Attitudes Toward the Body in Suicidal,Depressed, and Normal Adolescents

Our purpose was to investigate the hypothesis that suicidal adolescents, compared with depressed nonsuicidal and nonsuicidal normal adolescents, display a more negative attitude toward their bodies. Scales for suicidal tendencies, dissociative tendencies, perception of actual versus ideal body features, and feelings toward the body were administered to the subjects. The suicidal subjects showed a larger perceived discrepancy between actual versus ideal body features and a more negative feeling toward the body, and scored higher on some aspects of dissociation than the normal group. The suicidal group also displayed more negative feelings toward the body and scored higher on some aspects of dissociation than the depressed group. A series of correlations showed that the higher the suicidal tendency, the higher the dissociation, the larger the discrepancy, and the stronger the negative feelings toward the body. The findings were explained as reflecting unique characteristics of suicidal individuals that develop from early trauma and sadomasochistic relationships. These characteristics may facilitate suicidal behavior.     

The association between adolescents' attitudes toward suicide and their psychosocial background and suicidal tendencies.

The present study examined the relationship between adolescents' attitudes toward suicide and their psychosocial background. It also evaluated the association between attitudes toward suicide and the subjects' own suicidal tendencies. A questionnaire assessing these issues was administered to 525 Israeli adolescents. Results indicated that significantly more females, nonreligious adolescents, those exposed to suicidal behavior, and those with increased suicidal risk held more accepting attitudes. Ethnic origin, socioeconomic status, and living in intact/nonintact families were not associated with adolescents' attitudes toward suicide.     

Reported childhood trauma and suicide attempts in schizophrenic patients

Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire (CTQ). It was found that schizophrenics who had attempted suicide reported significantly higher CTQ scores for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect than schizophrenics who had never attempted suicide. Therefore, childhood trauma may be a risk factor predisposing schizophrenic patients to attempt suicide.     

The effects of individualistic‐collectivistic value orientations on non‐fatal suicidal behavior and attitudes in Turkish adolescents and young adults

This study aimed at investigating the effects of individualistic‐collectivistic value orientations on non‐fatal suicidal behavior and attitudes in Turkish adolescents and young adults. A questionnaire containing measures of individualism, collectivism (INDCOL), non‐fatal suicidal behaviors and suicidal attitudes was used to collect the data. The results showed that both suicidal ideation and attempts were significantly more frequent in participants classified as individualist than those who were classified as collectivist on the basis of INDCOL scale scores. Participants with individualistic tendencies displayed more permissive attitudes toward suicide than those with collectivistic tendencies but collectivists believed to a greater extent than the individualists that people should communicate suicidal problems to others. Participants with collectivistic tendencies showed more accepting and helping reactions to an imagined suicidal friend than those with individualistic tendencies. Suicidal ideation and attempts were more common among adolescents than young adults. The findings suggest that individualistic and collectivistic value orientations and developmental status specific stressors play a role in the distribution of nonfatal suicidal behavior and the nature of suicidal attitudes.     

Body attitudes and body experiences in suicidal adolescents

The relationships between cognitive and affective attitudes toward the body, body experiences (dissociation, insensitivity, and lack of control), and suicidal tendencies were examined as a derivative of the hypothesis that bodily attitudes and experiences may facilitate suicidal acting out. Three groups of adolescents (aged 14-18), including suicidal (made a suicide attempt) and nonsuicidal inpatients and controls, were compared with regard to suicidal tendencies, various body aspects, and depression and anxiety. A series of MANOVAs, discriminant analysis, Pearson correlations, and regressions were employed. The results show that the suicidal group differed from the two nonsuicidal groups in feelings toward the body, body protection, and body dissociation. Some aspects of bodily measures discriminated between suicidal and nonsuicidal subjects. In addition, various bodily measures were associated with and statistically predicted suicidal tendencies. The discussion focuses on the web of associations between body attitudes and experiences and their role in suicidal behavior.     

Religiosity,Meaning in Life and Suicidal Tendency Among Jews

The study examines the impact that meaning in life, or lack thereof, has on suicidal tendencies among youth, as well as the nexus between level of religiosity, meaning in life and suicidal tendencies. Subjects were 450 students from both Jewish religious and Jewish secular schools aged 15–18. Findings: a significant and negative correlation was found between a sense of meaning in life and suicidal tendencies, beyond gender or level of religiosity. In addition, no difference was found in level of suicidal tendency between Jewish religious and Jewish secular youth; however, among Jewish religious teens, a lower level of depression was reported in comparison with their secular peers. The study therefore concludes that meaning in life is the dominant variable in minimizing suicidal tendencies among youth. The results of this study may promote the establishment of prevention, intervention and therapy plans, especially in the age range that is crucial for suicide. Such programs should be based upon finding meaning in life.     

