The Epidemiology of Life-Threatening Events*

ABSTRACT: This paper explores the epidemiology and impact (both short- and long-term) of acute life-threatening experiences among a youthful population. Interviews were conducted with 649 individuals between the ages of 13 and 30. Thirty-four percent of these respondents reported a total of 290 analyzable, subjectively perceived death confrontation experiences. An estimate of over 2 1/2 million living ex-suicide attempters, under age 30, was derived, and suicide was found to be a significantly unique form of death confrontation. In contrast to earlier work, panic and fear were found significantly to describe the majority of impacts reported, while avoidance appears to be the modal long-term effect. Differential impacts and effects are reported by mode of event, and results are discussed in relation to their impact for crisis counseling.     

Even More About Exercise Imagery: A Grounded Theory of Exercise Imagery

Abstract

It is hypothesized that perceived team performance in competition can be analyzed in terms of event expectancy (expected, unexpected event), direction of lead (one's own team, opposing team) and momentum (positive, negative). These three variables determine “game standings”. The purpose of this study was to investigate the perceived relative contribution of these variables to extreme psychological arousal states (crisis, noncrisis). Forty-five elite team handball experts responded to a questionnaire in which they were asked to estimate the occurrence probability of all possible “game standings” under crisis and noncrisis conditions, according to the Bayesian approach. An ANOVA procedure revealed that under the crisis condition, negative momentum, unexpected event, and lead by opposing team were rated as more probable, whereas positive momentum, expected event, and lead of one's own team were judged to more likely occur under the noncrisis condition. Moreover, the athlete's psychological stale (Crisis, noncrisis) was judged to be more strongly related to momentum than to event expectancy and direction of lead. The results are discussed in reference to concepts such as self-efficacy and psychological performance crisis in competition.     

Precipitating events in adolescent suicidal crises: exploring stress-reactive and nonreactive risk profiles

Factors distinguishing adolescents who experienced a precipitating event in the week preceding a suicidal crisis from those who did not were examined. Among 130 suicidal inpatients (mean age = 15.01 years), those who experienced a precipitating event reported significantly lower depressive symptom scores, better perceived problem solving, less suicidal intent, and a lower rate of prior suicide attempts than those without a precipitating event. Levels of trait impulsivity, suicidal ideation, and current attempt status did not differentiate groups. Findings provide preliminary evidence consistent with at least two possible pathways to a suicidal crisis. Clinical implications and future directions are discussed.     

Martin Buber's relevance to institutional mental health care

A Buberian perspective on problems related to the establishment of therapeutic environments on mental hospital wards is offered. Depersonalization and over-reliance on a medical treatment orientation in human relationships are identified as central problem areas in mental hospitals. The therapeutic community is identified as a major alternative model to respond to these problem areas. Difficulties in applying the therapeutic community model are identified. Buber's social philosophy, especially his interpretations of spiritual crisis, cultural crisis, structural renewal, and genuine dialogue, are identified as useful tools to clarify and resolve those difficulties.     

The Kurt Cobain Suicide Crisis: Perspectives from Research,Public Health,and the News Media

The suicide of rock star Kurt Cobain in 1994 raised immediate concerns among suicidologists and the public at large about the potential for his death to spark copycat suicides, especially among vulnerable youth. The Seattle community, where Cobain lived and died, was especially affected by his sudden death. An overview of Cobain's life and death is presented and various crisis center and community-based interventions that occurred are discussed. Preliminary data collected from the Seattle Medical Examiner's Office and from the Seattle Crisis Center to assess the potential impact of Cobain's death on completed suicides and the incidence of suicide crisis calls are presented. The data obtained from the Seattle King County area suggest that the expected “Werther effect” apparently did not occur, but there was a significant increase in suicide crisis calls following his death. It is hypothesized that the lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain's suicide, and the crisis center and community outreach interventions that occurred. The Cobain suicide and the role of media influence on copycat suicides are further discussed in commentaries from public health and news media perspectives.     

Recognizing and responding to a suicide crisis.

Data from therapists who were treating 26 patients when they committed suicide were utilized to identify signs that warned of a suicide crisis. Three factors were identified as markers of the suicide crisis: a precipitating event; one or more intense affective states other than depression; and at least one of three behavioral patterns: speech or actions suggesting suicide, deterioration in social or occupational functioning, and increased substance abuse. Problems in communication between patient and therapist were identified as factors interfering with crisis recognition. Evaluation of the identified affects and behaviors may help therapists recognize a suicide crisis.     

