Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: The Importance of Active Engagement,Active Rescue,and Collaboration Between Crisis and Emergency Services

In 2012, the SAMHSA‐funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed.     

To Moscow with Love: Partial Reconstruction of Vygotsky’s Trip to London

The Russian psychologist Lev Vygotsky (1896–1934) left the Soviet Union only once to attend a conference on the education of the deaf in London. So far almost nothing was known about this trip, which took place in a period when Vygotsky was still completely unknown as a psychologist, both inside his own country and abroad. Making use of a newly discovered notebook, it proved possible to partially reconstruct Vygotsky’s journey and stay in London. Vygotsky’s very personal remarks show him to have been a very sensitive and spirited man, who was prey to strong emotions during the conference and afterwards. Rather surprisingly, Vygotsky’s own paper about the education of the deaf was never presented during the conference and the stay in London appears to have had a limited value for his own scientific development.     

Linkages between violence-associated attitudes and psychological,physical, and sexual dating abuse perpetration and victimization among male and female adolescents

Attitudes about violence and sex in dating relationships were related to psychological, physical, and sexual teen dating abuse perpetration and victimization. Data from Wave 4 of the national, randomly selected, Growing up with Media cohort (n = 876 adolescents aged 14-19 years), collected in 2011, were analyzed. Dating youth perceived more peer pressure to have sex and were more accepting of sex in brief or nonmarital relationships than pre-dating youth. Boys had higher levels of rape-supportive attitudes than girls. Among dating youth, the relative odds of involvement in teen dating abuse as a perpetrator or a victim were generally associated with greater acceptance of relationship violence, perceived peer pressure to have sex, and acceptance of sex in brief and/or nonmarital relationships. Rape-supportive attitudes were not significantly associated with any type of teen dating abuse involvement. Programs aimed at preventing dating abuse might benefit from targeting attitudes associated with sexual activity as well as relationship violence.     

Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.     

Relationship of purported measures of pathological and nonpathological dissociation to self-reported psychological distress and fantasy immersion

In order to investigate both the psychometric structure of the Dissociative Experiences Survey (DES) and the discriminant validity of the DES-Taxon (Waller, Putnam, & Carlson, 1996) as a specific marker of pathological dissociation, 376 non-clinical community based respondents completed the DES and a battery of psychopathology and imaginative involvement self-report measures. The DES was scored for both the Taxon and the DES-Absorption subscale. A DES subscale purported to tap normative dissociative processes. The two DES subscales demonstrated substantial overlap, both with each other (r = .80) and with the self-report measures with both DES scales comparably associated with high levels of psychological distress. Both DES subscales were also associated with elevated levels of "normative" imaginative involvement (fantasy proneness, absorption, daydreaming immersion). We conclude that both DES scales are largely indistinguishable from each other in relation to other self-report measures of psychopathology and fantasy access.     

Latent memory for sensitization in Aplysia

In the analysis of memory it is commonly observed that, even after a memory is apparently forgotten, its latent presence can still be revealed in a subsequent learning task. Although well established on a behavioral level, the mechanisms underlying latent memory are not well understood. To begin to explore these mechanisms, we have used Aplysia, a model system that permits the simultaneous study of memory at the behavioral, cellular, and molecular levels. We first demonstrate that robust latent memory is induced by long-term sensitization training of the tail-elicited siphon withdrawal reflex. It is revealed by its ability to facilitate the subsequent induction of three mechanistically distinct temporal domains of sensitization memory: short-term, intermediate-term, and long-term memory. Under our training conditions, the latent memory persists for at least 2 d following the decay of original memory expression but appears to be gone by 4 d. Interestingly, we also find that latent memory is induced even in the absence of overt memory for the original training. These findings now permit the analysis of the cellular and molecular architecture of a common feature of learning and memory.     

Physicians and obligatory social activism

This essay examines the claim that physicians have a special obligation to engage in social and political activism. Four ethical paradigms are considered. Two paradigms, the preventive medicine and the social medicine models, embody a limited professional obligation to advocate the priority of health in society; the justification for a more aggressive stance is limited by the failings of paternalism. The radical model and the heroic model speak to issues of personal virtue rather than professional obligation; they are not strictly comparable.     

Examination of a multi-factorial model of body-related experiences during pregnancy: the relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes

The aim of this cross-sectional study was to investigate relationships among women's body attitudes, physical symptoms, self-esteem, depression, and sleep quality during pregnancy. Pregnant women (N = 215) at 15–25 weeks gestation completed a questionnaire including four body image subscales assessing self-reported feeling fat, attractiveness, strength/fitness, and salience of weight and shape. Women reported on 29 pregnancy-related physical complaints, and completed the Beck Depression Inventory, Rosenberg Self-esteem Scale, and Pittsburgh Sleep Quality Index. In regressions, controlling for retrospective reports of body image, more frequent and intense physical symptoms were related to viewing the self as less strong/fit, and to poorer sleep quality and more depressive symptoms. In a multi-factorial model extending previous research, paths were found from sleep quality to depressive symptoms to self-esteem; self-esteem was found to be a mediator associated with lower scores on feeling fat and salience of weight and shape, and on higher perceived attractiveness.     

Suppression mediates the effect of 5‐HTTLPR by stress interaction on depression

A number of studies have shown that the presence of short (S), as opposed to long (L), allele of the serotonin transporter‐linked polymorphic region (5‐HTTLPR) is associated with a higher risk for depression following exposure to stressful life events. However, many other studies failed to confirm this association. One reason for this inconsistency might be the fact that the interaction of the 5‐HTTLPR polymorphism with stress may relate not to depression per se, but rather to adaptive or maladaptive emotion regulation strategies. Here we show that individuals homozygous for the long allele respond to stressful events by reappraising their emotional meaning, which may hamper the harmful effect of stress on mental health. In S genotype carriers, on the other hand, stress triggers the appearance of intrusive thoughts and vain attempts to suppress them, which in this group acts as a mediator between stress and depressive symptoms. These findings are in line with neuroimaging studies showing that 5‐HTTLPR polymorphism has an effect on the connectivity among key areas involved in emotion regulation.