Clinical trials for rapid changes in suicidal ideation: Lessons from ketamine

Rapid‐acting treatments for suicidal thoughts are critically needed. Consequently, there is a burgeoning literature exploring psychotherapeutic, pharmacologic, or device‐based brief interventions for suicidal thoughts characterized by a rapid onset of action. Not only do these innovative treatments have potentially important clinical benefits to patient populations, they also highlight a number of methodological considerations for suicide research. First, while most clinical trials related to suicide risk focus on suicide attempts, new clinical trials that use suicidal thoughts as the primary outcome require a number of slight modifications to their clinical trial design. Second, the rapid onset of these new interventions permits an experimental therapeutics approach to suicide research, in which psychological and neurobiological markers are embedded into clinical trials to better understand the underlying pathophysiology of suicidal thoughts. The following review discusses these methodological innovations in light of recent research using the N‐methyl‐D‐aspartate (NMDA) receptor antagonist ketamine, which has been associated with rapid effects on suicidal thoughts. We hope that “lessons learned” from the ketamine literature will provide a blueprint for all researchers evaluating rapid‐acting treatments for suicidal thoughts, whether pharmacologic or psychotherapeutic.     

Boredom proneness--the development and correlates of a new scale

This article reports the development, validation, and correlates of a self-report measure of boredom proneness. The 28-item Boredom Proneness (BP) Scale demonstrates satisfactory levels of internal consistency (coefficient alpha = .79) and test-retest reliability (r = .83) over a 1-week interval. Evidence of validity for the BP is supported by correlations with other boredom measures and from a set of studies evaluating interest and attention in the classroom. Other hypothesized relationships with boredom were tested, with significant positive associations found with depression, hopelessness, perceived effort, loneliness, and amotivational orientation. Additional findings indicate boredom proneness to be negatively related to life satisfaction and autonomy orientation. The relationship of boredom to other affective states is discussed, and directions for future research are outlined.     

Environmental,background, and psychological variables related to optimizing achievement and career motivation for high school girls

The purpose of the study was to investigate some environmental and psychological variables related to optimizing the achievement strivings of high school girls. It was hypothesized that environmental and psychological variables would have significant relationships to achievement strivings. The criterion variables were career motivation and achievement motivation. The predictor variables were: community support, early family socialization (environmental), self-esteem, risk preference, sex role orientation, and fear of success (psychological). Subjects were 10th-grade girls (N = 158) in a suburban midwestern high school district. Procedures involved group test administration involving 2 hr during the regular school day. Multiple regression analysis indicated that high achievement motivation and career choice were significantly associated with perceived support for achievement and career goals in the school and community environment (p < .01). Implications for increasing achievement and career motivation were discussed in relation to the requirements of the Education Amendments of 1972 and 1976 (Title IX).     

Visual search through color displays: Effects of target-background similarity and background uniformity

The effects of target-background similarity and background uniformity were investigated in two experiments in which subjects reported the presence or absence of an achromatic target item in arrays containing irrelevant chromatic items. In Experiment 1, both “present” and “absent” decision times were an increasing function of the similarity of a predefined target item to the background, and were shortened when the interitem similarity of the background set was increased. In Experiment 2, the effects of target-background similarity on the “present” decision were replicated when subjects were not informed on each trial as to which member of the target set might appear in the array, and the “absent” decision was faster when each row of the array comprised background items of a single color than when these items were allocated randomly to array locations. The results are interpreted in terms of the role of pre-attentive grouping operations.     

The role of muscle tension in “repression”

Using an active partial avoidance conditioning paradigm, muscle tension was conditioned to a verbal conditional stimulus (CS), and recall of words semantically unrelated and related to the CS was tested under conditions of three levels of induced muscle tension with 20 subjects (Ss). Results showed the expected decrease in latency of response with moderate tension for all stimuli during the pretreatment period and for the unrelated words during the posttreatment period and a significant increase in latency of response for the related words during the posttreatment period. It is suggested that if the level of muscle tension associated with the conditional response (CR) is induced in Ss, then recall of CS-related material will be inhibited or “repressed.”     

