Managing Elder Suicide: A Profile of American and Canadian Crisis Prevention Centers

Suicides among older adults in the United States and Canada in the last decade have accounted for an increasing share of all suicides. In both countries the use of firearms among older adults has steadily increased. Despite these trends, little is known about the extent to which crisis centers are prepared to prevent elder suicide. A survey of AAS-listed crisis prevention centers examined the training, knowledge, and current practices relevant to elder suicide among personnel in 321 crisis prevention centers in both countries. Results revealed insufficient training, a lack of familiarity with recent suicide trends, and limited outreach to older adults.     

Effects of Stimulus Number and Target-to-Distractor Ratio on the Performance of Random Array Letter Cancellation Tasks

Cancellation tests are commonly used in the clinical assessment of visuospatial function, but there has been little study of task characteristics influencing performance. This study was designed to assess factors which affect cancellation performance. Sixteen healthy subjects sequentially performed four random-array letter cancellation tasks. The forms contained 50 and 100 stimuli and target:distractor (T/D) ratios of 1:4 and 1:9 with target letter “A” and randomly selected letter distractors. The primary performance measure was calculated as the number of correctly cancelled targets divided by the time to complete the task, corrected for accuracy. This measure revealed a strong effect of T/D ratio (p< .0001), with performance adversely affected by higher proportion of distractors. There was no effect of stimulus number. This suggests that T/D ratio should be considered in cancellation test design and interpretation.     

Circumstances and Outcomes of a Firearm Seizure Law: Marion County,Indiana, 2006–2013

Indiana statute allows police to seize firearms without a warrant if the officer believes a person meets the law's definition of “dangerous.” Review of the use of this law in Marion County (Indianapolis), Indiana, showed that prosecutors filed petitions in court to retain weapons seized by police under this law 404 times between 2006 and 2013. Police removed weapons from people due to identification of a risk of suicide (68%) or violence (21%), or the presence of psychosis (16%). The firearm seizures occurred in the context of domestic disputes in 28% of cases and intoxication was noted in 26% of cases. There were significant demographic differences in the circumstances of firearm seizures and the firearms seized. The seized firearms were retained by the court at the initial hearing in 63% of cases; this retention was closely linked to the defendant's failure to appear at the hearing. The court dismissed 29% of cases at the initial hearing, closely linked to the defendant's presence at the hearing. In subsequent hearings of cases not dismissed, the court ordered the destruction of the firearms in 72% of cases, all when the individual did not appear in court, and dismissed 24% of the cases, all when the individual was present at the hearing. Overall, the Indiana law removed weapons from a small number of people, most of whom did not seek return of their weapons. The firearm seizure law thus functioned as a months-long cooling-off period for those who did seek the return of their guns. Copyright © 2015 John Wiley & Sons, Ltd.     

Therapeutic Contract Program: preliminary report on a behavioral alternative to the token economy

The token economy has been the primary model for the behavioral management of inpatient populations. However, this basically operant approach seldom emphasizes the development of cognitive-coping skills to help patients more effectively manage stressors that result in hospitalization. The Therapeutic Contract Program (TCP) is described as an inpatient-treatment strategy that is designed to help foster such cognitive-coping and self-control skills. While external structure is provided by components of this program, subprograms of the TCP have as their goal the development of internally-attributed coping skills and self-perceptions of competence. This preliminary report describes the structure of the TCP, as well as planned and in-progress measures of program participation and treatment outcome.