Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents

Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) among youth are major public health concerns. Although a growing body of research has focused on the complex association between nonsuicidal and suicidal self-injury, the temporal relationship between these two classes of behaviors is unclear. The current study addresses this empirical gap by examining the course of SITBs in adolescents receiving outpatient (N = 106; 82.1 % female) and inpatient (N = 174; 75.9 % female) treatment. SITBs (co-occurrence, age-of-onset, and time lag between SITBs) and major psychiatric disorders were assessed at a single time point with well-validated structured interviews. Adolescents in both clinical samples reported high co-occurrence of SITBs: most adolescents reported both lifetime nonsuicidal self-injury (NSSI) and suicidal thoughts. A similar temporal pattern of SITBs was reported in the two samples: thoughts of NSSI and suicide ideation had the earliest age-of-onset, followed by NSSI behaviors, suicide plans, and suicide attempts. However, the age-of-onset for each SITB was younger in the inpatient sample than in the outpatient sample. In terms of time lag between SITBs, suicide ideation occurred on average before initial engagement in NSSI, suggesting that pathways to NSSI and suicidal behavior may occur simultaneously rather than in succession from nonsuicidal to suicidal self-injury. Results also indicated that the time to transition between SITBs was relatively fast, and that a key period for intervention and prevention is within the first 6–12 months after the onset of suicidal thinking. Taken together, these findings have important implications for understanding the time-lagged relationship between nonsuicidal and suicidal self-injury.     

Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their Views and Experience of Facilitating Multi-Family Discussion Groups

Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors’ professional development.     

Musical competence and phoneme perception in a foreign language

We investigated whether musical competence was associated with the perception of foreign-language phonemes. The sample comprised adult native-speakers of English who varied in music training. The measures included tests of general cognitive abilities, melody and rhythm perception, and the perception of consonantal contrasts that were phonemic in Zulu but not in English. Music training was associated positively with performance on the tests of melody and rhythm perception, but not with performance on the phoneme-perception task. In other words, we found no evidence for transfer of music training to foreign-language speech perception. Rhythm perception was not associated with the perception of Zulu clicks, but such an association was evident when the phonemes sounded more similar to English consonants. Moreover, it persisted after controlling for general cognitive abilities and music training. By contrast, there was no association between melody perception and phoneme perception. The findings are consistent with proposals that music- and speech-perception rely on similar mechanisms of auditory temporal processing, and that this overlap is independent of general cognitive functioning. They provide no support, however, for the idea that music training improves speech perception.     

The emotional integration of childhood experience: physiological, facial expressive, and self-reported emotional response during the adult attachment interview

Attachment researchers claim that individual differences in how adults talk about their early memories reflect qualitatively distinct organizations of emotion regarding childhood experiences with caregivers. Testing this assumption, the present study examined the relationship between attachment dimensions and physiological, facial expressive, as well as self-reported emotional responses during the Adult Attachment Interview (AAI). Consistent with theoretical predictions, more prototypically secure adults behaviorally expressed and reported experiencing emotion consistent with the valence of the childhood events they described. Insecure adults also showed distinctive and theoretically anticipated forms of emotional response: Dismissing participants evidenced increased electrodermal activity during the interview, a sign of emotional suppression, whereas preoccupied adults showed reliable discrepancies between the valence of their inferred childhood experiences and their facial expressive as well as reported emotion during the AAI. Results substantiate a case that the AAI reflects individual differences in emotion regulation that conceptually parallel observations of attachment relationships in infancy.     

Is cognitive therapy consistent with what we know about emotions?

The cognitive perspective has been a dominant force in psychology and psychotherapy since the 1970s. Cognitive therapies share an emphasis on the priority of changing cognition as the key to bringing about changes in patterns of dysfunctional emotional reactions and symptomatic behaviors. In this article, the author examined the basis for the assumptions of cognitive therapy in the context of recent evidence of the long-term effects of stressful experiences. This evidence contradicts the assumption of many cognitive therapists that changing cognition is prior to and necessary to changing emotional reactions. Neurobiological evidence indicates that emotions can be experienced without cortical interpretations of stimuli, and clinical evidence indicates that experiences can be stored as isolated affective fragments that function later to distort cognition. This suggests that cognitive therapies are based on a limited model of mental functions that sometimes must be supplemented by broader psychodynamic concepts if lasting changes are to occur.     

Infants' memory for musical performances

We evaluated 6- and 7-month-olds' preference and memory for expressive recordings of sung lullabies. In Experiment 1, both age groups preferred lower-pitched to higher-pitched renditions of unfamiliar lullabies. In Experiment 2, infants were tested after 2 weeks of daily exposure to a lullaby at one pitch level. Seven-month-olds listened significantly longer to the lullaby at a novel pitch level than at the original pitch level. Six-month-olds showed no preference but their low-pitch preference was eliminated. We conclude that infants' memory for musical performances is enhanced by the ecological validity of the materials. Moreover, infants' pitch preferences are influenced by their previous exposure and by the nature of the music.     

Effects of an Internet-based voucher reinforcement program for smoking abstinence: a feasibility study

The present study tested the feasibility of an Internet-based method to obtain objective evidence of smoking abstinence and to deliver vouchers for evidence of abstinence. Four heavy smokers participated in this 4-week study. Twice daily, participants made video recordings of themselves providing a breath carbon monoxide (CO) sample with a Web camera. The video was sent electronically to the smoking clinic. Participants could earn vouchers for gradual reductions in breath CO during an initial shaping condition, and then for achieving abstinence (CO < or = 4 ppm). Vouchers could be exchanged for merchandise at select Internet vendors. Relative to baseline conditions, participants substantially reduced their smoke intake, and 3 achieved sustained periods of abstinence. The study suggests that an Internet-based voucher reinforcement program is a feasible method to promote abstinence from cigarette smoking.