Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Nonmonetary and nonreciprocal freecycling: Motivations for participating in online alternative giving communities

This research examines consumers' participation in a nonmonetary, nonreciprocal form of online consumer exchange wherein consumers may decide to give only, receive only, or both give and receive. Given the lack of financial incentives or relational norms that would traditionally drive participation in this societally beneficial consumption activity for which we advance the term alternative giving, this research examines consumers' participation motivations. Are consumers, as prior research suggests, motivated to participate in alternative giving activities on the basis of prosocial motives or for other reasons? Through a content analysis of the online Freecycle Network, we found that participation is driven primarily by fundamental consumer needs and wants, though other prosocial, less materialistic factors are also drivers. Our findings also identify an inconsistency in product categories between what givers offer and what receivers seek, suggesting that supply–demand imbalances can emerge within alternative giving communities.     

Reviews: Books, Art

POLITICS ON THE COUCH: CITIZENSHIP AND THE INTERNAL LIFE. By Andrew Samuels, 235 pp. New York: Karnac (Other Press). $16.00. MARTHA, MARTHA: HOW CHRISTIANS WORRY. By Elaine Leong Eng, M.D. Binghamton, NY: Haworth Press, Inc., 2000. $14.95. SPILT MILK: PERINATAL LOSS AND BREAKDOWN. Edited by Joan Raphael-Leff. 100 pp. London: Institute of Psychoanalysis, 2000. MOTHERHOOD AND SEXUALITY. By Marie Langer, 305 pp. New York: Other Press, 2000. $30.00. BRANCHING STREAMS FLOW IN THE DARKNESS: ZEN TALKS ON THE SANDOKAI. By S. Suzuki. Eds: M. Weitsman and M. Wegner. 193 pp. Berkeley, CA: University of California Press. $22.50. RESTORED HARMONY: AN EVIDENCE BASED APPROACH FOR INTEGRATING TRADITIONAL CHINESE MEDICINE INTO COMPLEMENTARY CANCER CARE. By Stephen Sagar, MD. xviii + 134 pp. Hamilton, Ontario, Canada: Dreaming Dragonfly Communications, 2001. $19.95 (US); $29.95 (Can.), paperback. (ISBN: 0-9689488-0-4). CHIYO-NI, WOMAN HAIKU MASTER. By Patricia Donegan and Yoshie Ishibashi, 184 pp. Boston: Charles E. Tuttle Co., 1998. $16.95. THE METAPHYSICAL CLUB: A STORY OF IDEAS IN AMERICA. By Louis Menand, 442 pp. New York: Farrrar, Straus, and Giroux, 2001. $27.00. BUDDHISM WITHOUT BELIEFS: A CONTEMPORARY GUIDE TO AWAKENING. By Stephen Bachelor, 127 pp. Riverhead Books, 1997. $21.95. Video Art is Dead, Long Live Video Art     

Action-based and vision-based selection of input: Two sources of control

In the first part of this paper we review evidence suggesting that there exists a mechanism that selects input on the basis of its similarity to the required action. This response-based input selection differs from the more established space- and object-based input selection in that it is not constrained by the structure of the input. Our evidence suggests that the two-choice Stroop effect is caused by this response-based selection mechanism. By contrast, it is known that the flanker effect is determined by the space- and object- based selection mechanisms. We explore whether the conflict resolution of the Stroop and flanker tasks is different as well by embedding these two tasks in a PRP (Psychological Refractory Period) paradigm. We show that the Stroop and the PRP effects are additive whereas the flanker and the PRP effects are underadditive, suggesting that the processes in charge of the conflict resolution in the Stroop and the flanker tasks are indeed different. We discuss possible reasons for this difference, and discuss possible ways in which the response-based mechanism can be implemented in information processing models.     

Coincident induction of long-term facilitation at sensory-motor synapses in Aplysia: presynaptic and postsynaptic factors

Induction of long-term synaptic changes at one synapse can facilitate the induction of long-term plasticity at another synapse. Here we show that if Aplysia sensory neuron (SN) somata and their remote motor neuron (MN) synapses are simultaneously exposed to serotonin (5HT) pulses, which at either site alone are insufficient to induce long-term facilitation (LTF), processes activated at these sites interact to induce LTF. Coincident induction of LTF requires: (1) that the synaptic pulse occurs within a brief temporal window of the somatic pulse and (2) that local protein synthesis occurs immediately at the synapse, followed by delayed protein synthesis at the soma. LTF at the SN-MN synapses can also be induced with cell-wide application of repeated pulses of 5HT. However, these two forms of LTF differ mechanistically: (1) coincident LTF requires protein synthesis in the postsynaptic motor neuron, whereas repeated 5HT LTF does not, and (2) repeated 5HT LTF is accompanied by intermediate-term (3 h) facilitation, whereas coincident LTF is not. Thus LTF expressed in the same temporal domain can result from different underlying mechanisms.     

Win-shift and win-stay learning in the short-beaked echidna (<Emphasis Type="Italic">Tachyglossus aculeatus</Emphasis>)

Numerous previous investigators have explained species differences in spatial memory performance in terms of differences in foraging ecology. In three experiments we attempted to extend these findings by examining the extent to which the spatial memory performance of echidnas (or "spiny anteaters") can be understood in terms of the spatio-temporal distribution of their prey (ants and termites). This is a species and a foraging situation that have not been examined in this way before. Echidnas were better able to learn to avoid a previously rewarding location (to "win-shift") than to learn to return to a previously rewarding location (to "win-stay"), at short retention intervals, but were unable to learn either of these strategies at retention intervals of 90 min. The short retention interval results support the ecological hypothesis, but the long retention interval results do not. Electronic Publication     

The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

Body checking and avoidance and the core features of eating disorders among obese men and women seeking bariatric surgery

This study examined two aspects of body checking and avoidance, and their relations to the core psychopathology of eating disorders (EDs), in severely obese men and women seeking bariatric surgery. A consecutive series of 260 (44 male and 216 female) gastric bypass candidates were administered measures to assess body checking and avoidance, binge eating, restraint, and overevaluation of weight and shape. The majority of patients reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations were observed between checking and restraint, and between avoidance and binge eating. Both checking and avoidance behaviors were significantly associated with overevaluation of weight and shape. The positive associations between each of the two behaviors (body checking and avoidance) with overevaluation of weight/shape remained significant even after controlling for the effects of avoidance on body checking and vice versa. Stepwise multiple regression analyses revealed that binge eating, body checking, and avoidance behaviors made significant unique contributions and jointly accounted for 22-25% of the variance in overevaluation of weight and shape, respectively. This study documents the presence of eating disorder psychopathology among severely obese patients seeking bariatric surgery. The findings support the view that body checking and avoidance behaviors are manifestations of overevaluation of weight and shape and disordered eating.