The trauma of attempted suicide

Suicide is a traumatic event, one which may acutely recreate a previously-experienced traumatic situation. The person's capacity to think after a failed suicide attempt is affected by the use of defence mechanisms against persecutory anxieties and depressive pain, and there is a wish to turn a blind eye to the seriousness of the suicidal act. This includes the damaging effects on the person's relationships with others, and damage to his own psychic integrity.

The need to turn a blind eye to the consequences of a failed suicide attempt may also be mirrored by the therapist who assesses and treats the patient in the early hours after such an event. Suicide is associated not only with the pain of despair but also with a ruthless abandonment of life. It is a complex and difficult task for a therapist in the immediate aftermath of a suicide attempt to be able to keep in mind a concept of suicide that includes both the patient's role as the perpetrator of great violence against himself, in which death is the intended outcome of his actions, and at the same time recognise the patient's identification with an abandoned and cruelly treated object.

In this paper, we describe some of the psychodynamic factors that affect and influence the assessment and treatment of patients in the immediate period following a failed suicide attempt. We emphasise the importance of supervision in helping prevent destructive acting-out by the therapist when treating disturbed patients under such painful circumstances.     

Development of the Trauma Appraisal Questionnaire

This study describes the development and psychometric properties of the Trauma Appraisal Questionnaire (TAQ). Items were generated based on interviews with 72 ethnically diverse community participants exposed to a range of trauma types. From the interviews, more than 600 items that tapped beliefs, emotions, and behaviors were generated for 9 appraisal categories (e.g., fear, betrayal, shame). Based on expert feedback, 108 items were retained for initial testing in a sample of 714 undergraduate volunteers. Using a factor analytic strategy, we arrived at a 6-scale, 54-item solution. The reliability and validity of the new measure were evaluated in community (N = 119) and undergraduate (Ns = 139 and 79) samples. The measure demonstrated excellent reliability (test–retest and internal consistency) and validity (convergent, discriminant, and concurrent).     

Love and the need for comprehension

The question of how well we need to be known, to be loved, is considered. A ‘second-person’ model is argued for, on which love requires that the beloved's demands to be known be respected. This puts pressure on the idea that lovers need to make a beloved's interests their own, taking that to require comprehension of the beloved's interests: a lover would have to appreciate the normative intelligibility and motivating force of an interest. The possibility of love with failure of comprehension is defended, using illustrations from Marilynne Robinson's novel Gilead.     

Social Cohesion and Self-Rated Health: The Moderating Effect of Neighborhood Physical Disorder

Using data from the Los Angeles Family and Neighborhood Survey and its companion datasets, we examined how neighborhood disorder, perceived danger and both individually perceived and contextually measured neighborhood social cohesion are associated with self-rated health. Results indicate that neighborhood disorder is negatively associated with health and the relationship is explained by perceived cohesion and danger, which are both also significant predictors of health. Further, individually perceived cohesion emerges as a more important explanation of self-rated health than neighborhood-level social cohesion. Finally, neighborhood disorder and perceived cohesion interact to influence health, such that cohesion is especially beneficial when residents live in neighborhoods characterized by low to moderate disorder; once disorder is at high levels, cohesion no longer offers protection against poor health. We interpret our findings as they relate to prior research on neighborhoods, psychosocial processes, and health, and discuss their implications for intervention efforts that address disorder in urban communities.     

Repairing links: building attachments in the preschool classroom

A psychoanalytic model of preschool consultation is presented, born of the conviction that psychoanalysis has powerful tools with which to tackle some of our most difficult and entrenched community problems. Since trauma is known to impact our ability to think reflectively and symbolically (Fonagy, Moran, and Target 1993), the clinical methods of psychoanalysis-drawing on the ideas of container/contained, the capacity to hold alternate points of view, and the capacity to reflect empathically (here with teachers in the face of their at times harsh and insensitive treatment of students)-are crucial to success in work with cumulatively traumatized staff (Khan 1963). The strongest resistances to consultation arise from an anti-attachment system developed as a result of cumulative trauma and operating at multiple levels in the preschool. Consultation services are organized around an understanding of this anti-attachment system. At various levels of the system, including staff, parents, and children, consultants work to facilitate secure relationships in the preschool setting. These relationships foster recognition of children's emotional complexities and build cooperative links between staff and parents, in an atmosphere that otherwise might often push adults into fearful, self-protective states that interfere with their contact with children's states of mind.     

