Accuracy of Clinician Predictions of Future Self‐Harm: A Systematic Review and Meta‐Analysis of Predictive Studies

Assessment of a patient after hospital‐treated self‐harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self‐harm. Through systematic review and a series of meta‐analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18–0.50), specificity 0.85 (0.75–0.92), positive predictive value 0.22 (0.21–0.23), and negative predictive value 0.89 (0.86–0.92). Clinician classification was too inaccurate to be clinically useful. After‐care should therefore be allocated on the basis of a needs rather than risk assessment.     

An Empirical Test of the Three‐Step Theory of Suicide in U.K. University Students

The purpose of this study was to further our understanding of how individuals move down the pathway from first thinking about suicide to ultimately attempting to take their own lives by empirically testing the Three‐Step Theory (3ST) in a sample of university students (n = 665). Results largely support the theory's central propositions. First, an interactive model of pain and hopelessness accounted for substantial variance in suicidal desire. This result replicated in both men and women, and across age groups (i.e., below 35 and at or above 35). Also, as predicted, connectedness was protective against ideation in those high on both pain and hopelessness. However, contrary to our prediction, connectedness was similarly protective among everyone else. Finally, suicide capacity predicted suicide attempt history over and above current and lifetime suicide ideation. These findings provide further support to the 3ST.     

An Exploration of Family Problem-Solving and Affective Involvement as Moderators Between Disease Severity and Depressive Symptoms in Adolescents with Inflammatory Bowel Disease

Little is known about how family functioning relates to psychosocial functioning of youth with inflammatory bowel disease (IBD). The study aim was to examine family problem solving and affective involvement as moderators between adolescent disease severity and depressive symptoms. Participants were 122 adolescents with IBD and their parents. Measures included self-reported and parent-reported adolescent depressive symptoms, parent-reported family functioning, and physician-completed measures of disease severity. Disease severity was a significant predictor of adolescent-reported depressive symptoms, but not parent-reported adolescent depressive symptoms. Family affective involvement significantly predicted parent-reported adolescent depressive symptoms, while family problem-solving significantly predicted adolescent self-report of depressive symptoms. Neither affective involvement nor problem-solving served as moderators. Family affective involvement may play an important role in adolescent emotional functioning but may not moderate the effect of disease severity on depressive symptoms. Research should continue to examine effects of family functioning on youth emotional functioning and include a sample with a wider range of disease severity to determine if interventions aimed to enhance family functioning are warranted.     

Implicit memory for novel conceptual associations in amnesia

In two experiments, we evaluated the status of implicit memory for novel associations in amnesia. Experiment 1 assessed priming in a category exemplar generation task in which contextual information associated with a target could increase the likelihood of target generation. Control participants, but not amnesic patients, showed associative priming. Amnesics’ impairment was not due to the use of explicit memory by control subjects but reflected a genuine impairment in implicit memory for novel conceptual associations. Experiment 2 assessed priming in a relatedness judgment task, in which associative priming was manifest as longer latencies for old than for recombined pairs of unrelated words. Amnesic patients showed intact associative priming in this task. We discuss differences in the status of implicit memory for novel conceptual associations in amnesia, with reference to the nature of the representation that supports priming in the two tasks and the type of processing that is required at test.     

A dual-process account of digit invariance learning

Performance in the McGeorge and Burton (1990) digit invariance task was originally thought to be mediated by unconscious abstraction of a “rule” that identified the invariant feature across all study items. Subsequent explanations have suggested explicit strategy use or similarity-to-exemplar matching rather than abstraction. This paper presents data that suggest that both similarity and abstraction can be used under different task demands. Delay between study and test afforded abstraction of the invariant knowledge whereas reducing the pool of study exemplars enhanced responding based on specific similarity. These results parallel effects found in the categorization literature. Rule abstraction in this sense may be due to statistical learning of feature frequency rather than abstraction of a central tendency or a complex/conceptual rule. Categorizing responses into subjective memory states (remember/know/guess) demonstrates that neither the similarity matching nor the abstraction mechanism uses information from episodic memory. Confidence measures show that participants are more confident of responses when the prototypical representation is used but not specific similarity. Taken together, these data suggest that abstracted knowledge is not held consciously but that participants have meta-awareness of when they are using the abstracted representation.