Attachment and Mother-Child Communication in Adjustment to the Death of a Father Among Cambodian Adolescents

This study examined quality of attachment to the mother and child-mother communication in adolescents' adjustment to the death of a father. Forty-eight Cambodian adolescents whose father had died within the previous 3 years completed a set of measures that included attachment, communication, grief, and self-esteem. Results showed that quality of attachment to the mother and whether the adolescent communicated with the mother about the father and found this to be helpful were positively related to adaptive grief and self-esteem. Moreover, support was shown for an indirect effect of quality of attachment to the mother on adaptive grief as mediated by communication. Implications of the findings for quality of attachment in adjustment to bereavement in a non-Western cultural context are discussed.     

Elevated suicide rates at high altitude: sociodemographic and health issues may be to blame

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low<1000m; middle=1000-1999m; high≥2000m). Of reported suicides, 5% were at high and 83% at low altitude, but unadjusted suicide rates per 100,000 population were higher at high (17.7) than at low (5.7) altitude. High and low altitude victims differed with respect to race, ethnicity, rural residence, intoxication, depressed mood preceding the suicide, firearm use and recent financial, job, legal, or interpersonal problems. Even after multivariate adjustment, there were significant differences in personal, mental health, and suicide characteristics among altitude groups. Compared to low altitude victims, high altitude victims had higher odds of having family or friends report of a depressed mood preceding the suicide (OR 1.78; 95%CI:1.46-2.17) and having a crisis within 2weeks before death (OR 2.00; 95%CI:1.63-1.46). Suicide victims at high and low altitudes differ significantly by multiple demographic, psychiatric, and suicide characteristics; these factors, rather than hypoxia or altitude itself, may explain increased suicide rates at high altitude.     

Youth Suicide Deaths: Investigation of Clinical Predictors in a Statewide Sample

Death by suicide is a significant cause of mortality among youth. However, there is limited information on the demographic and clinical factors associated with youth suicide deaths. The objective of this study was to link large statewide databases to describe demographic, clinical, and cause of death characteristics among youth who died by suicide. We examined 1,218 decedents under age 26 who died by suicie between 2000 and 2014. Eighteen died before age 12, 53 died between ages 12 and 14, 292 died between ages 15 and 18, and 855 died between ages 19 and 25. Most were male (83%), and firearm was most common cause of death; 28% previously attempted suicide, 31% had a mental health diagnosis, and 17% were prescribed psychotropic medication. Younger children died by hanging/smothering (89% of all 7‐ to 11‐year olds), and overdose/poisoning increased progressively with age. Adolescents had a higher proportion of females than young adults (23% vs. 14%, p  = .002). Combining data from the medical examiner and large hospital systems allows examination of youth suicide from a developmental perspective. Differences between age groups included gender, method, diagnosed mental illness, and diagnosis of attention deficit hyperactivity disorder. These data point to missed opportunities for effective interventions for specific developmental stages.     

Some Psychological Reflections on the Death of Malcolm Melville*

ABSTRACT: Malcolm Melville died on September 12, 1867, at age 18 from—to quote his death certificate—a “pistol shot wound in [his] right temporal region.” Contemporary designations of the mode of his death changed within hours from suicide, to accident, to death while of unsound mind. Historically, the mode of his death has remained equivocal. In order to approach this enigma a “psychological autopsy” of an equivocal death case as identical to Malcolm Melville's as was possible was conducted as though it were a genuine current “open” case at the Los Angeles Suicide Prevention Center in 1973. That procedure resulted in a near-unanimous judgment by the center staff that the most accurate certification of the death as described was “probable suicide,” which would then be certified as “suicide.” In this paper the assertion is made that Herman Melville himself had been a psychologically “battered child” and, in a way typical for battered children, psychologically battered his own children when it came his turn to be a parent. The further assertion is made that, for Malcolm, his father was suicidogenic; and established this penchant in Malcolm (through his neglect, active rejection, fearsomeness, and his fixed attention to his own writing—Redburn, White Jacke, and Moby Dick) within the first 2 years of Malcolm's life. For Malcolm, the psychological basis of his suicidal state was isolated desperation—a ubiquitous characteristic of most suicides. Malcolm had a deep unconscious feeling of not being wanted by his father; that it would be better if he were out of the way, dead. On the morning of his death, the choice for Malcolm was between the memory of his mother's kiss a few hours before and the terror of (and the need to protect himself against) his father's rage to come.     

