Comparison of the Effects of Telephone Suicide Prevention Help by Volunteers and Professional Paid Staff: Results from Studies in the USA and Quebec,Canada

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.     

Follow‐up with Callers to the National Suicide Prevention Lifeline: Evaluation of Callers’ Perceptions of Care

Continuity of care for suicidal individuals engaged with a variety of health and mental health care systems has become a national priority, and crisis hotlines are increasingly playing a part in the risk management and continuum of care for these individuals. The current study evaluated a national initiative to have crisis centers in the National Suicide Prevention Lifeline network provide follow‐up care to suicidal callers. Data were obtained from 550 callers followed by 41 crisis counselors from 6 centers. Two main data sources provided the information for the current study: a self‐report counselor questionnaire on the follow‐up activities completed on each clinical follow‐up call and a telephone interview with follow‐up clients, providing data on their perceptions of the follow‐up intervention's effectiveness. The majority of interviewed follow‐up clients reported that the intervention stopped them from killing themselves (79.6%) and kept them safe (90.6%). Counselor activities, such as discussing distractors, social contacts to call for help, and reasons for dying, and individual factors, such as baseline suicide risk, were associated with callers’ perceptions of the impact of the intervention on their suicide risk. Our findings provide evidence that follow‐up calls to suicidal individuals can reduce the perceived risk of future suicidal behavior.     

Why older adults make more immediate treatment decisions about cancer than younger adults

Literature relevant to medical decision making was reviewed, and a model was outlined for testing. Two studies examined whether older adults make more immediate decisions than younger adults about treatments for prostate or breast cancer in authentic scenarios. Findings clearly showed that older adults were more likely to make immediate decisions than younger adults. The research is important because it not only demonstrates the consistency of this age-related effect across disease domains, gender, ethnic groups, and prevalent education levels but begins to investigate a model to explain the effect. Major reasons for the effect focus on treatment knowledge, interest and engagement, and cognitive resources. Treatment knowledge, general cancer knowledge, interest, and cognitive resources relate to different ways of processing treatment information and preferences for immediate versus delayed decision making. Adults with high knowledge of treatments on a reliable test tended to make immediate treatment decisions, which supports the knowledge explanation. Adults with more cognitive resources and more interest tended to delay their treatment decisions. Little support was found for a cohort explanation for the relationship between age and preference for immediate medical decision making.     

Characteristics of Telephone Crisis Hotline Callers with Suicidal Ideation in Japan

Hotline callers do not always have suicidal ideation and previous studies have noted that the rate of such callers is limited. Crisis hotline counselors must be able to identify high‐risk callers in order to provide appropriate support. This study investigated the characteristics of Japanese crisis hotline callers in 2012 (N = 541,694) and is the first to analyze crisis hotline data for all parts of Japan over 1 year. About 14% of the callers had suicidal ideation and 6% had a history of attempted suicide. The odds ratio for suicidal ideation among those with a history of attempted suicide was 15.5. The suicidal ideation rate was much smaller compared to previous studies in other countries. There is a psychological barrier that must be broken for high‐risk people to use support hotlines. In addition, attempted suicide is a strong exclusive predisposing factor for death due to suicide; therefore, counselors should pay careful attention to callers with a history of attempted suicide. The characteristics of Japanese crisis hotline callers and the features of suicidal ideation revealed in the present study are expected to be useful in developing telephone crisis hotline strategies.     

