A Note on Spinoza's Contribution to Systemic Therapy

Writing 300 years ago the philosopher Spinoza anticipated some of the fundamental principles of systemic therapy, notably a respect for the remorseless logic of natural systems and the value of positive connotation. In the debate about the ethics of paradoxical methods, he offers a logical, and humble, defense.     

Factors Associated with Suicide Ideation in Severely Obese Bariatric Surgery‐Seeking Individuals

There are high rates of suicide ideation and/or behavior in severely obese individuals. The potential contributors to suicide ideation in a sample of 334 severely obese bariatric surgery candidates was explored. Lack of college education, a history of suicide ideation and/or behavior, psychological distress, hopelessness, loneliness, history of physical and/or sexual abuse, and lifetime major depression were associated with current suicide ideation. Some of the correlates of suicide ideation in severely obese bariatric surgery‐seeking samples are similar to those found in the general community and this knowledge may serve to improve the psychological assessment and care for this group.     

Is Veteran Status and Suicide Risk Assessed in Community Long‐Term Care? A Review of the States' Assessment Instruments

Given recent policy initiatives to address suicide risk among older persons and veterans, community‐based elder serving agencies may serve an important role in identifying and referring individuals at risk for suicide. A review of state‐level long‐term assessment instruments was conducted to determine whether veteran status and suicide are assessed. Data from forty‐three state's Units on Aging instruments were content analyzed. Results indicate that over two thirds of the states in this review included questions about suicide and veterans in their assessments, 69.8% and 67.4% respectively. Suicide risk among elders and veterans must be addressed at local, state, and federal levels so that concerted attention and oversight can be provided for matching elders to the services they need.     

Considerations Regarding Online Methods for Suicide‐Related Research and Suicide Risk Assessment

Frequent advances in technology provide new and exciting opportunities for conducting suicide research and suicide risk assessments. However, to the authors' knowledge, best practices for using technology, specifically the Internet, to conduct research protocols involving suicide risk assessments have not been examined. In research contexts, the use of technology for research on suicidal behavior and suicide risk assessment can offer benefits relative to other forms of data collection. These advantages, which include increased validity, feasibility, and efficiency, as well as improvements in data collection and management, are presented. Considerations regarding the implementation of an online system for suicide risk assessment as well as limitations and future directions are discussed.     

Marital Discord and Suicidal Outcomes in a National Sample of Married Individuals

Suicide is the tenth leading cause of death in the United States, with an average of 105 suicides committed daily. The association between marital discord and 12‐month prevalence of suicidal ideation and suicide attempt was studied in a population‐based sample of married adults (N = 1,384). Marital discord was significantly and positively associated with suicidal ideation and suicide attempt, and these associations remained significant when controlling for demographics and 12‐month prevalence of mood, anxiety, and substance use disorders. Results suggest that marital discord is an important correlate of suicidal outcomes and may be important to target in preventing and treating suicide.     

A Five‐Month Longitudinal Study of Psychache and Suicide Ideation: Replication in General and High‐Risk University Students

Shneidman's (1993) model of psychache as the cause of suicide was evaluated in a 5‐month longitudinal study of psychological pain and suicide ideation. Replicating across general (N = 683) and high‐risk undergraduates (N = 262), psychache was significantly associated with suicide ideation, and change in psychache was significantly associated with change in suicide ideation. For general suicide ideation and suicide preparation, these significant results were maintained even when depression and hopelessness were statistically controlled. This research is a unique contribution being the first large‐sample longitudinal study that evaluates and supports Shneidman's psychache causal model of suicidality in general and high‐risk groups.     