A case control study of suicide and attempted suicide in older adults

Risk factors for serious suicidal behavior among older adults were examined in a case control study of 53 adults aged 55 and older who died by suicide or made medically serious suicide attempts and who were compared with 269 randomly selected comparison subjects. Multivariate analyses suggested that risk of serious suicidal behavior was elevated among those with current mood disorders (OR = 179, CI = 52.8-607.6), psychiatric hospital admission within the previous year (OR = 24.4, CI = 1.9-318.7), limited social network (OR = 4.5, CI = 1.4-14.6). The predominant role of mood disorders was confirmed by population attributable risk (PAR) estimates (73.6%), suggesting that the improved detection, treatment and management of mood disorders should be the primary focus of suicide prevention strategies for older adults.     

Outpatient health care utilization of suicide decedents in their last year of life

The characteristics of health care utilization during the last year of life by Taiwanese who died by suicide were analyzed. The degree of health services utilization was evaluated by extracting the data of National Health Insurance (NHI) outpatient cohort records in 2006. A total of 4,406 fatal suicide cases were matched with the 17,587,901 subjects in the NHI beneficiary registry file. Rate of visit of the suicide decedents for all NHI outpatient services during their last year before death was 85%, and that for mental disorders service only was 30.2%. Average number of visits per person-year of the suicide decedents was 24.5 visits per year, two times higher than that of the survivors. The average numbers of visits (ANV) of male suicide decedents who used the mental disorders services was increased 6.8 times compared to that for all survivors. The increase in female decedents, in contrast, was 2.7 times. The increase in ANV for 15-24 age group was 14.6 times, significantly higher than that for the other age groups (<4 times). Effective prediction or prevention of potential suicides through increased awareness and surveillance of medical care resource utilization is possible, especially for male and young adult patients under mental disorder health care.     

Adolescent Suicide Attempters: What Predicts Future Suicidal Acts?

Predictors for repetition of suicide attempts were evaluated among 92 adolescent suicide attempters 9 years after an index suicide attempt (90% females). Five were dead, two by suicide. Thirty-one (42%) of 73 had repeated a suicide attempt. In multiple Cox regression analysis, four factors had an independent predictive effect: comorbid disorders, hopelessness, having ever received treatment for mental or behavior problems, and having a father exerting control without affection. Prediction on an individual level was difficult. Since almost half repeated a suicidal act, the best strategy is to evaluate all adolescent suicide attempters thoroughly and provide treatment as needed.     

Does Marital Status Predict the Odds of Suicidal Death in Taiwan? A Seven‐Year Population‐Based Study

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds.     

Hospital-Treated Psychiatric Disorders in Adults with a Single-Parent and Two-Parent Family Background: A 28-Year Follow-up of the 1966 Northern Finland Birth Cohort

This study investigates the relationship between the family type (two-parent and 4 different single-parent types, mainly divorced) during childhood up to 14 years of age and adult hospital-treated psychiatric disorders in a sample from the unselected, general population Northern Finland 1966 Birth Cohort (N = 11,017). Up to the end of 1994, a total of 387 individuals (3.5%) had a hospital-treated psychiatric disorder, with 3.1% in two-parent families and 5.4% in single-parent families (p < .001). The single-parent family was not associated with the child's schizophrenia or other psychotic disorders. The adjusted odds ratios (OR) for personality disorders were highest among individuals without a father before the age of 14 years (OR 4.8), or at birth only (OR 4.0), or with a history of parental divorce (OR 2.8). Parental divorce was also associated with alcoholism (OR 3.7) and parental death with depressive disorders (OR 3.4). In conclusion, we found an elevated risk of hospital-treated nonpsychotic disorder among individuals from a single-parent family background. It is likely that a combination of the single-parent family and psychosocial and/or genetic risk may influence the development of these disorders.     

