The Predictors of Suicidality in Previous Suicide Attempters following Case Management Services

Suicide attempts constitute a serious clinical problem. People who have attempted suicide are at an elevated risk for additional suicide attempts, but there is limited evidence regarding the predictors of suicidality of suicide attempters following case management services. In the present study the indicators of suicidality after case management were examined. A total of 1,056 subjects who had recently attempted suicide were recruited from January 1, 2011, to June 30, 2011. The suicide prevention center of Kaohsiung City in Taiwan provided case management services and followed up on suicide attempt cases for 6 months. The salient factors for repeat suicide attempts were estimated using a logistic regression analysis. The results showed that multiple factors, including a “willingness to receive mental health services during a crisis,” “social support,” “a history of mental disorders,” and “a history of suicide,” could predict repeat suicide attempts with hazard ratios (0.58, 0.54, 3.84, 1.51) and 95% confidence interval (0.39–0.86, 0.36–0.83, 2.41–6.10, 1.03–2.21). The four factors mentioned above were the most accurate predictors of subsequent suicidality when case management services were utilized after 6 months of follow‐up. The findings of our study could help clarify future strategies for suicide prevention.     

Processing fearful and neutral sentences: Memory and heart rate change

Abstract

Thirty college student subjects were instructed to process fearful or neutral sentences on cue. Cue tones were presented randomly within a repetitive series of non-signal tones (1 every 6sec). A change in tone frequency (higher or lower) was the signal to recall either the fearful or the neutral member of a previously memorised sentence pair. At the first signal for retrieval, and depending on group assignment, subjects engaged in one of three text processing tasks: null task (i.e. subjects were told not to process the sentence at this first cue), silent articulation of the sentence, or imagery of the text content. A second retrieval signal followed the first, at which time all subjects did the imagery task. Fearful sentences resulted in greater heart rate acceleration than neutral sentences. This affective discrimination was greatest for imagery (during both processing periods), but it was also apparent during articulation, and even to some extent during null sentence processing. This result was interpreted as evidence of spread of activation from language propositions to response propositions, consistent with the associative network structure of fear described in bio-information processing theory.