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.     

Description and Evaluation of a Measurement Technique for Assessment of Performing Gender

The influence of masculinity and femininity on behaviors and outcomes has been extensively studied in social science research using various measurement strategies. In the present paper, we describe and evaluate a measurement technique that uses existing survey items to capture the extent to which an individual behaves similarly to their same-gender peers. We use data from the first four waves of The National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of adolescents (age 12–18) in the United States who were re-interviewed at ages 13–19, 18–26, and 24–32. We estimate split-half reliability and provide evidence that supports the validity of this measurement technique. We demonstrate that the resulting measure does not perform as a trait measure and is associated with involvement in violent fights, a pattern consistent with theory and empirical findings. This measurement technique represents a novel approach for gender researchers with the potential for expanding our current knowledge base.     

Highlighting the Way Forward: A Review of Community Mental Health Research and Practice Published in AJCP and JCP

Articles published in the two most prominent journals of community psychology in North America, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP), provide a clear indicator of trends in community research and practice. An examination of community psychology's history and scholarship suggests that the field has reduced its emphasis on promoting mental health, well‐being, and liberation of individuals with serious mental illnesses over the past several decades. To further investigate this claim, the current review presents an analysis of articles relevant to community mental health (N = 307) published in the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP) from 1973 to 2015. The review focuses on article characteristics (e.g., type of article and methods employed), author characteristics, topic areas, and theoretical frameworks. Results document a downward trend in published articles from the mid‐1980s to mid‐2000s, with a substantial increase in published work between 2006 and 2015. A majority of articles were empirical and employed quantitative methods. The most frequent topic area was community mental health centers and services (n = 49), but the past three decades demonstrate a clear shift away from mental health service provision to address pressing social issues that impact community mental health, particularly homelessness (n = 42) and community integration of adults with serious mental illnesses (n = 40). Findings reflect both the past and present state of community psychology and suggest promising directions for re‐engaging with community mental health and fostering well‐being, inclusion, and liberation of adults experiencing serious mental health challenges.     

Fears of death and fears of dying in the counter-transference

It is commonplace for people to say they are not afraid of death but they are afraid of dying. I discuss unconscious aspects of fears of dying and fears of death which are revealed in counter-transference experiences in therapy with people suffering from terminal illnesses and with older people. Studying the counter-transference shows that fears of dying, which usually refer to lingering and disabling illnesses, unconsciously are linked with fears of dependency and the apprehension that if one becomes dependent then no-one will want to look after you. This apprehension is often a residue of failures in the early dependency relationship which can be re-enacted in adult life through projective identification when therapists and carers may be induced to abandon the caring role. Despite the ubiquitous denial, fears of death surface in the counter-transference, often obliquely but always with a particular terror for the survival of the self. This unconscious terror confirms Freud’s insight about the denial of death that what is unthinkable is the annihilation of the self. I conclude with a discussion about the importance of setting an ending date in therapy with those who are old or terminally ill.     

Early Adolescent Growth in Depression and Conduct Problem Symptoms as Predictors of Later Substance Use Impairment

Most studies of adolescent substance use and psychological comorbidity have examined the contributions of conduct problems and depressive symptoms measured only at particular points-in-time. Yet, during adolescence, risk factors such as conduct problems and depression exist within a developmental context, and vary over time. Though internalizing and comorbid pathways to substance use have been theorized (Hussong et al. Psychology of Addictive Behaviors 25:390-404, 2011), the degree to which developmental increases in depressive symptoms and conduct problems elevate risk for substance use impairment among adolescents, in either an additive or potentially a synergistic fashion, is unclear. Using a school-based sample of 521 adolescents, we tested additive and synergistic influences of changes in depressive symptoms and conduct problems from 6th to 9th grade using parallel process growth curve modeling with latent interactions in the prediction of late adolescent (12th grade) substance use impairment, while examining gender as a moderator. We found that the interaction between growth in depression and conduct disorder symptoms uniquely predicted later substance use problems, in addition to main effects of each, across boys and girls. Results indicated that adolescents whose parents reported increases in both depression and conduct disorder symptoms from 6th to 9th grade reported the most substance use-related impairment in 12th grade. The current study demonstrates that patterns of depression and conduct problems (e.g., growth vs. decreasing) are likely more important than the static levels at any particular point-in-time in relation to substance use risk.     

The effects of action,normality, and decision carefulness on anticipated regret: Evidence for a broad mediating role of decision justifiability

Two distinct theoretical views explain the effects of action/inaction and social normality on anticipated regret. Norm theory (Kahneman & Miller, 1986) emphasises the role of decision mutability, the ease with which one can imagine having made a different choice. Decision justification theory (Connolly & Zeelenberg, 2002) highlights the role of decision justifiability, the perception that the choice was made on a defensible basis, supported by convincing arguments or using a thoughtful, comprehensive decision process. The present paper tests several contrasting predictions from the two theoretical approaches in a series of four studies. Study 1 replicated earlier findings showing greater anticipated regret when the chosen option was abnormal than when it was normal, and perceived justifiability mediated the effect. Study 2 showed that anticipated regret was higher for careless than for careful decisions. Study 3 replicated this finding for a sample holding a different social norm towards the focal decision. Finally, Study 4 found that, when decision carefulness, normality and action/inaction were all specified, only the former showed a significant effect on anticipated regret, and the effect was again mediated by perceived justifiability. Decision justification theory thus appears to provide a better account of anticipated regret intensity in this context than does norm theory.     

Relationship of Adult Representations of Childhood Parenting and Personality Tendencies to Adult Stressors and Political Ideology

Undergraduate students in a Southeastern US University (n = 232) responded to an inventory that included retrospective measures of their parents’ style of parenting (authoritarian vs. authoritative) and their own childhood psychological tendencies (insecurity vs. confidence), as well as their adult stressors and political orientation. Authoritative parenting positively correlated with childhood confidence and negatively correlated with both childhood insecurity and adult stressors. Conversely, authoritarian parenting was positively associated with childhood insecurity and adult stressors but was not significantly correlated with childhood confidence. For the most part, parenting styles, early childhood tendencies, and adult stressors were unrelated to adult political ideology, contrary to previous longitudinal research reporting these connections.