Evaluating the Interpersonal Needs Questionnaire: Comparison of the Reliability,Factor Structure,and Predictive Validity across Five Versions

Five versions of the Interpersonal Needs Questionnaire (INQ), a self‐report measure of perceived burdensomeness and thwarted belongingness, have been used in recent studies (including 10‐, 12‐, 15‐, 18‐, and 25‐items). Findings regarding the associations between perceived burdensomeness, thwarted belongingness, and suicidal ideation using different versions have been mixed, potentially due to differences in measurement scales. This study evaluated factor structure, internal consistency, and concurrent predictive validity of these five versions in three samples. Samples 1 and 2 were comprised of 449 and 218 undergraduates, respectively; Sample 3 included 114 adolescent psychiatric inpatients. All versions demonstrated acceptable internal consistency. The 10‐item version and 15‐item version demonstrated the best, most consistent model fit in confirmatory factor analyses. Both perceived burdensomeness and thwarted belongingness consistently predicted concurrent suicidal ideation on the 10‐item INQ only. Future research should consider using the 15‐item or 10‐item versions.     

The Importance of High Distress Tolerance in the Relationship between Nonsuicidal Self‐Injury and Suicide Potential

Research has indicated that nonsuicidal self‐injury (NSSI) and suicidal behavior are strongly related to one another, with a sizable portion of individuals with a history of NSSI also reporting a history of nonlethal suicide attempts. Nonetheless, little research has examined possible moderators of this relationship. One potentially important construct is distress tolerance (DT), which has been shown to be negatively associated with NSSI and positively associated with the acquired capability for suicide. In this study, 93 adult inpatients (54.8% male) receiving treatment for substance use disorders completed a structured interview assessing prior suicidal behavior and questionnaires assessing DT, NSSI, and psychopathology. Results indicated that DT moderates the relationship between NSSI frequency (but not number of NSSI methods) and suicide potential (a continuum ranging from no prior suicidal behavior to suicidal behavior with minimal bodily harm to highly lethal suicidal behavior), ΔR² = .04; p < .023; f² = .06, with this relation increasing in strength at higher levels of DT. These results are consistent with an emerging line of research indicating that high levels of DT facilitate suicidal behavior in at‐risk populations and suggest that the capacity to tolerate aversive physiological and affective arousal might be vital to engagement in serious or lethal suicidal behavior.     

Frequency of Nonsuicidal Self‐Injury in Adolescents: Differences in Suicide Attempts,Substance Use,and Disordered Eating

The relationship between frequency of nonsuicidal selfinjury (NSSI) and suicide attempts, substance use, and disordered eating was assessed in a community sample of 4,839 adolescents, 922 of whom reported NSSI in the past year. It was expected that the engagement in risk behaviors would significantly increase as NSSI frequency increased. Participants completed the Youth Risk Behavior Survey (Centers for Disease Control and Prevention, 2009) and were subdivided into five NSSI frequency groups: none, 1 time, 2–3 times, 4–5 times, and 6 or more times. A one‐way MANOVA found significant mean differences for all variables across NSSI frequency groups. The no NSSI group was significantly lower than all other groups on all variables. For suicide attempts, all frequency groups were significantly different from each other, with attempt frequency increasing with each increase in NSSI frequency. The six or more group reported significantly more substance use and disordered eating than all other groups. Overall, adolescents with more frequent NSSI represent a group at risk for concurrent unhealthy behaviors and suicide attempts.     

Suicidal Behavior Outcomes of Childhood Sexual Abuse: Longitudinal Study of Adjudicated Girls

Childhood sexual abuse (CSA) histories are prevalent among adolescent girls in the juvenile justice system (JJS) and may contribute to their high rates of suicidal behavior. Among 166 JJS girls who participated in an intervention trial, baseline CSA and covariates were examined as predictors of suicide attempt and nonsuicidal self‐injury (NSSI) reported at long‐term follow‐up (7–12 years later). Early forced CSA was related to lifetime suicide attempt and NSSI history and (marginally) to postbaseline attempt; effects were not mediated by anxiety or depressive symptoms. Findings suggest that earlier victimization and younger entry into JJS are linked with suicide attempt and NSSI.