological positions, for example regarding the age of the universe, evolution and the veracity of talmudic science and medicine. More recently, British Jewry began to be the subject of a similar analysis. Geoffrey Alderman, Miri Freud-Kandel and, to some extent, Todd Endelman, have made the case that there was a swing to the right among Orthodox Jews in Britain. They argue that it can be traced to the 1960s or even 1950s and that it has continued and gathered momentum. I have taken a different position from these scholars. In this article I want to develop my ideas on the basis of further evidence and thought and taking into account objections to my work.

In this article I will first clarify my existing analysis of the period 1945–1970 in the light of criticisms. Second, I will expand my explanation of developments in British Jewry in that period, offering an alternative explanation to that of a straightforward swing to the right. Finally, I will examine the period from 1970–1990 and provide an initial account of the changes that took place. Some of these could be labelled a swing to the right but I will argue they are better understood as a specifically British phenomenon; more of a ‘shift to the centre’, and with rather different causes and consequences. This article makes no claims to being final or definitive, but only one step forward (I hope) in our understanding.     

Client Suicide: What Now?

The loss of a client to suicide is a painful personal and professional experience for mental health providers. Whether trainee or experienced professional, the affected clinician often reports feeling overwhelmed and unprepared for the experience of client suicide, together with significant emotional distress and diminished work performance. In this article, we present a brief overview of the literature on the impact of client suicide and ideas for coping with the psychological and professional issues that typically arise. We also provide suggestions for managing the associated practical and administrative tasks, as well as resources for obtaining professional support and guidance in the wake of this tragic event.     

Are UN Peacekeepers at Risk for Suicide?

Media reports connecting UN peacekeeping duties by Canadian soldiers to their subsequent suicide prompted this study of peacekeeping as suicide risk. In a case-control design we retrospectively compared 66 suicides in the Canadian military between 1990 and 1995 with two control groups: (a) 2,601 controls randomly selected from the electronic military database and (b) 66 matched controls with complete personnel and medical data. We found no increased risk of suicide in peacekeepers except among a subgroup of air force personnel. Here confounding individual factors, isolation from supports, and possibly inadequate preparation for deployment elucidated their suicides. Theater of deployment (e.g., Bosnia) did not affect the suicide rate. Military suicides experienced psychosocial stresses and psychiatric illness more often than their matched controls. We conclude that although peacekeeping per se does not increase overall suicide risk, military life-styles may strain interpersonal relationships, encourage alcohol abuse, and contribute to psychiatric illness and suicide in a minority of vulnerable individuals irrespective of peacekeeping assignment. Careful selection, and preparatory military training that encourages intragroup bonding and mutual support, may protect against suicide risk.     

IS SCIENCE THE ONLY WAY TO TRUTH?

Abstract. In the context of contemporary life questions, especially that of world peace, this essay first develops the view that truth is essentially scientific truth. Although religion gives insights for living, as science encompasses more and more of human experience it reinforces and modifies religious truths with its own firm knowledge. However, because of several limitations, it is concluded that science alone cannot give a complete account of humanity and the universe. For our first beliefs and principles we must look to other kinds of truth, which are in accord with scientific truth but go beyond scientific method in their justification.     

Meriwether Lewis: Was it Suicide?

Even 200 years following the conclusion of the Lewis and Clark Expedition, questions remain about whether Meriwether Lewis' death was a suicide. The purpose of this article is to consider this issue by examining historical evidence from a psychological perspective. A risk factor model for suicide assessment (Sanchez, 2001) is employed to evaluate the nature of Lewis' historical, personal, psychosocial environmental, and clinical risk factors as well as protective factors. The authors conclude that though there is some evidence to support a theory of murder, Lewis was at a high suicide risk at the time of his death, and that the preponderance of the evidence indicates that he died by his own hand.     

Are Adoptees at Increased Risk for Attempting Suicide?

