Connect: an effective community-based youth suicide prevention program

Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in knowledge and attitudes about suicide, increased belief in the usefulness of mental health care, and reduction of stigma associated with seeking help. Adults' preparedness to help also increased significantly as did the likelihood that youth participants would seek adult assistance if they were concerned about a peer. Implications of findings are discussed.     

Motivations for preventing versus assisting suicide

The motivations of those seeking to prevent and assist suicide are conceptualized as defensive styles of repression versus sensitization adopted to deal with personal suicidal desires.     

Generating animal and tool names: an fMRI study of effective connectivity

The present fMRI study of semantic fluency for animal and tool names provides further evidence for category-specific brain activations, and reports task-related changes in effective connectivity among defined cerebral regions. Two partially segregated systems of functional integration were highlighted: the tool condition was associated with an enhancement of connectivity within left hemispheric regions, including the inferior prefrontal and premotor cortex, the inferior parietal lobule and the temporo-occipital junction; the animal condition was associated with greater coupling among left visual associative regions. These category-specific functional differences extend the evidence for anatomical specialization to lexical search tasks, and provide for the first time evidence of category-specific patterns of functional integration in word-retrieval.     

Storytelling: An enjoyable and effective therapeutic tool

Storytelling has great potential for stimulating insight and behavior change, particularly when client and clinician seem to have reached an impasse, as is frequently the case with adolescent clients. The storytelling process provides a viable alternative to the traditional therapeutic communication style in which the client is the only storyteller. It provides a means to circumvent client resistance and present new concepts and paradigms for healthy behavior. This paper provides a practical guide for the use of therapeutic metaphors and storytelling as an intervention technique, provides examples of successful interventions made through the storytelling process with both adolescent and adult clients, and outlines suggestions for the effective use of storytelling as a therapeutic tool.Joyce Divinyi, MS, a licensed professional counselor, is a consultant with The Wellness Connection, Peachtree City, Georgia, providing wellness education and mental health training programs and individual and family counseling services. She was formerly the executive director of a residential treatment program for adolescent girls. Reprint requests should be sent to the author at The Wellness Connection, 125 Highgreen Ridge, Peachtree City, GA 30269.     

It's a funny thing about suicide: a personal experience

In contrast to discussions about suicide from medical, psychiatric, psychological and other objectivist perspectives, this paper focuses vividly on its personal, subjective aspects. The complex role of suicidal rumination in the course of an intermittent but chronic depression is discussed, as are the importance of cognitive schema, interpersonal exacerbation, and failed diagnosis. A key feature of the paper is the central heuristic of a therapist disclosing and examining her own suicidality.     

Intentional infection with the AIDS virus as a means of suicide

This brief paper describes a case study in which a woman attempted to commit suicide by deliberately trying to become infected with HIV. A psychodynamic perspective is developed. A ‘death wish’ of this kind should be taken into consideration in evaluating health education and in the management of some suicidal people.     

Menstruation and suicide: an exploratory study

Previous research has reported mixed findings on the effect of the menstrual cycle on suicidal behavior. The contribution of menstruation to completed suicide is also controversial, though the studies are very limited and have not been carefully designed. To explore the relationship, 217 autopsies on completed suicides were performed, matched to a control group at the All India Institute of Medical Sciences in New Delhi. The results show that 54.46% of people who died by suicide were menstruating (results excluded pregnancies), compared to 6.75% of the control group. Menstruation in those who completed suicide, compared to a control group, appeared to have an association with suicide. More research is warranted.     

Six year follow-up of health status changes in Danish adults with suicide tendency in 1994

The purpose of this study was to determine whether suicidal ideation and/ or suicide attempts have any long-term health effects. The relationship between suicidal thoughts and/or a previous suicide attempt in 1994 and the presence of suicidal ideation in 2000 was analyzed. We found that health status in 1994 differed significantly between the groups with and without suicidal ideation or a previous suicide attempt and that the differences persisted or even deepened (not significant) after 6 years. Further, people who had suicidal ideation or a suicide attempt in 1994 had a significantly greater risk (OR = 7.4) of having suicidal ideation in 2000 than people who had not.     

Goal-directed imitation: the means to an end

The effects of goal-directed imitation and observational learning were examined whilst learning a goal-directed motor skill (three-ball cascade juggling). An observational learning (OL) group observed a model and a control (CON) group received minimal verbal instructions regarding how to hold and release the juggling balls. The OL group performed more juggling cycles across practice and retention than the CON group. In addition, the OL group's upper limb coordination and ball flight trajectory pattern were more similar to the model's movements than the CON group. These data show that when the to-be-learnt movement pattern and end-goal are not specified by the task's mechanical constraints, or can be achieved by modifying a pre-existing motor skill, individuals have difficulty learning on the basis of discovery processes alone. Under these circumstances, observational learning is effective because it conveys to the individual the specific means by which the end-goal can be achieved. These findings lead us to suggest that when the end-goal and the means to achieve the end-goal are directly linked, the means are given sufficient weight in the goal hierarchy such that the model's movement is imitated.     

