The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Researach

Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness of preventive interventions, is practically unknown in suicidology. The study authors discuss the application of both concepts to suicide research and prevention, and review literature on the subject. Despite several methodological and conceptual limitations, both PAR and PF are valuable instruments to inform development and evaluation of suicide prevention programs.     

Coping with the exposure to torture

This paper describes approaches taken at the International Rehabilitation and Research Centre in Copenhagen to helping torture victims and their families cope with the exposure to and aftermath of torture.     

Signalling and incentive processes in instrumental reinforcer devaluation

We have previously reported that conditioning an aversion to the reinforcer using an isotonic lithium chloride (LiCl) solution following instrumental training reduces performance in a subsequent extinction test only if animals are re-exposed to the reinforcer prior to the test. Rescorla (1992), in contrast, reported an immediate devaluation effect using a hypertonic LiCl solution that did not depend upon re-exposure. In two experiments we examined the effect of using a hypertonic LiCl solution to condition the aversion to the reinforcer on subsequent instrumental performance in extinction, with and without re-exposure. In Experiment 1 thirsty rats were trained to press a lever for a sucrose solution before being injected with 0.6 M LiCl either immediately or after a delay. Half of the immediate and delay groups were then re-exposed to the sucrose in the absence of the lever, with the remainder being exposed to water. Contrary to the previously reported effects of isotonic LiCl, a hypertonic solution induced a reinforcer devaluation effect in all the immediately poisoned animals, which did not depend upon re-exposure to the reinforcer. In Experiment 2 the possibility that this devaluation effect was induced by the discomfort associated with the hypertonicity of the solution was assessed by replicating Experiment 1 but, in addition, using two immediately poisoned groups given the LiCl injection under anaesthesia. In the absence of anaesthesia, the devaluation effect observed without re-exposure to the reinforcer in Experiment 1 was replicated. When the injection was given under anaesthesia, however, a reinforcer devaluation effect was observed only in animals that were re-exposed to the reinforcer prior to the extinction test. These results were interpreted as evidence that a reinforcer devaluation effect induced by pairing the reinforcer with illness depends upon a process of incentive learning, whereas a devaluation effect mediated by learning a signalling relationship between the reinforcer and somatic discomfort does not.     

Personality characteristics of Divorce-Prone individuals: A preliminary clinical study

This study focuses on Divorce-Prone individuals and the question of why some persons fail in one marriage after another. The authors studied 12 individuals who had each been divorced two or more times. They found that the cases fell into one of three broad and overlapping groups. The groups have been called the Self-Involved Narcissists, the Compliant Depressed, and the Casualties of Life's Vicissitudes. The individuals and the groups demonstrate a different etiology, different treatment problems, and a very different prognosis.     

Family crisis intervention: fish or fowl?

This paper considers the status of family intervention as an area of interest defined by its literature (70 publications) and includes a brief history, assessment of present status, and recommendations for future development of family crisis intervention as a distinct field with concepts and goals that can be clearly defined, taught, researched, and repeated in treatment. Recommendations are made for the development of an explicit paradigm for intervention with a clear, common language of terms and concepts for family involvement. Suggested directions for developing the paradigm and language are explored.     

Variables differentiating affective interaction in a family therapy and a control group: Father-child welfare and mother-child emergency affect

In this study of 37 pre-therapy and 23 matched control families who never sought family therapy, father-child welfare affect and mother-child emergency affect were significantly higher in the control families. Control families were found generally to express more Welfare and Emergency emotion. Affective expression between parents did not significantly differentiate the groups.This study has been supported by Grant No. MA-4510 of the Medical Research Council of Canada and was presented at the annual meeting of the Canadian Psychiatric Association, Ottawa, Ontario, Canada, September 1983. The authors wish to express their thanks to Toby Schwartz, Harriet Gold-Kaats, and Terry Tannenbaum-Dascal, who acted as coders and research assistants; Joseph Beltempo, BSc, who helped in the statistical analysis; and James Robbins, PhD, who gave much valuable advice.