Managing Elder Suicide: A Profile of American and Canadian Crisis Prevention Centers

Suicides among older adults in the United States and Canada in the last decade have accounted for an increasing share of all suicides. In both countries the use of firearms among older adults has steadily increased. Despite these trends, little is known about the extent to which crisis centers are prepared to prevent elder suicide. A survey of AAS-listed crisis prevention centers examined the training, knowledge, and current practices relevant to elder suicide among personnel in 321 crisis prevention centers in both countries. Results revealed insufficient training, a lack of familiarity with recent suicide trends, and limited outreach to older adults.     

Effects of Stimulus Number and Target-to-Distractor Ratio on the Performance of Random Array Letter Cancellation Tasks

Cancellation tests are commonly used in the clinical assessment of visuospatial function, but there has been little study of task characteristics influencing performance. This study was designed to assess factors which affect cancellation performance. Sixteen healthy subjects sequentially performed four random-array letter cancellation tasks. The forms contained 50 and 100 stimuli and target:distractor (T/D) ratios of 1:4 and 1:9 with target letter “A” and randomly selected letter distractors. The primary performance measure was calculated as the number of correctly cancelled targets divided by the time to complete the task, corrected for accuracy. This measure revealed a strong effect of T/D ratio (p< .0001), with performance adversely affected by higher proportion of distractors. There was no effect of stimulus number. This suggests that T/D ratio should be considered in cancellation test design and interpretation.     

Therapeutic Contract Program: preliminary report on a behavioral alternative to the token economy

The token economy has been the primary model for the behavioral management of inpatient populations. However, this basically operant approach seldom emphasizes the development of cognitive-coping skills to help patients more effectively manage stressors that result in hospitalization. The Therapeutic Contract Program (TCP) is described as an inpatient-treatment strategy that is designed to help foster such cognitive-coping and self-control skills. While external structure is provided by components of this program, subprograms of the TCP have as their goal the development of internally-attributed coping skills and self-perceptions of competence. This preliminary report describes the structure of the TCP, as well as planned and in-progress measures of program participation and treatment outcome.