Evidence for an emotion-cognition interaction in the statistical prediction of suicide attempts

Suicidal behavior is a prevalent problem among adolescents and young adults. Although most theoretical models of suicide suggest that this behavior results from the interaction of different risk factors, most prior studies have tested only bivariate associations between individual risk factors and suicidal behaviors. The current study was designed to address this limitation by testing the effect of an emotion–cognition interaction on suicide attempts among youth. Specifically, we hypothesized that the interaction of emotion reactivity and problem-solving skills would statistically predict the probability of a recent suicide attempt among 87 adolescents and young adults. Results revealed a significant interaction, such that emotion reactivity was strongly associated with the probability of a suicide attempt among those with poor problem-solving skills, moderately associated among those with average problem-solving skills, and not significantly associated among those with good problem-solving skills. The next generation of studies on suicidal behavior should continue to examine how risk factors interact to predict this dangerous outcome.     

Screening as an approach for adolescent suicide prevention

Among the provisions of the recently signed Garrett Lee Smith Memorial Act, Congress called for the use of screening to detect adolescents who are at risk for suicide. After a review of the literature, 17 studies involving screening instruments and programs were identified. We addressed the question: What do we know about the demonstrated effectiveness and safety of screening as a tool or program to prevent suicide among adolescents? While youth suicide screening programs offer the promise of improving identification for those who need treatment the most, further research is essential to understand how, when, where, and for whom screening programs can be used effectively and efficiently.     

Development of a tool to assess suicide risk factors in urban adolescents

Dramatic increases in the adolescent suicide rate over the past three decades have underscored the need for risk-assessment tools. The tools that do exist are oriented to older populations and their application to adolescents is questionable. A project was initiated at the University of Utah's Health Education Department to develop a pilot instrument to examine the differences between adolescents who have attempted suicide and other teenagers. Eighty-two subjects between the ages of 14 and 19 participated in the test of this instrument. Twenty-five subjects were identified by a physician or psychologist as having failed in a sincere suicide attempt within the previous 18 months. Fifty-seven nonsuicide attempters with similar demographic profiles served as a comparison group. An 86-item questionnaire was administered to both groups. Questions were generated from a review of the literature of the past three decades for problems associated with suicide in this population. Questions were sorted into three domains (family environment, social environment, and self-perceptions), with each domain having several subdomains. Statistical analysis revealed significant differences for each of the three domains and on 55 of 86 questions. The results were used to create a streamlined instrument for assessing suicide risk that can be administered in 20 minutes.     

Biblical narratives for positive psychology and suicide prevention: an evidence supported approach

Suicide is the ultimate outcome of a tragic view of life that is prevalent in ancient Greek writings. Indeed, over 16 suicides and self-mutilations can be found in the 26 surviving tragedies of Sophocles and Euripides. In contrast, only six suicides can be found in the Hebrew Scriptures, and only one suicide in the Christian Scriptures. In addition, the Hebrew Scriptures present numerous suicide-prevention narratives that are psychologically instructive. This paper examines evidence regarding seven risk factors for suicide and contrasts Greek and Biblical narratives to underscore the clinical and theoretical utility of the Biblical approach: (1) Feeling isolated and ignored; (2) Feeling one’s life is meaningless; (3) Feeling exiled from one’s home or homeland; (4) Feeling unable to be oneself with others; (5) Feeling alone in one’s life mission; (6) Feeling abandoned by one’s child; and (7) Feeling doomed by a dysfunctional family of origin.     

Examining a brief suicide screening tool in older adults engaging in risky alcohol use

Alcohol misuse increases risk of suicidal behavior in older adults. The Depressive Symptom Inventory‐Suicidality Subscale (DSI‐SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for older adults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061) of older adult outpatients to examine the scale’s measurement invariance and population heterogeneity and its relation to suicide attempt history. Analyses supported the equivalence of the DSI‐SS in risky and nonrisky drinkers. The DSI‐SS significantly predicted past suicide attempts. Findings support the viability of the DSI‐SS as suicide screening tool for older adults.     

Estimating the population of survivors of suicide: seeking an evidence base

Shneidman (1973) derived an estimate of six survivors for every suicide that, in the ensuing years, has become an assumed fact underlying public health messaging campaigns in support of suicide prevention and postvention programs worldwide, in spite of it lacking either empirical testing or validation. This report offers a first test designed to derive estimates of suicide survivors and raises an array of empirical questions needing further study to reasonably address the impact of suicide on others.