With a Spirit that Understands: Reflections on a Long‐term Community Science Initiative to End Suicide in Alaska

This retrospective analysis of a long‐term community‐based participatory research (CBPR) process spans over two decades of work with Alaska Native communities. A call to action from Alaska Native leadership to create more effective strategies to prevent and treat youth suicide and alcohol misuse risk initiated a response from university researchers. This CBPR process transformed into a collaborative effort to indigenously drive and develop solutions through research. The People Awakening project started our team on this translational and transformational pathway through community intervention science in the Central Yup'ik region of Alaska. We examine more deeply the major episodes and their successes and struggles in maintaining a long‐term research relationship between university researchers and members of Yup'ik Alaska Native communities. We explore ways that our CBPR relationship has involved negotiation and engagement with power and praxis, to deepen and focus attention to knowledge systems and relational elements. This paper examines these deeper, transformative elements of our CBPR relationship that spans histories, cultures, and systems. Our discussion shares vignettes from academic and community perspectives to describe process in a unique collaboration, reaching to sometimes touch upon rare ground in emotions, tensions, and triumphs over the course of a dozen grants and twice as many years. We conclude by noting how there are points where, in a long‐term CBPR relationship, transition out of emergence into coalescing and transformation can occur.     

Cognitive behavioral therapy for panic disorder and comorbidity: more of the same or less of more?

This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with "straying" to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with 'straying' to CBT for comorbid disorders.     

The relations of parental autonomy support to cultural internalization and well-being of immigrants and sojourners

Previous research has demonstrated that autonomy support is one particularly effective means of promoting internalization and fostering well-being. The present study sought to determine if this would also be the case with regards to culture by testing the relation of perceived parental autonomy support to the cultural internalization and well-being of multicultural students. In Study 1, 105 multicultural participants living in Canada were more likely to have fully internalized their host and heritage cultures and to have higher self-reported well-being when they reported that their parents were autonomy supportive. In Study 2, 125 Chinese-Malaysians sojourners were also more likely to have fully internalized their heritage culture and indicated higher well-being when they perceived their parents as autonomy supportive. In both studies, heritage cultural internalization was also associated with higher well-being.     

Appropriateness of the Multi-Attitude Suicide Tendency Scale for non-White individuals

Analyses of data collected from 480 university students (approximately 56% White and 44% Black) challenge the utility of the Multi-Attitude Suicide Tendency Scale (MAST) for use with individuals of diverse cultural backgrounds. This size sample allowed for an examination of the psychometric properties and cultural relevance of the MAST for non-Whites. Correlations between scores on the MAST, suicide, and depression measures were in the expected directions for Whites but not for Blacks or Latinos. The White sample data fit the four-factor model of the MAST, but the model required several modifications to fit the data from the Black sample. Verification of the cultural relevance of the MAST and a revision of the scale are recommended to improve its usefulness.     

Thought action fusion: can it be corrected?

The goal of this study was to investigate whether or not a brief educational intervention delivered prior to engaging in an anxiety-provoking task (writing a sentence about hoping that a friend/relative was in a car accident) would be effective in offsetting anxiety in college students with a strong propensity to endorse statements of thought action fusion (TAF). As hypothesized, individuals receiving the educational intervention were less anxious than a placebo intervention control group at post task; they were also less likely to endorse statements of TAF after receiving the educational intervention. Also, those who chose to neutralize after writing the sentence (regardless of experimental group) were more likely to report feeling guiltier, more immoral and a greater sense of responsibility about writing the sentence prior to neutralizing than those who did not subsequently neutralize. These results are discussed in relation to the cognitive theory of obsessive-compulsive disorder and implications for prevention programs.     

The Positive and Negative Suicide Ideation (PANSI) inventory: psychometric evaluation with adolescent psychiatric inpatient samples

In this study, we evaluated the factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory (Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) using confirmatory factor analysis (CFA). The PANSI assesses the frequency of negative risk and protective factors that are related to suicidal behavior. Participants (n = 195) were adolescent psychiatric inpatients, ages 14 to 17 years, in the CFA. Results of the CFA supported the fit for the 2-factor oblique model as the best fitting model. The internal consistency reliability estimates of the 2 subscales, the PANSI-Negative (alpha = .96) and the PANSI-Positive (alpha = .89) were high. Scores on the PANSI scales differentiated between suicide attempters and controls and those at severe risk for suicide and controls. Correlational analyses provide strong support for the concurrent validity of the scales. The results of the logistic regression analyses provide support for the use of this new inventory as a risk measure of suicide-related behaviors: Scores on the PANSI scales (n = 54) also showed satisfactory evidence for test-retest reliability over a 2-week period.     

Answering the Conventionalist Challenge to Natural Rights Theory

Res Publica - Ben Bryan argues that the strongest challenge to natural rights theory is to explain how it overcomes the Problem of Authority. Given that our natural rights are multiply realisable...