Revisiting the association of aggression and suicidal behavior in schizophrenic inpatients

Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n = 186) with other diagnoses and to schizophrenic non-attempters regarding aggression. Logistic regression analysis was performed to explore risk factors for attempted suicide. Schizophrenic suicides/suicide attempters did not differ from other suicides/suicide attempters or from schizophrenic non-attempters with regard to aggression. Risk of inpatient suicide attempt was increased for patients with attempted suicide at admission, high school graduation, and disorganized subtype. Aggression could not be found to be a predictor of attempted suicide. Aggression seems to have a minor role for suicidal behavior in schizophrenia.     

Psychosis and functioning as risk factors for later suicidal activity among schizophrenia and schizoaffective patients: a disease-based interactive model.

The present research explores the relationship of positive symptoms, negative symptoms, and posthospital functioning to subsequent suicidal behavior over a 7 1/2-year period, and examines whether these patterns vary with diagnosis. The results support a multifactor model of suicide risk. Both psychosis and poor functioning show some relationship to later suicidal activity for both schizophrenic and schizoaffective patients. Psychosis may remain a risk factor for suicidal activity for schizoaffective patients, even when functioning is partialed out. This is in contrast to the schizophrenia patients, for whom funtioning seems to mediate the effects of psychosis on later suicidality. In general, adequacy of overall posthospital functioning mediates the effects of some risk factors on suicidal activity within different diagnostic groups.     

Dissociation,Physical Pain,and Suicide: A Hypothesis

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self-harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.     

Schizophrenia--a high-risk factor for suicide: clues to risk reduction.

Suicide is the chief cause of premature death among schizophrenic persons. The lifetime incidence of suicide for patients with schizophrenia is 10% to 13% compared to a general population estimate of about 1%, and is quite close to that observed among those with major affective disorder. The magnitude of increased risk for suicide among schizophrenics peaks before middle age and declines thereafter, although schizophrenic persons tend to be at increased risk throughout the life span. Among psychiatric patients, schizophrenics are overrepresented among suicides, and often schizophrenics constitute the majority of inpatient suicides. It is important in evaluating suicide risk among schizophrenic persons to assess depression and suicidal ideation especially during index admission and during acute phases of the illness. It is noteworthy that schizophrenic persons often commit suicide as the overall level of psychopathology decreases during a nonpsychotic phase. Research has yielded salient risk factors for suicide in schizophrenic persons and "types" of especially vulnerable patients, even though statistical prediction of individual suicides has not proven effective.     

A Reexamination of the Color-Shading Rorschach Test Response and Suicide Attempts

This research adds support to a previous finding that the use of shading in colored areas of the Rorschach plates by hospitalized psychiatric patients is an indicator of suicidal tendencies. The color-shading response occurred significantly more often among patients who had attempted suicide than among those who had not attempted suicide. Speculations about psychological processes that may be involved in the color-shading determinant are offered.     

Similarities and Differences Between Younger and Older Suicidal People

More younger people attempt and more older people commit suicide, but the bulk of research and treatment activities, presumably by younger professionals, is devoted to the younger suicidal population. In this paper, both younger and older suicidal patients were compared for age differences, age similarities, and the relationships between generations. Examples are presented of the precipitants and family determinants that were most frequently associated with suicidal behavior, with a discussion of their theoretical and clinical implications. The precipitants were based upon developmental tasks and crises which differ with age, while the family determinants were similar at all ages. Families also played a major role in the origin, outcome, and healing of a suicidal state. To a great extent, the steps leading to a self-destructive episode occurred outside of awareness. The examples illustrated both the typical and the unusual experiences that take place during the treatment of suicidal individuals, often involving the therapist in emotional, dramatic, and moving situations.     

The ‘living dead’ — Survivors of torture and psychosis

Regardless of all differences between patients who have suffered from psychotic breakdowns and those with the sequelae of torture, our experience have shown that some common features can be recognized. We can attempt to understand patients' experience of being ‘living dead’ in terms of regression to the ‘psychotic core’ in the personality, and in terms of actualisation and enactment of archaic relations to primary objects. The major difference between thee two categories of patients deals with a located, limited, and concrete traumatic event in the life of the torture-survivor, whilst in the schizophrenic individual the trauma also emanates from within through own destructiveness and rage. Regressive forms of relations toward distorted, aggressively cathected and persecutory primary objects are reestablished in both cases, leading to a more or less stable reorganisation of the ego. Difficulties in psychotherapy with schizophrenic patients and torture-survivors are here discussed as a consequence of the patients' persistently holding onto the distorted and regressive forms of relating to primary objects, when the projections of the patients' own destructiveness and hate is followed by a strong tendency to symbiotic merging.     

