Post-Admission Cognitive Therapy: A Brief Intervention for Psychiatric Inpatients Admitted After a Suicide Attempt

To date, no empirically based inpatient intervention for individuals who have attempted suicide exists. We present an overview of a novel psychotherapeutic approach, Post-Admission Cognitive Therapy (PACT), currently under development and empirical testing for inpatients who have been admitted for a recent suicide attempt. PACT is adapted from an efficacious and brief outpatient cognitive therapy protocol (Brown, Henriques, Ratto, & Beck, 2002; Brown et al., 2005) for inpatient delivery to individuals with recent suicide attempts. Within a cognitive framework, attempting suicide is conceptualized as a maladaptive coping strategy that deserves immediate targeted clinical attention regardless of the patient's diagnosis. The primary aims of PACT are to reduce the likelihood of suicide attempt recurrence as well as decrease the severity of established psychological risk factors for suicide. The three phases of PACT involve (1) building a therapeutic alliance and developing a cognitive conceptualization based on the recent suicide attempt; (2) instilling hope, practicing effective coping strategies, and addressing problem-solving deficits; and (3) preventing relapse, constructing a safety plan, and promoting timely linkage with outpatient aftercare services. The efficacy of PACT as a targeted inpatient treatment package remains to be established. The cognitive behavioral components of PACT, as described here, are based on evidence-informed practices aimed at improving the quality of care provided to inpatients following a suicide attempt.     

Happiness and Unhappiness in the Developing World: Life Satisfaction Among Sex Workers, Dump-Dwellers, Urban Poor, and Rural Peasants in Nicaragua

Little in-depth research exists on subjective well-being (SWB) in the developing world, especially among the poor and extremely poor. Biswas-Diener and Diener (Soc Indic Res 55:329–352, 2001) employed a study design in the slums of Calcutta, India to address this gap in SWB research. They found slightly negative global SWB but slightly positive domain specific satisfaction in their sample. The current study employs the same paradigm and investigates the SWB of female sex workers, city dump dwellers, and urban and rural poor in Nicaragua, Central America. The current study was able to replicate the Biswas-Diener and Diener (Soc Indic Res 55:329–352, 2001) finding of slightly negative SWB for marginalized urban groups. In addition, an overall model for predicting SWB was constructed using personality dispositions, objective income, social support, and social rootedness as predictors. Social support and objective income were the only significant predictors in the model but more zero order relations existed. Additionally, this study contrasted urban poor versus rural poor and found no significant SWB differences.     

The relative roles of physical education teachers and parents in adolescents’ leisure-time physical activity motivation and behavior

Objectives

The purpose of this study was to explore the relative contributions of perceived parent and physical education teacher autonomy support, involvement, and modeling to adolescent leisure-time physical activity motivation and behavior within the framework of self-determination theory.

Design

Cross-sectional survey.

Method

161 Middle school students completed a paper survey which assessed the study variables.

Results

Three sets of models were tested that examined the relationships of autonomy support, involvement, and modeling from mothers, fathers, and physical education teachers to adolescent leisure-time physical activity self-determined motivation and behavior. In the models, each social support variable had a significant, positive, direct relationship to motivation, and a significant, positive, indirect relationship to physical activity behavior mediated by motivation. Further, the relationships between social support from each significant other and motivation were of similar magnitude.

Conclusions

Mothers and fathers both play modest, yet significant roles in their adolescent’s leisure-time physical activity motivation. Additionally, physical education teachers, although not present in the leisure-time physical activity context, serve an equally important role in supporting adolescents’ leisure-time physical activity. Lastly, adolescent self-determined motivation for leisure-time physical activity is a strong determinant of self-reported leisure-time physical activity behavior.     

The deformation of soap film junctions by applied forces

The equilibrium configuration of soap films in a tetrahedral frame is well known, and a study is reported here of the displacement of the tetrahedral vertex formed at the junction of the Plateau borders between the films. Applying a force to this junction causes an increase in soap film area, and hence surface energy, which is modelled both theoretically and numerically. In the present work, this force is conceived as being due to the displacement of a small particle at the centre of the vertex and the energy dependence of the configuration on both the size of the particle and the magnitude of the displacement is calculated. The results underline the importance of the curvature of the films in any detailed analysis of the suspension of particles in a foam, as, for example, in the industrial process of foam flotation. The results are relevant also to problems of foam drainage and stability.     