Life satisfaction trajectories among junior high school students in China: The role of parent–child communication

A 3-year follow-up test (from grades 7 to 9) was administered to 807 junior high school students from two regions in Hunan Province, China, using multilevel analysis to examine trends in junior high school students' life satisfaction, differences by gender and location of life and the effects of father–child/mother–child communication on the development of life satisfaction. The results showed that (1) Chinese junior high school students' life satisfaction showed a decreasing trend from the seventh grade to the ninth grade, and there was a significant decreasing process in the eighth grade; (2) father–child communication and mother–child communication had a significant positive predictive effect on Chinese junior high school students' life satisfaction and (3) father–child communication and mother–child communication had a significant negative predictive effect on the decreasing trend of life satisfaction, in which the effect of mother–child communication was particularly significant.     

Lives and deaths: Biographical notes on selections from the works of Edwin S. Shneidman

Edwin S. Shneidman (DOB: 1918-05-13; DOD: 2009-05-15) is a father of contemporary suicidology. His work reflects the intensive study of lives lived and deaths, especially suicides, and is the mirror to his mind. His contributions can be represented by five categories: psychological assessment, logic, Melville and Murray, suicide, and death. His works on suicide can be further divided into five parts: definitional and theoretical, suicide notes, administrative and programmatic, clinical and community, and psychological autopsy and postvention. In this article, not only are the selected works explicated, but also Dr. Shneidman's rather personal biographical notes are shared to allow the reader to understand one more unique individual's life lived, and his death: Edwin S. Shneidman.     

Self-defeating personality and memories of parents' child-rearing behavior: a replication

A recent study of correlations of self-defeating personality and memories of parents' child-rearing behaviour has been replicated on a larger sample. Non-clinical volunteers (145 women and 114 men) were administered Schill's Self-defeating Personality Scale and a short version of the EMBU-Egna Minnen Betr?ffande Uppfostran (own memories of parental education) scale. Replicating previous findings, memories of rejecting or nonsupportive parents were significantly correlated with scores for the Self-defeating Personality Scale for both women (rejecting mother, r = 24; supportive mother, r = -.29; rejecting father, r = .23; supportive father, r = -.36) and men (rejecting mother, r = 40; rejecting father, r = .41; supportive father, r = -.28). Memories of an overinvolved parent were significantly correlated with self-defeating personality scores only among men (mother: r = .41; father: r = .36) as in the original study.     

Early father's and mother's involvement and child's later educational outcomes

Background: Few studies have investigated the individual long‐term contributions that mothers and fathers make to their children's schooling. Aims: (1) To explore the role of early father involvement in children's later educational attainment independently of the role of early mother involvement and other confounds, (2) to investigate whether gender and family structure moderate the relationship between father's and mother's involvement and child's educational attainment, and (3) to explore whether the impact of father's involvement depends on the level of mother's involvement. Sample: The study used longitudinal data from the National Child Development Study. The initial sample were those 7,259 cohort members with valid data on mother involvement at age 7, father involvement at age 7, and school‐leaving qualification by age 20. Of those, 3,303 were included in the final analysis. Method: The measures were control variables, structural factors (family structure, sibship size and residential mobility), child factors (emotional/behavioural problems, cognitive ability and academic motivation), and father's and mother's involvement. Results: Father involvement and mother involvement at age 7 independently predicted educational attainment by age 20. The association between parents' involvement and educational attainment was not stronger for sons than for daughters. Father involvement was not more important for educational attainment when mother involvement was low rather than high. Not growing up in intact two‐parent family did not weaken the association between father's or mother's involvement and educational outcomes. Conclusion: Early father involvement can be another protective factor in counteracting risk conditions that might lead to later low attainment levels.     

双元孝道代际传递:亲子性别和子女年龄的调节作用

配对调查了591户家庭的亲子被试,考察了亲子女性别、子女年龄对双元孝道代际传递的影响。结果显示：（1）权威性孝道和互惠性孝道分别在父亲、母子与子女之间具有相似传递模式,但母亲互惠性孝道还能够预测子女权威性孝道;（2）子女性别能显著调节整个模型,母亲互惠性孝道能预测男性子女权威性孝道,但不能预测女性子女的权威性孝道,且母子之间互惠性孝道传递效应显著高于母女,并显著高于父子之间的同一路径系数;（3）子女年龄对模型的部分路径系数具有显著调节作用,母亲互惠性孝道仅能预测成年子女权威性孝道,母亲对成年子女的互惠性孝道代际传递效应显著高于父亲对成年子女,而父亲对青少年子女的互惠性孝道代际传递效应显著高于其对成年子女。据此研究结果,亲子性别和子女年龄是影响双元孝道代际传递的重要“传递带”。     