Information selectivity in decision making by younger and older adults

Past research has demonstrated that older adults are more likely than younger adults to exhibit information selectivity in decision making. Two alternative explanations have been proposed to account for this age difference. One explanation attributes the increase in information selectivity to older adults' reliance on prior knowledge, whereas the other explanation suggests that it reflects reduced information processing capacity. The aim of this research was to explore the latter explanation by controlling for experiential factors and varying the cognitive demands involved in decision making. Specifically, participants were faced with unfamiliar decision problems, and had to base their decisions on the available information in order to reach a desired goal. In Experiment 1 younger and older participants were required to play a game involving chance. The outcome payoff was varied between three conditions (approach, avoidance, and control). The results indicated that both the younger and the older participants based their decisions on payoff, though the older participants did so to a lesser extent. In Experiment 2 younger and older participants performed a similar decision task but with higher cognitive demands. Specifically, the decision‐making task included two dimensions of information, outcome probability and outcome payoff. The results showed that the younger participants based their decisions on probability and payoff whereas the older participants based their decisions on probability alone. In Experiment 3 younger and older participants made decisions in a sale context and received instructional cue to incorporate payoff information in their decisions. As before, the younger participants utilized probability and payoff, whereas the older participants based their decisions only on probability information. The findings are discussed in terms of age differences in information‐processing capacity, metacognition, motivation, and goal‐setting.     

The significance of task significance: Job performance effects, relational mechanisms, and boundary conditions

Does task significance increase job performance? Correlational designs and confounded manipulations have prevented researchers from assessing the causal impact of task significance on job performance. To address this gap, 3 field experiments examined the performance effects, relational mechanisms, and boundary conditions of task significance. In Experiment 1, fundraising callers who received a task significance intervention increased their levels of job performance relative to callers in 2 other conditions and to their own prior performance. In Experiment 2, task significance increased the job dedication and helping behavior of lifeguards, and these effects were mediated by increases in perceptions of social impact and social worth. In Experiment 3, conscientiousness and prosocial values moderated the effects of task significance on the performance of new fundraising callers. The results provide fresh insights into the effects, relational mechanisms, and boundary conditions of task significance, offering noteworthy implications for theory, research, and practice on job design, social information processing, and work motivation and performance.     

An evaluation of the effectiveness of a telephone counseling center

Three-thousand questionnaires were distributed to students on campus to identify a sample of actual telephone counseling center users and their ratings of the effectiveness of the help received and of the counselor. Ratings of help received and impact of counseling on life as it is today were considered for sex of caller and counselor across type of problem. A sample of 66 actual callers was identified who had used the service for personal problems at least once. Of male callers, 67% reported that telephone counseling helped at least somewhat, while 80% of female callers reported favorable results of telephone counseling. Female callers who talked with male counselors reported a significantly greater impact on their life than did the callers in any other caller/counselor sex interaction. Only one average rating of counseling effectiveness by problem type fell below the neutral rating. Results are presented as evidence for the effectiveness of paraprofessional counselors.     

Daily stressors and memory failures in a naturalistic setting: findings from the VA Normative Aging Study

Laboratory studies of stress and memory have generally found that people with more stress tend to have poorer cognitive performance. The present investigation examined the relationship between stressors and memory failures in a naturalistic setting via a daily diary study of 333 older adults in the VA Normative Aging Study. Multilevel models indicated that on days when people experienced stressors, particularly interpersonal stressors, they were more likely to report memory failures. These stressors were also associated with an increase in memory failures from one day to the next. The findings may be important for preventions to mitigate age-related cognitive decline.     

Both Risk and Reward are Processed Differently in Decisions Made Under Stress

Years of research show that stress influences cognition. Most of this research has focused on how stress affects memory and the hippocampus. However, stress impacts other regions involved in cognitive and emotional processing, including the prefrontal cortex, striatum, and insula. New research examining how stress affects decision processes reveals two consistent findings. First, acute stress enhances selection of previously rewarding outcomes but impairs selection of previously negative outcomes, possibly due to stress-induced changes in dopamine in reward-processing brain regions. Second, stress amplifies gender differences in strategies during risky decisions, with males taking more risk and females less risk under stress. These gender differences in behavior are associated with differences in activity in the insula and dorsal striatum, brain regions involved in computing risk and preparing to take action.     