An evaluation of the response modulation hypothesis in relation to attention-deficit/hyperactivity disorder

Several hypotheses related to Newman's (e.g., Patterson & Newman, 1993) response modulation hypothesis were examined among adolescents with attention-deficit/hyperactivity disorder (ADHD; n=18) and normal controls (n=23). Consistent with predictions, youth with ADHD committed more passive avoidance errors (PAEs) than controls during the latter trials of a computerized go/no go task with mixed incentives, and this effect remained significant or marginally significant even after common variance associated with variables that covary with ADHD (i.e., IQ, oppositional-defiant/conduct disorder [ODD/CD] symptoms, anxious/depressed mood) was removed. While a moderate inverse association was observed between PAE frequency and the amount of time spent viewing response feedback following punishment, both categorical (diagnostic) and dimensional analyses of ADHD symptomatology indicated that ADHD and reflection on punishment feedback are uniquely associated with PAE commission. Findings from this study are discussed in relation to models of disinhibition applicable to youth with ADHD.     

An Evaluation of the Response Modulation Hypothesis in Relation to Attention–Deficit/Hyperactivity Disorder

Several hypotheses related to Newman's (e.g., Patterson & Newman, 1993) response modulation hypothesis were examined among adolescents with attention-deficit/hyperactivity disorder (ADHD; n=18) and normal controls (n=23). Consistent with predictions, youth with ADHD committed more passive avoidance errors (PAEs) than controls during the latter trials of a computerized go/no go task with mixed incentives, and this effect remained significant or marginally significant even after common variance associated with variables that covary with ADHD (i.e., IQ, oppositional-defiant/conduct disorder [ODD/CD] symptoms, anxious/depressed mood) was removed. While a moderate inverse association was observed between PAE frequency and the amount of time spent viewing response feedback following punishment, both categorical (diagnostic) and dimensional analyses of ADHD symptomatology indicated that ADHD and reflection on punishment feedback are uniquely associated with PAE commission. Findings from this study are discussed in relation to models of disinhibition applicable to youth with ADHD.

Accounting for subordinate perceptions of supervisor power: an identity-dependence model

The authors present a model that explains how subordinates perceive the power of their supervisors and the causal mechanisms by which these perceptions translate into subordinate outcomes. Drawing on identity and resource-dependence theories, the authors propose that supervisors have power over their subordinates when they control resources needed for the subordinates' enactment and maintenance of current and desired identities. The joint effect of perceptions of supervisor power and supervisor intentions to provide such resources leads to 4 conditions ranging from highly functional to highly dysfunctional: confirmation, hope, apathy, and progressive withdrawal. Each of these conditions is associated with specific outcomes such as the quality of the supervisor-subordinate relationship, turnover, and changes in the type and centrality of various subordinate identities.     

A chimpanzee (Pan troglodytes) analogue of cross-national generalization of personality structure: zoological parks and an African sanctuary

Six personality factors, including five resembling the human Big Five, had previously been identified in a separate group of zoo-housed chimpanzees. Comparability of chimpanzee personality factor structure was examined in two highly contrasting habitats: zoos and a large African sanctuary. Questionnaires for the zoo chimpanzees were in English, while most for the chimpanzees in the sanctuary were in French. Differences between the two settings were sufficiently extensive to make them analogous to cross-national human personality studies. Internal consistencies for five of the six factors did not differ between the two samples. The patterns of correlations between the unit-weighted factors were also similar for the two samples. Data from these two samples were pooled and factor analyzed. The resulting factor structure was then rotated to the factor structure described in the original study of chimpanzee personality. Dominance, Extraversion, Dependability, and Agreeableness had high congruences. Emotionality and Openness did not, but the items that had the highest loadings were consistent with the factors' definitions. Finally, sex and age effects for all factors generalized across habitats.     

Variations in stress responses following involvement in a railway suicide or attempted suicide

Three train drivers were interviewed one month after their involvement in a railway suicide or suicide attempt. The case studies demonstrate that reactions to these incidents vary from the severe and debilitating (concurrent diagnoses of post-traumatic stress disorder and neurotic depression) to the relatively mild (few reported symptoms). All train drivers reported a significant reduction in symptoms at a follow-up interview six months after the incident. Although the psychological effects of these incidents may be severe they appear to be time-limited.