Describing suicidality: an investigation of qualitative SSF responses

Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.     

Weathering the storm: children's long-term recall of Hurricane Andrew

Children who experienced a highly stressful natural disaster, Hurricane Andrew, were interviewed within a few months of the event, when they were 3-4 years old, and again 6 years later, when they were 9-10 years old. Children were grouped into low, moderate, or high stress groups depending on the severity of the experienced storm. All children were able to recall this event in vivid detail 6 years later. In fact, children reported over twice as many propositions at the second interview as at the first. At the initial interview, children in the high stress group reported less information than children in the moderate stress group, but 6 years later, children in all three stress groups reported similar amounts of information. However children in the high stress group needed more questions and prompts than children in the other stress groups. Yet children in the high stress group also reported more consistent information between the two interviews, especially about the storm, than children in the other stress groups. Implications for children's developing memory of stressful events are discussed.     

Spanish-language measures of mania and depression

Efforts to better understand bipolar spectrum disorders across ethnic groups are often hampered by the lack of commonly used self-report instruments to assess mania and depression in individuals who speak languages other than English. This article describes the translation into Spanish of 2 self-report measures of manic symptoms (i.e., the Internal State Scale and the Hypomanic Personality Scale) and 2 self-report measures of depression (i.e., the Inventory to Diagnose Depression and the Inventory to Diagnose Depression, Lifetime version). The authors translated these measures into Spanish and assessed their psychometric properties among bilingual college students (N = 88). Results suggest that the Spanish versions have psychometric properties comparable to the English versions of the instruments.     

Psychological research online: report of Board of Scientific Affairs' Advisory Group on the Conduct of Research on the Internet

As the Internet has changed communication, commerce, and the distribution of information, so too it is changing psychological research. Psychologists can observe new or rare phenomena online and can do research on traditional psychological topics more efficiently, enabling them to expand the scale and scope of their research. Yet these opportunities entail risk both to research quality and to human subjects. Internet research is inherently no more risky than traditional observational, survey, or experimental methods. Yet the risks and safeguards against them will differ from those characterizing traditional research and will themselves change over time. This article describes some benefits and challenges of conducting psychological research via the Internet and offers recommendations to both researchers and institutional review boards for dealing with them. ((c) 2004 APA, all rights reserved)     

Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality

The influence of complicated grief (CG) on suicidality among bereaved adults was examined. The Yale Evaluation of Suicidality scale and the Inventory of Complicated Grief-Revised were administered to 309 bereaved adults in face-to-face interviews conducted at baseline (6.2 months post-loss) and at follow-up (10.8 months post-loss). Cross-sectionally, CG was associated with a 6.58 (95% CI: 1.74-18.0) times greater likelihood of "high suicidality" at baseline, and an 11.30 (95% CI: 3.33-38.10) times greater risk of high suicidality at follow-up, after controlling for gender, race, major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and social support. Longitudinally, CG at baseline was associated with an 8.21 (95% CI: 2.49-27.0) times greater likelihood of high suicidality at follow-up, controlling for the above confounders. The study results indicate that CG substantially heightened the risk of suicidality after controlling for important confounders such as MDD and PTSD, suggesting that CG poses an independent psychiatric risk for suicidal thoughts and actions.     

Beyond the individual: the impact of ethnic context and classroom behavioral norms on victims' adjustment

With a sample of 1,630 sixth-grade students from 77 classrooms, the authors used hierarchical linear modeling to examine how ethnicity within context and classroom social disorder influenced the association between peer victimization and social-psychological adjustment (loneliness and social anxiety). Victimized students in classrooms where many classmates shared their ethnicity reported feeling the most loneliness and social anxiety. Additionally, classroom-level social disorder served as a moderator such that the association between victimization and anxiety was stronger in classrooms with low social disorder. Both findings were interpreted as evidence that problem behavior deviating from what is perceived as normative in a particular context heightens maladjustment. The authors discuss implications for studying ethnicity and classroom behavioral norms as context variables in peer relations.     

MMPI-2 profile code types and measurement error

We studied simulated MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) code type stability and change expected with measurement error for 12 MMPI-2 well-defined mean code type profiles. Profile scores for the 2 scales defining the code type were systematically varied to represent target code type profiles at 9 different levels of T-score profile definition. We randomly generated samples of 50 simulated, estimated true score profiles at each level of profile definition for each code type around the estimated true scores for each scale at each level of profile definition. Two sets of simulated profiles were developed. The first simulation was based on the reported means, test-retest reliabilities, and the standard errors of measurement for the MMPI-2 normative group. The second simulation was based on the means, standard deviations, and estimated retest stability for a clinical group of psychiatric patients. We calculated frequencies and percentages of simulated profiles with the highest estimated true scores on the same 2 scales as the original code type profile. Percentages of simulated profiles with the same 2 highest scales as the original code type profiles increased from 27% to 37% for the 3-point level of definition, 37% to 49% for the 5-point definition, 46% to 61% for 7-point definition, 63% to 78% for 10-point definition, 78% to 89% for 13-point definition, 83% to 93% for 15-point definition, and greater than 90% for profile definition greater than 15 points.     

When remembering is not enough: reflecting on self-defining memories in late adolescence

This study examined which kinds of self-defining memories show spontaneous references to larger meanings, and listener responses to two kinds of meaning-lessons and insights. Narratives of three self-defining memories and episodes of telling the memories to others were collected from each of 168 late adolescents (M age=19). Narratives were coded for event type (relationship, mortality, achievement, and leisure) and for references to tension and to meaning (lesson or insight). Narratives of memorable episodes of having told the memories to others were coded for listener response (positive or negative). References to meaning emerged in one-fourth of the memory narratives, and meaning was more common for self-defining memory narratives that contained references to tension. Memories that reportedly had not been told to others in the past showed the same proportion of meaning as did memories that had been told to others (23%), with insights more prevalent than lessons. For memories that had been told to others, insights were more likely to be accepted by listeners than lessons. Implications were discussed for understanding the development of meaning in self-defining memories and the collaborative construction of identity.     

Interactions between study task, study time, and the low-frequency hit rate advantage in recognition memory

In studies of episodic recognition memory, low-frequency words (LF) have higher hit rates (HR) and lower false alarm rates (FAR) than do high-frequency words (HF), which is known as the mirror pattern. A few findings have suggested that requiring a task at study may reduce or eliminate the LF-HR advantage without altering the LF-FAR effect. Other studies have suggested that the size of the LF-HR advantage interacts with study time. To explore such findings more thoroughly and relate them to theory, the authors conducted 5 experiments, varying study time and study task. The full mirror pattern was found only in 2 cases: the standard condition requiring study for a later memory test and a condition requiring a judgment about unusual letters. The authors explain their findings in terms of the encoding of distinctive features and discuss the implications for current theories of recognition memory and the word frequency effect.