Implicit motives and sexual conservatism as predictors of sexual behaviors

This study was designed to provide an assessment of the relationship between the two most important implicit motives and the most frequently studied sexual behaviors. A community sample of 102 men and 92 women completed measures of implicit power and affiliation-intimacy motives, sexual conservatism, social desirability, and sexual behavior. For men, high power motivation was positively associated with the number of sexual partners and the frequency of sex. There was an interaction between sexual conservatism and power motivation in women. For women low in sexual conservatism, high power motivation was positively associated with the number of sexual partners and with earlier initiation to intercourse and oral sex. There were few associations between affiliation-intimacy motivation and sexual behaviors; however, women high in this motive reported later initiation to oral sex.     

The push and pull of temptation: the bidirectional influence of temptation on self-control

This article examines how people respond to the emergence of temptation in their environment. Three studies demonstrated that how people respond to temptation depends critically on their visceral state--whether or not they are actively experiencing visceral drives such as hunger, drug craving, or sexual arousal. We found that when people were in a "cold," nonvisceral state, the presence of temptation prompted cognition to support self-control. However, when people were in a "hot," visceral state, temptation prompted the same cognitive processes to support impulsive behavior. Study 1 examined how heterosexual men's level of sexual arousal influences their attention to attractive women. Study 2 examined whether satiated and craving smokers would engage in motivated reasoning in order to dampen (or enhance) the appeal of smoking when confronted with the temptation to smoke. Study 3 tested the boundaries of the interaction between visceral state and temptation.     

Reactivity to Stress: When Does a History of Medical Adversity Foster Resilience Versus Vulnerability?

Young adults with (or without) a history of medical or physical disorders (MPDs) were exposed to repeated laboratory stress. The effects of MPD status on habituation (as measured by changing levels of cortisol) were found to be moderated by the extent to which respondents reported “attachment feelings” in their relationships (as measured by the Social Provisions Scale). Students in the MPD group who reported attachment feelings showed (a) cortisol increases during their first exposure to a laboratory stressor; and (b) cortisol decreases during a second exposure to the same stressor 1 week later. No equivalent benefit was found for students who lacked this medical history. Findings suggest the extent to which medical adversity—under the right interpersonal circumstances—promotes resilience.     

Who Wants to Marry a Millionaire? Reality Dating Television Programs, Attitudes Toward Sex, and Sexual Behaviors

Past research has revealed associations between television viewing and sexual attitudes and behaviors. We examined a burgeoning new television genre, reality dating programs (RDPs). Undergraduate students (ages 18–24) reported their overall television viewing, their RDP viewing, and their involvement with RDPs (watching in order to learn and watching in order to be entertained). They also completed measures of attitudes toward sex, dating, and relationships, and answered questions about sexual behavior. Most participants were occasional or frequent viewers of at least one RDP. Men reported using RDPs for learning more than did women; there was no gender difference in use of RDPs for entertainment. Total amount of RDP viewing was positively correlated, for both men and women, with adversarial sexual beliefs, endorsement of a sexual double standard, and the beliefs that men are sex-driven, that appearance is important in dating, and that dating is a game. In all cases, however, these relationships were partially or totally mediated through viewer involvement. Men and women who watched RDPs tended to be less sexually experienced; there were few other correlations with sexual behaviors.     

Behavioral trainings and manipulations to reduce delay discounting: A systematic review

In everyday decision-making, individuals make trade-offs between short-term and long-term benefits or costs. Depending on many factors, individuals may choose to wait for larger delayed reward, yet in other situations they may prefer the smaller, immediate reward. In addition to within-subject variation in the short-term versus long-term reward trade-off, there are also interindividual differences in delay discounting (DD), which have been shown to be quite stable. The extent to which individuals discount the value of delayed rewards turns out to be associated with important health and disorder-related outcomes: the more discounting, the more unhealthy or problematic choices. This has led to the hypothesis that DD can be conceptualized as trans-disease process. The current systematic review presents an overview of behavioral trainings and manipulations that have been developed to reduce DD in human participants aged 12 years or older. Manipulation studies mostly contain one session and measure DD directly after the manipulation. Training studies add a multiple session training component that is not per se related to DD, in between two DD task measurements. Ninety-eight studies (151 experiments) were identified that tested behavioral trainings and manipulations to decrease DD. Overall, results indicated that DD can be decreased, showing that DD is profoundly context dependent and changeable. Most promising avenues to pursue in future research seem to be acceptance-based/mindfulness-based trainings, and even more so manipulations involving a future orientation. Limitations and recommendations are discussed to identify the mechanistic processes that allow for changes in discount rate and behavior accordingly.