Demythologizing the emotions: adaptation,cognition, and visceral representations of emotion in the nervous system

This article highlights four issues about the neurobiology of emotions: adaptation vs. dysfunction, peripheral and central representations of emotion, the regulation of the internal milieu, and whether emotions are cognitive. It is argued that the emotions evolved to play diverse adaptive roles and are biologically vital sources of information processing. They were not designed as pieces of pathology, though they certainly can underlie some psychophathologies. Emotions are, in part, appraisal systems that are operative at numerous level of the nervous system from the brainstem to the cortex. Like other information processing systems they are not perfect cognitive systems. Emotional systems often utilize somatic and visceral information for appraisals of events to facilitate decisions of whether to approach or avoid objects. The neural systems of emotions traverse the entire neural axis and are linked to the regulation of the internal milieu. Thus, in addition to the experiential aspects of emotions, emotions embody appraisal systems that are pervasive to all levels of the brain to facilitate function, adaptation, and survival.     

Effects of traumatic stress and perceived stress on everyday cognitive functioning

Stressful or traumatic events have been shown to impair cognitive functioning on laboratory-based tasks due to stress-related intrusive thoughts and avoidance. However, research on the effects of stress on everyday cognitive functioning has been lacking. A sample of 909 undergraduates completed measures of perceived stress, PTSD symptoms, and everyday cognitive failures. The results revealed that both perceived stress and PTSD symptoms uniquely predicted cognitive failures, even after controlling for a number of potentially confounding variables. Additionally, there was a significant interaction. Participants with low scores on both measures of stress reported the fewest occurrences of everyday cognitive failures. In contrast, participants with elevated scores on either measure of stress reported higher levels of cognitive failures. These results suggest that there are unique negative effects of perceived stress and PTSD symptoms on everyday cognitive functioning and sharpen our understanding of the relationship between stress and cognition.     

Effects of traumatic stress and perceived stress on everyday cognitive functioning

Stressful or traumatic events have been shown to impair cognitive functioning on laboratory-based tasks due to stress-related intrusive thoughts and avoidance. However, research on the effects of stress on everyday cognitive functioning has been lacking. A sample of 909 undergraduates completed measures of perceived stress, PTSD symptoms, and everyday cognitive failures. The results revealed that both perceived stress and PTSD symptoms uniquely predicted cognitive failures, even after controlling for a number of potentially confounding variables. Additionally, there was a significant interaction. Participants with low scores on both measures of stress reported the fewest occurrences of everyday cognitive failures. In contrast, participants with elevated scores on either measure of stress reported higher levels of cognitive failures. These results suggest that there are unique negative effects of perceived stress and PTSD symptoms on everyday cognitive functioning and sharpen our understanding of the relationship between stress and cognition.     

Ambiguity Attitudes over Time

Previous research demonstrates that individuals exhibit a stronger level of ambiguity aversion for high probabilities than for low probabilities. Given that risky and ambiguous prospects are often unresolved until a future date (e.g., investment decisions, new product launches, and medical interventions), this study examines the impact of time on ambiguity preferences at different probability levels. Our experimental results indicate that although ambiguity preferences for low‐probability events remain constant, a robust effect of time occurs for high‐probability events. More specifically, temporal distance mitigates ambiguity aversion. This effect is consistent for different elicitation methods (preference rating and probability–ambiguity trade‐off tasks). We propose a dual‐process model (affective versus cognitive processing styles) to explain our results. Affective processing for high‐probability lotteries resolved in the current period increases ambiguity aversion, while cognitive processing leads to less ambiguity‐averse choices for future lotteries. Copyright © 2015 John Wiley & Sons, Ltd.     

Social problem‐solving,perceived stress,depression and life‐satisfaction in patients suffering from tension type and migraine headaches

This study aimed at investigating social problem solving, perceived stress, depression, and life‐satisfaction in patients with tension type and migraine headaches. Forty‐nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self‐report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T‐tests, chi‐square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life‐satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life‐satisfaction in patients suffering from primary headache.     