Association between maternal sensitivity and externalizing behavior from preschool to preadolescence

Using data from the longitudinal NICHD Study of Early Child Care and Youth Development (N = 1364), this study examined the association between mothers' sensitivity and children's externalizing behavior from preschool to preadolescence. Externalizing behavior declined on average across this period with a slowing of this decline around middle childhood. Maternal sensitivity remained relatively stable on average, and there was significant variation across mothers. A decrease in maternal sensitivity from ages 3 to 11 was related to an increase in externalizing behavior from ages 4 to 12. A model-based test of the direction of the effect suggested that the association between changes in maternal sensitivity and externalizing behavior from ages 4 to 11 was driven by child effects on mothers and not vice-versa. Between late preschool age and preadolescence, the behavior problems of children appear to strongly influence the sensitive support of mothers. Practical implications were discussed in light of these findings.     

Diagnosis without treatment: responding to the War on Terror

The War on Terror has exposed deep problems within contemporary political practice. It has demonstrated the moral fragility of liberal democracy. Much critical literature on the topic is devoted to uncovering the sources of this fragility. In this paper, we accept the general thrust of much of this literature, but turn our attention to the practical upshot of the criticism. A common feature of the literature is that, when it comes to offering remedies of the problems it identifies, what is offered is ‘diagnosis without treatment’. The negation of a problem is regarded as a solution. For example, if the problem is that the USA is not acting as a good international citizen, the solution is that it begins to act as such. This is like a doctor diagnosing gout and recommending to the patient that they reduce the level of uric acid in their big toe. We argue that diagnosis without treatment is endemic in literature on the War on Terror and the ills of liberal democracy. We divide this literature into five categories and examine representative works in each. At the end of the paper, we describe what is required to avoid offering yet more diagnosis without treatment.     

Relationship of Enlightenment to the Cultural Mandate for a Biblical View of Education

The benchmark of success for many Christian schools and for Christian education, in general, is in their public-school counterparts. The very act of comparing to the standards of institutions seen as antithetical to Christianity is a major indicator of the degree to which Christian education has lost sight of its own identity and purpose. One genre of antithetical influences over Christian education is that of Enlightenment-style thinking. After an analysis of this dilemma vis-a-vis the cultural mandate, a list of highly distinctive educational goals inherent to Christian living are recommended.     

Appraisals of Fear, Helplessness, and Perceived Life-Threat During Emergent Cardiac Surgery: Relationship to Pre-surgical Depression, Trauma History, and Posttraumatic Stress

Depression and posttraumatic stress (PTS) have been linked to medical/psychological outcomes following coronary artery bypass graft (CABG) surgery. This study assessed pre-surgical trauma history, PTS, and depression; and peri-surgical appraisals of fear, helplessness, and perceived life-threat among 110 patients. All CABGs were emergent, rather than elective, surgeries. In hierarchical multiple regressions, total severity score for pre-surgical PTS predicted fear regarding the cardiac event and the CABG, and perceived life-threat regarding the cardiac event and the CABG. Pre-surgical depression predicted perceived helplessness regarding the cardiac event and the CABG, and contributed to prediction of perceived life-threat. Trauma history contributed to prediction of fear and perceived helplessness regarding surgery (but not regarding the cardiac event necessitating surgery). When posttraumatic stress disorder diagnosis (PTSD) was entered, rather than total severity of PTS, PTSD did not predict any appraisals, and depression showed stronger prediction of fear, helplessness, and perceived life-threat than did PTSD.     

Transmitting delusional beliefs in a hypnotic model of folie à deux

Folie à deux is the transference of delusional ideas from one ‘primary’ individual to one or more ‘secondary’ individuals (Lasègue & Falret, 1877). However, it is difficult to investigate experimentally because often only one patient is identified as delusional. We investigated whether hypnosis could model the experiences of the secondary in this delusion. Our primary was a confederate, who displayed two delusional beliefs and attempted to transmit them to hypnotised subjects. We manipulated the status of the confederate so that they were portrayed as either “credible” or merely “interesting”. Many high hypnotisable individuals adopted the confederate’s beliefs and confabulated evidence in support of them. Also, subjects who interacted with a credible confederate extended their delusions beyond those displayed by the confederate. We discuss the strengths and limitations of this approach and suggest ways to improve the validity of this model.