Death anxiety and counseling skill in the suicide interventionist

In light of recent evidence that suicide intervention workers may experience greater fear of death than the general population, the present study examined the death anxiety of interventionists and its relation to skill in responding to suicidal clients. A sample of 109 suicide prevention workers from three independent crisis centers were administered the Death Anxiety Scale (Templer, 1970) and the Suicide Intervention Response Inventory (Neimeyer & MacInnes, 1981). Compared to 109 matched controls, the interventionists were found to have significantly lower death anxiety, thereby reversing the earlier finding. Moreover, no linear or curvilinear relationship between death anxiety and suicide counseling skill could be identified. Together, these results give some justification to the traditional neglect of death concern as a factor in screening or training crisis intervention personnel.     

A Philosophical Analysis of the Concept of Crisis

In our times, philosophy has been suffering from a spiritual crisis that takes the forms of the crisis of culture, the crisis of meaning, and the crisis of way of life. As the soul of culture, philosophy should contribute valuable responses to the problems of our times. Thus understood, this paper intends to analyze the concept of crisis in a phenomenological approach. The concept of crisis is concerned with the philosophical themes of time and death, and the crises of our times are primarily the crises of life-meaning and the life-world. Drawing sources from Husserl and other phenomenologists, as well as experiences from Chinese culture, I argue that a philosophy of crisis should find its point of departure from the crisis of philosophy.     

CREATED CO-CREATOR AND THE PRACTICE OF MEDICINE

Abstract There is a crisis of interpretation experienced by those making critical‐care decisions and creating health‐care policies and by the patients and families who make life‐and‐death decisions. For example, at both the beginning and end of life, new technologies are changing the way we define life and death. We can prolong life or hasten death in ways that we could not earlier have imagined. This crisis of interpretation demands new ways of thinking and doing. My task is to explicate how the created co‐creator can be used as a springboard to help link theological concepts with feminist concerns about two issues: interpreting the culture and practice of medicine in a new way, and explicating the ambiguity of decision making when considering issues of life and death.     

The Preparedness and Reactions of Citizens to Warnings and Crisis Relocation for Nuclear Attack1

A total of 200 residents of Columbus, Ohio, were questioned over the telephone about their knowledge of U.S. and Soviet crisis relocation plans, their feelings about chances of surviving nuclear attack, and their behavioral intentions in the event of an evacuation. Few respondents displayed knowledge of the existence or substance of crisis relocation plans. Most gauged survival rates in the event of a nuclear attack as substantially higher with an evacuation plan than without one, but in both cases expectations were that fewer than 50% of the population would survive. While most respondents stated they would follow evacuation procedures, evidence of possible noncompliance was found.     

The Invisible Griever

Many people are equipped, through crisis intervention strategies and plans, to handle the immediate ramifications of a death within a particular school or community system. However, after the crisis has passed the question generally surfaces as to how one can help the children who have been greatly impacted by the death and are in the midst of the grieving process. The grieving child has often been invisible to adult caregivers like counselors, teachers, and school psychologist. The means of helping a child who has experienced a death in his family can be greatly enhanced by the developmcnt of grief support groups. Through the use of support groups children can learn to share their feelings, discover that they are not alone, and move through the grieve process.     

Undesirable life-events and depression in young adolescents

We compared the relationship between individual undesirable life-events and comprehensive life-event factors, as well as major depression in adolescents. Students in four public suburban middle schools were screened for depressive symptomatology and life-events by a self-administered questionnaire. Seven of 21 individual events (parents' divorce, parental job loss, problems between parents, problems between the adolescent and his/her parents, failing a grade in school, school suspension, death of a close friend) and three of six life-event factors (conflict/disappointment, marital discord, maladjustment) were significantly related to depression in univariate models. A multivariate examination of the individual events was difficult to interpret, but examination of the event factors found maladjustment and conflict/disappointment significant. Analyses using the undesirable life-event factors provided a clearer picture of the relationships investigated by grouping related events into a more manageable number of independent categories. Specific combinations of life-events suggest stronger associations with adolescent depression than others. Clinicians may identify youths at risk for depression when specific combinations of undesirable life-events occur.     

How a crisis mindset activates implicit knowledge and brings it into awareness: The role of attentional switch cost

In this study, we relied on the attentional switch cost to ascertain whether a crisis mindset can activate and momentarily bring related implicit knowledge into awareness. We found that the attentional switch cost was higher in a crisis mindset condition than in a common mindset condition in which non-crisis-related stimuli were being attended to (Experiment 1). However, the attentional switch cost was lower in the crisis mindset condition when crisis-related stimuli were being attended to (Experiment 2A), and the reduced cost was not attributable to the complexity of the stimuli (Experiment 2B). A link emerged in the crisis mindset condition between the attentional switch cost and related implicit knowledge (Experiment 3A and 3B). Potential confounding factors were adequately controlled (see the Appendix). In conclusion, the results offer insight into the pivotal role of a crisis mindset. This finding delineates an alternative pathway in which implicit knowledge can be activated and brought into working memory once an event is perceived and interpreted as a crisis.     