Coping strategies in the workplace: Relationships with attributional style and job satisfaction

This paper examined the relationships between workplace coping strategies, occupational attributional style, and job satisfaction among a sample of 190 nurses employed with a Veterans Affairs Medical Center. As an occupational group, nurses experience high levels of chronic workplace stressors. Participants completed a questionnaire packet containing the Brief COPE, the Minnesota Satisfaction Questionnaire (MSQ)-Short Form, and the Occupational Attributional Styles Questionnaire (OASQ). Results indicated that a positive occupational attributional style was associated with greater use of problem solving/cognitive restructuring coping styles and less use of avoidance coping styles to deal with workplace stress. This pattern of coping strategies was also associated with greater job satisfaction. Further analyses indicated that the relationship between occupational attributional style and job satisfaction was mediated by the use of problem solving/cognitive restructuring, and avoidance coping strategies to deal with workplace stress. Implications for workplace interventions and work adjustment counseling are discussed.     

Factors Influencing Level of Stress During the Nursing Home Decision Process

This investigation examined whether characteristics of elders and their caregivers and facets of the nursing home decision-making context were associated with recalled levels of stress during nursing home decision-making. Employing a conceptual framework based upon the literature on caregiver stress and nursing home decision-making, we considered a number of factors that might influence sponsors' stress as decisions were being made about nursing home placements. We examined data from telephone interviews with a sample of 142 sponsors (responsible parties) of first-time, recently admitted nursing home residents. Higher levels of reported stress were directly associated with more factors triggering the decision to admit, higher levels of competing demands, and limited time. Employment was indirectly related to higher stress through its impact on demands. Hospitalization and being the spouse or an adult child of the resident were indirectly related to stress because they were associated with limited available time. The results offer some insights into the types of individuals who may be vulnerable to higher levels of stress and the kinds of interventions that might avert high stress in the nursing home decision process.     

Neuropsychological impairment in Parkinson's disease without dementia

Cognitive dysfunction in Parkinson's Disease (PD) has been consistently reported, but little is known about cognitive impairment in PD patients without dementia, and its association with clinical characteristics, neuropsychiatric disturbance and functional activities. Therefore, we evaluated 52 non-demented PD patients, 22 of them with mild cognitive impairment (PD-MCI) who were matched with 52 healthy controls. Our results confirm the existence of dysfunction in information processing speed, executive function, verbal memory and visuo-perceptual processing in PD. On the other hand, PD-MCI was associated with advanced age at the onset of PD, more neuropsychiatric symptoms, caregiver stress and functional problems. The study supports the hypothesis that specific neuropsychological impairments may act as modulators of functional impairment in PD, for instance slowness of information processing.     

Cognitive factors in the explanation of the mismatch between confidence and competence in performing basic life support

Abstract

The main approach to rectifying the well documented poor basic life support (BLS) skills of doctors and nurses, based on a Skills Model, has met with only partial success. This study compares the utility of a Skills Model with one that incorporates a cognitive component in predicting BLS skills. Outcome-expectancy, self-efficacy, training and experience of BLS, and BLS ability were assessed in 53 trained nurses. Ability was unrelated to training or experience of BLS. Nurses who scored highest on the BLS skills assessment perceived the procedure as significantly more successful than those with lower scores. Self-efficacy was unrelated to ability, but was related to status: senior nurses were significantly more confident but no more competent in performing BLS than junior nurses. Nurses who had attended more arrests, while more confident, were no more competent than those who had attended fewer. Assessment of BLS skills reduced self-efficacy beliefs. A model for predicting the relationship between self-assessed ability and objectively assessed skill is outlined.     

The Interactive Effects of Race,Gender, and Job Type on Job Suitability Ratings and Selection Decisions1

The present study examined the main and interactive effects of race, gender, and job type on job suitability ratings and selection decisions. Consistent with the double‐advantage additive effects model of race and gender, highly educated Black women were rated as more suitable for jobs and more likely to be selected for jobs requiring high levels of cognitive ability than were comparably educated White men, White women, or Black men. These results suggest that selection decisions might be jointly determined by race, gender, and the nature of a job. The implications of these findings for overcoming biases in employment‐related decision making are discussed.