Describing suicidality: an investigation of qualitative SSF responses

Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Development and psychometric properties of the disability application appraisal inventory

This article describes the development and psychometric properties of an inventory to assess cognitive appraisal of the Department of Veterans Affairs (VA) disability application process, the Disability Application Appraisal Inventory (DAAI). Participants were 439 veterans seeking disability status for posttraumatic stress disorder through the VA and subgroups from that sample. The 3 DAAI scales assess (a) understanding of the disability application process (Knowledge scale) (b) expectations specific to the process (Negative Expectations scale) and (c) investment in obtaining disability status (Importance scale). The scales are internally consistent and largely uncorrelated. Test-retest correlations are adequate for the Negative Expectations and Importance scales. Evidence of factorial and construct validity is presented.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Two- and three-year-olds infer and reason about design intentions in order to categorize broken objects

In naming artifacts, do young children infer and reason about the intended functions of the objects? Participants between the ages of 2 and 4 years were shown two kinds of objects derived from familiar categories. One kind was damaged so as to undermine its usual function. The other kind was also dysfunctional, but made so by adding features that appeared to be intentional. Evidence that 2‐, 3‐ and 4‐year‐olds were more likely to apprehend the broken objects than the intentionally dysfunctional objects as members of the familiar lexical categories favors the conclusion that, in naming, children may spontaneously infer and reason about design intentions from an early age. This is the first evidence that 2‐ and 3‐year‐olds not only take design intentions into account in object categorization, but that they do so even without explicit mention of the objects’ accidental or intentional histories. The results cast doubt on a proposal that young children's lexical categorization is based on automatic, non‐deliberative processes.     

Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality

The influence of complicated grief (CG) on suicidality among bereaved adults was examined. The Yale Evaluation of Suicidality scale and the Inventory of Complicated Grief-Revised were administered to 309 bereaved adults in face-to-face interviews conducted at baseline (6.2 months post-loss) and at follow-up (10.8 months post-loss). Cross-sectionally, CG was associated with a 6.58 (95% CI: 1.74-18.0) times greater likelihood of "high suicidality" at baseline, and an 11.30 (95% CI: 3.33-38.10) times greater risk of high suicidality at follow-up, after controlling for gender, race, major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and social support. Longitudinally, CG at baseline was associated with an 8.21 (95% CI: 2.49-27.0) times greater likelihood of high suicidality at follow-up, controlling for the above confounders. The study results indicate that CG substantially heightened the risk of suicidality after controlling for important confounders such as MDD and PTSD, suggesting that CG poses an independent psychiatric risk for suicidal thoughts and actions.     

Ethnicity, expressed emotion, attributions, and course of schizophrenia: family warmth matters

The authors examined the role of family factors and the course of schizophrenia by carrying out additional assessments and analyses in 2 previously published studies of Mexican American and Anglo American patients and families. The authors found partial support for an attributional model of relapse for families who are low in emotional overinvolvement. Attributions of control, criticism, and warmth together marginally predicted relapse. The data also indicated that for Mexican Americans, family warmth is a significant protective factor, whereas for Anglo Americans, family criticism is a significant risk factor. These findings suggest that the sociocultural context shapes the pathways by which family processes are related to the course of illness. Moreover, the warmth findings suggest that families may contribute to preventing relapse.     

Integrity, conscientiousness, and honesty

Undergraduate volunteers from the Psychology participant pool (N=86, age M=22.7, SD=4.8 yr.; 72 of 86 were female) took two tests, a commercially available integrity test (the Personnel Selection Inventory) and the NEO-Five Factor Inventory. Later in the study, each participant was given an opportunity to report dishonestly the amount of time spent in the laboratory and thus to receive more extra-credit points than earned. An observer recorded participants' actual times in the laboratory to provide an accurate assessment of participants' honesty. Analysis indicated that the Personnel Selection Inventory did not predict whether the participant was honest or dishonest in reporting time spent. Conscientiousness as measured by the NEO-Five Factor Inventory, however, not only predicted behavior, but did so significantly better than did the Personnel Selection Inventory. The study provides new information about the value of integrity tests by comparing integrity and personality tests in the simultaneous prediction of a specific criterion.     

VIZ: The visualization assessment and training Web site

The VIZ Website(http:/viz.bd.psu.ech]/viz/) was developed as a free and open portal for assessment and training of spatial skills. Using Macromedia Authorware, it allows the collection of response times and accuracies from four spatial tasks: mental rotation, paper folding, water level judgments, and spatial working memory. Additional tasks are under development. The site has been used for a variety of teaching and research purposes. For example, incoming engineering students have completed the tasks to assess their spatial skills before beginning their graphics courses. Those with poorer skills can then receive the appropriate remedial instruction. The VIZ site has also been used to teach about spatial cognition and to do research outside the laboratory setting. Finally, we are using the site to conduct basic research on spatial cognition, including an examination of the factors that may reduce gender differences in performance.     

Perceptions of Ethical Behaviour among Business Faculty in Canada

Faculty members at Canadian business schools were surveyed regarding their ethical perceptions of behaviours related to undergraduate instruction. Fifty-five behavioural statements were listed and respondents were asked to rate the extent to which they felt each behaviour was ethical or unethical. The only item that respondents endorsed as unequivocally unethical (90% indicated it was definitely unethical) was Becoming sexually involved with an undergraduate in one of your classes. We also compared the results of our sample to those of an American sample. Overall, an interesting pattern of differences emerged between the responses obtained in Canada and the U.S. In general, the direction of the significant differences was such that Canadian professors viewed the behaviours in question as less ethical than did their American counterparts.