Parent–child relationships and offspring’s positive mental wellbeing from adolescence to early older age

We examined parent-child relationship quality and positive mental well-being using Medical Research Council National Survey of Health and Development data. Well-being was measured at ages 13–15 (teacher-rated happiness), 36 (life satisfaction), 43 (satisfaction with home and family life) and 60–64 years (Diener Satisfaction With Life scale and Warwick Edinburgh Mental Well-being scale). The Parental Bonding Instrument captured perceived care and control from the father and mother to age 16, recalled by study members at age 43. Greater well-being was seen for offspring with higher combined parental care and lower combined parental psychological control (p < 0.05 at all ages). Controlling for maternal care and paternal and maternal behavioural and psychological control, childhood social class, parental separation, mother’s neuroticism and study member’s personality, higher well-being was consistently related to paternal care. This suggests that both mother–child and father–child relationships may have short and long-term consequences for positive mental well-being.     

Father contributions to cortisol responses in infancy and toddlerhood

The current study is one of the first prospective examinations of longitudinal associations between observed father caregiving behaviors and child cortisol reactivity and regulation in response to emotional arousal. Observations of father and mother caregiving behaviors and child cortisol levels in response to challenges at 7 months and 24 months of child age were collected. Analyses were based on a subsample of children from the Family Life Project who lived with both their biological mothers and fathers and for whom there was at least partial cortisol data (7 months: n = 717; 24 months: n = 579). At the challenge conducted at 7 months of child age, 49.0% of the sample were girls; racial composition of the sample was 25.8% African American and 74.2% European American. At the challenge conducted at 24 months of child age 49.9% of the sample were girls; racial composition was 24.7% African American and 75.3% European American. We conducted analyses across assessment points simultaneously using mixed linear modeling for repeated measures data to test for differential effects of fathering across infancy and toddlerhood. Concurrent measures of father negativity were positively associated with greater increases in child cortisol levels in response to emotion challenge at 7 months (p = .01) and with higher overall levels of cortisol at 24 months (p < .001). However, there was no evidence that father caregiving during infancy independently predicted later cortisol activity during toddlerhood.     

Medical Conditions and Nearly Lethal Suicide Attempts

P hysical illness has been studied as a risk factor for suicidal behavior, but little is known about this relationship among younger persons. We conducted a population‐based, case‐control study in Houston, Texas, from November 1992 through September 1995. The final sample consisted of 153 case‐ and 513 control‐subjects aged 13 to 34 years. Case patients were identified at hospital emergency departments and met criteria for a nearly lethal suicide attempt. Control subjects were recruited via a random‐digit‐dial telephone survey. Case patients were more likely than controls to report having any serious medical conditions (crude OR = 3.23; 95% CI = 2.12–4.91). After controlling for age, race/ethnicity, alcoholism, depression, and hopelessness, the adjusted odds ratio for men was 4.76 (95% CI = 1.87–12.17), whereas the adjusted odds ratio for women was 1.60 (95% CI‐0.62–4.17), suggesting that young men with medical conditions are at increased risk for nearly lethal suicide attempts. Increased efforts to identify and appropriately refer these patients are needed.     

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.     

Comparison of Mothers', Fathers', and Teachers' Reports on Problem Behavior in 5- to 6-Year-Old Children

Evidence exists that there is low agreement between multiple informants reporting on children's and adolescents' behavior problems. Few studies, however, focus on agreement between informants in specific age groups. This study examined correspondence and disagreement between mother, father, and teacher reports of problem behavior by analyzing CBCL and TRF data of 2 nonclinical samples of 5- to 6-year-old preschool children (N = 424). Findings indicated that interrater agreement was low to moderate. This was shown by the intercorrelations, the explained variance in regression analyses and the little overlap in the number of children rated as behaviorally disturbed by all 3 informants. Agreement between mother and father reports was highest, whereas agreement between mother and teacher reports was lowest. Disagreement between informants was highest for internalizing problems. Potential explanations for the lack of agreement are discussed. Guidelines are formulated to refine assessment and optimize clinical decision-making processes.