This study addresses the controversy of whether adopted adolescents are at risk for more mental health problems than the nonadopted and specifically evaluates differences in suicide ideation and depression. Same gender comparisons were made between 346 adopted adolescents and nearly 14,000 others living with biological parents, with nationally representative data from the National Longitudinal Study of Adolescent Health. Results showed few divergences in suicide ideation, attempts, and depression between adopted and nonadopted adolescents and young adults. Future studies employing this same dataset will need to pay closer attention to the high percentages of respondents adopted by blood relatives, which only became known with the collection of the Wave III Add Health data.     

Suicide Terrorists: Are They Suicidal?

Are suicide terrorists suicidal? A review of the worldwide literature on suicide terrorism uncovered five published empirical studies describing data collected from potential suicide terrorists or the surviving friends and families of deceased terrorists. The many discrepancies uncovered between suicide terrorists and other suicides on key factors known to underpin suicidality, suggest that such terrorists are not truly suicidal and should not be viewed as a subgroup of the general suicide population. Nonetheless, methods developed by suicidologists, such as the psychological autopsy, will help increase our understanding of the individual and group factors that underpin suicide terrorism.     

DOES SCIENCE CLARIFY GOD'S RELATION TO THE WORLD?

Abstract. Central to the work of Arthur Peacocke on science and religion is the intention to develop a reasonable faith within an intelligible framework of meaning. Showing the inadequacy of reductionism is necessary for this purpose. Knowledge of God is related to what science can tell us about creation. From an evolutionary framework, characterized as a delicate balance that issued in humans, and manifested through contingency and chance, God's actions are expressed as exploring the potentialities of creation. The creation is understood to be in God, but God is more than the world, as in panentheism. God suffers with the creation in love, and the focus of human meaning is expressed in Jesus Christ, the Incarnation, the sacrament of God.     

WHOM TO BLAME FOR THE CHARGE OF SECULARIZATION?

Abstract. In the last century science and technology have been viewed as guilty of contributing to the modern secularization process and also to a crisis in religion. The extent of this influence is less clear today: while technology is stronger, and an easy target for any kind of social and cultural criticism, science seems weaker than it used to. The aim of this commentary is to examine in a critical way the arguments for and against scientific and technological involvement in the crisis religion faces today. In the end, a revision of the future of religion is called into question, especially in the light of a more “technological theology.”     

Predatory Conferences: What Are the Signs?

Like predatory journals, predatory conferences are a growing part of the academic landscape, but unlike their journal counterparts, to date predatory conferences have not been extensively investigated, and many unanswered questions about their workings exist. From a positive ethics perspective, a more complete understanding of predatory conferences is desirable, as it can support researchers in making ethically appropriate choices about conference attendance. Ten predatory conference organisations were the focus of this study. The investigation first set out to identify and document the attributes of such conferences. They were then analysed to understand which attributes can most easily and reliably be used to distinguish them from legitimate conferences. A tool to assist prospective participants is introduced. The implications for positive ethics, in terms of making decisions about conference attendance, are discussed.

     

Older Adults: The Next Suicide Epidemic?

Suicide rates historically and currently are highest by age among those over the age of 65. Predictions of markedly higher rates for future older adults have been advanced. Possible alternative factors that might produce lower risk among future elderly Americans are presented and it is argued that future trends are uncertain. Predictions of elderly suicide are made based on an assumption of stable rather than changing rates. Constant rates produce estimates of more than twice the current number of suicides and a proportionate increase in the number of suicides from one in five for the 1980s to one in three by the year 2030. The elderly are and likely will be a group with high suicide risk. Immediate efforts to lower elderly suicide risk and avert high future rates are recommended.     

WHEN CAN THE SUBJECT BE TRUSTED NOT TO THINK?

Sjöberg , L. When can the subject be trusted not to think?Scand. J. Psychol., 1968, 9, 274–276.—Many tasks can be approached either in an intuitive or an analytical mode. Hence, problems of interpretation may arise. Such problems are particularly pressing in cases where the results can be explained as the outcome of a trivial, analytic process. Certain recent work is discussed where such a risk appears to be present.