The Self‐Directed Violence Classification System and the Columbia Classification Algorithm for Suicide Assessment: A Crosswalk

The lack of a standardized nomenclature for suicide‐related thoughts and behaviors prompted the Centers for Disease Control and Prevention, with the Veterans Integrated Service Network 19 Mental Illness Research Education and Clinical Center, to create the Self‐Directed Violence Classification System (SDVCS). SDVCS has been adopted by the Department of Veterans Affairs and the Department of Defense. Another classification system, the Columbia Classification Algorithm for Suicide Assessment, has been recommended by the Food and Drug Administration. To facilitate the use of both systems, this article provides a “crosswalk” between the two classification systems.     

On a Pedestal—Sport as an Arena for Admiration

ABSTRACT

In philosophical analyses of the value of sport, a relatively unheralded feature is the opportunity that sport offers for admiration. While we readily salute many of the things that people admire (the amazing catch, the sensational comeback), we do not sufficiently appreciate that admiration itself is a positive good that is beneficial to the admirer. At a time when much in the world around us seems distinctly unadmirable and when admiration itself is often dismissed as naïve, athletic achievements and the qualities that propel them present palpable counter-evidence to our darker conclusions. Shining a spotlight on sports’ displays of human beings doing difficult things can pay healthy dividends, as admiration fuels aspiration.

The paper proceeds in four stages. It first explains what admiration is and then identifies the kinds of things that sport distinctly offers, to admire. The heart of it demonstrates the value of athletic admiration, tracing how this contributes to a flourishing life in three principal ways: through the role-modeling that it offers, the action that it encourages and the feelings that it fosters. Finally, the paper considers four possible objections, which serves both to clarify and to fortify its central contention.     

Preventing Suicide at Suicide Hotspots: A Case Study from Australia

The Gap Park Self‐Harm Minimisation Masterplan project is a collaborative attempt to address jumping suicides at Sydney's Gap Park through means restriction, encouraging help‐seeking, and increasing the likelihood of third‐party intervention. We used various data sources to describe the Masterplan project's processes, impacts, and outcomes. There have been reductions in reported jumps and confirmed suicides, although the trends are not statistically significant. There has been a significant increase in police call‐outs to intervene with suicidal people who have not yet reached the cliff's edge. The collaborative nature of the Masterplan project and its multifaceted approach appear to be reaping benefits.     

The Functions of Social Support as Protective Factors for Suicidal Ideation in a Sample of Air Force Personnel

This study examined various functions of social support (i.e., tangible, esteem, belonging, and appraisal) were examined as protective factors for suicidal ideation in a sample of 273 active duty Air Force Security Forces personnel. Generalized linear regression analyses were conducted to determine if various social support functions were differentially associated with the presence and severity of suicidal ideation, both as main effects and as moderators of emotional distress. None of the four social support functions differentiated suicidal from nonsuicidal Airmen, but esteem support (i.e., feeling respected, encouraged, and valued by others) was associated with significantly less severe suicidal ideation (B = ?.074, SE = .025, p = .003). A significant interaction of tangible support (i.e., access to material resources) with emotional distress indicated that emotional distress was associated with more severe suicidal ideation only among Airmen reporting low levels of tangible support (B = .006, SE = .003, p = .018). When considered concurrently, both tangible and self‐esteem functions of social support are differentially associated with decreased suicidal ideation among Airmen, but belonging (i.e., having someone to do things with) and appraisal (i.e., having someone to talk to about problems) functions were not. Findings suggest that different aspects of social support affect suicidal ideation in different ways.     

An Examination of the Connections Between Eating Disorder Symptoms,Perceived Burdensomeness,Thwarted Belongingness,and Suicide Risk Among Undergraduate Students

Suicide attempts and premature mortality due to suicide are elevated in people with eating disorders. Informed by the interpersonal theory of suicide, two studies examined the role of perceived burdensomeness and thwarted belongingness in explaining the association between eating disorder symptoms and suicide risk. Results indicated that various eating disorder symptoms had an indirect effect on suicide risk through perceived burdensomeness and thwarted belongingness. Targeting perceived burdensomeness and thwarted belongingness may be useful for decreasing suicide risk among undergraduates with eating disorder symptoms.     

Shame,Guilt, and Suicide Ideation among Bondage and Discipline,Dominance and Submission,and Sadomasochism Practitioners: Examining the Role of the Interpersonal Theory of Suicide

To date, no study has examined rates of suicide ideation or theory‐based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty‐seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma‐related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation.     

Thoughts of Self‐Harm and Help‐Seeking Behavior among Youth in the Community

The association between thoughts of self‐harm and help‐seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School‐aged Children Study (n = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help‐seeking behaviors among youth with and without thoughts of deliberate self‐harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help‐seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self‐harm in community and school settings.     

Suicide Risk Assessment and Risk Formulation Part II: Suicide Risk Formulation and the Determination of Levels of Risk

The suicide risk formulation (SRF) is dependent on the data gathered in the suicide risk assessment. The SRF assigns a level of suicide risk that is intended to inform decisions about triage, treatment, management, and preventive interventions. However, there is little published about how to stratify and formulate suicide risk, what are the criteria for assigning levels of risk, and how triage and treatment decisions are correlated with levels of risk. The salient clinical issues that define an SRF are reviewed and modeling is suggested for an SRF that might guide clinical researchers toward the refinement of an SRF process.