Levels of Meaning in Family Stress Theory

Major stressful life events, particularly those that have chronic hardships, create a crisis for families that often leads to reorganization in the family's style of functioning. A major factor in this reorganization is the meaning the family gives to the stressful event. Often the meaning extends beyond the event itself and leads to a changed view of the family system and even to a changed view of the world. Building on other family stress models, we elaborate the family's definition of the stressor into three levels of family meanings: (1) situational meanings, (2) family identity, and (3) family world view. Examples from clinical work and studies of families adapting to chronic illness are used to illustrate the relationship between these three levels of meaning, particularly as they change in response to crisis. Implications for clinical and empirical work are discussed.     

Michel de Certeau's keys of political discernment in May 1968: The theological-spiritual assumptions that informed his tools of analysis

This article seeks to identify the theoretical tools that supported Michel de Certeau's political discernment during the crisis of May 1968 in France. De Certeau's ability to elucidate the novelty and complexity of this event is linked to the intertwining of his experiences as a historian, traveller (voyageur), and Christian (specifically a Jesuit). De Certeau's articulation of a 'theology of difference' allowed him to construct the intellectual and spiritual tools that enabled a lucid discernment of May 1968. Through this theology, derived from negative theology, de Certeau made the experience of faith operative at a moment of cultural crisis. The article also analyses possibilities involved in the ‘rupture’, that is, the fracture that is implied in modernity; in the notion of an event that highlights the deficiency of language, its incapacity to establish ‘a truthful communication’ in society; and the recognition of the poetic dimension of speech, which is capable of interweaving speech and action. The May 1968 event invites these elements mutually to redefine themselves.     

样例在理解时间相关事件中的作用

该文的两个实验探讨了人们理解自己和熟悉的人物日常惯例事件的方式。实验1在中文条件下验证了Coleombe等（2002）的研究,即人们不利用已经形成的原型去理解和袁征自己或熟悉人物的日常惯例事件;实验2证明了出现这一结果是因为人们在理解这些事件时利用了过去生活中与当前描述相同的具体样例。实验2还发现,即使不存在上述样例,被试仍然没有启用相关的原型。     

Selective perception of events

Two hundred and twelve subjects were given one of two interpretive sets prior to viewing an event. Following observation, the first interpretation was discredited, and subjects were asked to interpret the event they had seen under the contrasting set. Some subjects were only provided with the alternate interpretation, while others were also given an opportunity to view the event a second time. Both the perceptual segmentation and the subjects' impressions of the participants in the event were assessed. Results disclosed that (1) the two sets produced both differing perceptual organization and differing impressions of the participants; (2) reversing the sets produced a reversal of the impressions of the participants only when accompanied by a second viewing; and (3) the reversal of the impressions was accompanied by a shift in the perceptual organization of the event. It was concluded that observers may differ in their initial perception of an event as the result of differences in prior expectations, and that the resulting biased sample of information they acquire may limit their retrospective reinterpretation of the event.     

Les pratiques professionnelles au cœur de la crise dans la gestion de l’urgent : l’exemple de la crise du COVID-19

Our organisations have been severely shaken by the COVID-19 pandemic and the world of work has not been spared. Only essential activities continued in order to maintain a minimum level of functioning, just like in hospitals or in local authorities. During the first five months of the crisis in 2020 (from March to July), 34 interviews were conducted in these two public service entities in order to examine the management of urgent matters in the light of “activity” and at the heart of the crisis. The results show that while the emergency is mainly managed by an improvisation activity based on the intuition of the actors in the field, the crisis is managed by governance in a rational manner leading to the drafting of procedures after the event. This crisis situation pushed organisations to reconfigure themselves in an emergency, allowing the development of new professional practices. The strategies of damage control and proceduralization will be discussed. Perspectives are opened on the questions of training for these crisis situations against a background of developing presumption of ignorance.     

The death of a parent: Its impact on middle-aged sons and daughters

Coming to terms with finitude is the central task of mid-life. The death of a parent of middle-aged sons and daughters intensifies that crisis in three ways: being without a parent is like being a middle-aged orphan; the death of one or both parents may finally make autonomy possible; when the last parent dies, death seems closer because the buffer is gone. Pastoral theological implications of this thesis are explored.     

Infertility as boundary ambiguity: one theoretical perspective

Infertility as a life event can be understood from a number of conceptual perspectives: a developmental crisis, a grief reaction, a disruption of marital contracts and roles, a crisis of identity, sexuality, and/or values, or a challenge of decision-making processes. Stress theory and the construct of boundary ambiguity can augment the understanding of the crisis of infertility by providing a different approach and unique perspective. It is the hypothesis of this article that the involuntarily childless couple may experience infertility as a stress of boundary ambiguity, that is, not knowing who is in and who is out of the family system. As infertile couples attempt to make the transition to parenthood they may experience the child they wish to have as a family member who is psychologically present but physically absent.