Predicting Suicidal Tendencies Among High Risk Youth With the General Theory of Crime

This study examines whether suicidal tendencies among a group of juveniles who have come to the attention of Child Protective Services can be predicted by self-control theory. Using data from the National Survey of Child and Adolescent Well-Being, we find that self-control predicts suicidal tendencies. In addition, the effect of self-control remains significant even when controlling for the juveniles’ depression and previously reported suicidal thoughts and behaviors. This study lends further support to the claim that self-control serves as a general explanation for a wide range of problematic outcomes. In addition, these findings provide caseworkers with another tool for assessing the risk of suicide among high risk youth.     

STUDIES IN PERSONALITY. II

Experimentally determined fixation-ambivalence measures are related to some anxiety estimates obtained from a projective test in a group of male adolescents. It is shown that (i) fixation increases with increase in corporal injury anxiety when ambivalence is kept constant, (ii) ambivalence increases with increase in separation anxiety when fixation is kept constant, (iii) extremely hetero-fixated subjects show presence of intense guilt and absence of aggression towards the mother; one effect of this system of organizers seem to be suicidal tendencies, (iv) extremely ambivalent subjects have intense separation anxiety; one effect seems to be suicidal tendencies combined with high ambition and impaired cognitive capacity.     

The suicidal risk in severe personality disorders: differential diagnosis and treatment.

This article describes the clinical approach to patients with severe personality disorders who present suicidal intention and behavior, developed at the Personality Disorders Institute of the Department of Psychiatry at Cornell University Medical College and the Westchester Division of the New York Presbyterian Hospital. It describes the diagnostic evaluation of patients' suicidal potential, personality disorder, and the presence or absence of a spectrum of regressive illness. The analysis of the combined features in these three symptomatic domains determines alternative strategies of psychotherapeutic and psychopharmacological interventions. Within these strategies, transference-focused psychotherapy is described as a specific psychodynamic psychotherapy geared to treat characterologically based suicidal and parasuicidal tendencies in the context of the treatment of the patient's personality disorder.     

The subjective experience of problem irresolvability and suicidal behavior: dynamics and measurement.

This article presents the dynamics and measurement of a relatively unstudied concept in children's and adolescents' suicidal behavior: the subjective experience of problem irresolvability (SEPI). This concept relates to the youngsters' sense of lack of control due to being pressured to resolve irresolvable problems within the family circle. The first study describes the construction and factor analysis of the SEPI scale as well as its relationship to suicidal tendencies, perceived parental care, and self-esteem. The second study presents a repeated factor analysis and the association between the SEPI scale and suicidal tendencies, hopelessness, depression, anxiety, and commitment to parents. The results suggest that the scale has a 4-factor structure with sound psychometric properties that distinguish successfully between suicidal adolescents on the one hand, and psychiatric and normal adolescents on the other. The SEPI was also found to be associated with the various studied variables.     

Deficits of subliminal self-face processing in schizophrenia

Most studies show that self-processing in schizophrenia is impaired at the supraliminal level. Schizophrenic patients generally lack the ability to prioritize the processing of self-related information, such as their own face. However, some evidence suggests that schizophrenic patients may retain intact subliminal processing abilities even though their conscious experiences are compromised. We conducted the first study exploring schizophrenic patients’ subliminal self-face processing. Using a breaking continuous flash suppression (bCFS) paradigm, we interocularly suppressed face images (self, famous, and unknown faces). Participants’ reaction times to detect the faces when they broke the suppression were recorded as an index for the subliminal processing of faces. Unlike the healthy controls, schizophrenic patients did not demonstrate a processing advantage for their own face when it broke interocular suppression; only a face familiarity effect was found. These findings contribute to the understanding of self-processing deficits in schizophrenia.     

Internet message boards for suicidal people: a typology of users.

Clinical psychological discourse contains a varied array of evaluations of the risks and/or benefits of Internet message boards where people can discuss their suicidal thoughts. Public opinion contends they are harmful. To assess this assumption, an online questionnaire (N = 164) survey was conducted on a German message board for suicidal people. Three user types were identified with differing motives for visiting the forum and different usage effects of the message board. The results contradict the assumptions that suicide message boards are generally a source of potential harm and that they foster suicidal tendencies and point instead to their predominantly constructive or even suicide-preventive functions.     

The Shedler–Westen Assessment Procedure (SWAP): Making Personality Diagnosis Clinically Meaningful

A group of 38 severe anxiety patients and a group of 36 acute schizophrenic patients produced series of afterimages (AIs) of a simple, red stimulus. It was predicted that projective tendencies in these patients would be revealed by lack of stable congruence between AI color and stimulus. Symptoms of sensitivity together with results from the MCT (Meta-Contrast Technique) served as criteria in the anxiety group and symptoms of paranoia in the schizophrenic group. The hypothesis was affirmed: despite the unicolored stimulation, sensitive and paranoid subjects tended to report variegated A1s or A1s shifting from one color to another. It was concluded that, in case this plastic type of perception remains more or less permanent, it would serve as a fruitful breeding-ground for projective defenses.