Treating the Capability for Suicide: A Vital and Understudied Frontier in Suicide Prevention

Current efforts at suicide prevention center largely on reducing suicidal desire among individuals hospitalized for suicidality or being treated for related psychopathology. Such efforts have yielded evidence‐based treatments, and yet the national suicide rate has continued to climb. We propose that this disconnect is heavily influenced by an unmet need to consider population‐level interventions aimed at reducing the capability for suicide. Drawing on lessons learned from other public health phenomena that have seen drastic declines in frequency in recent decades (HIV, lung cancer, motor vehicle accidents), we propose that current suicidality treatment efforts trail current suicidality theories in their lack of focus on the extent to which individuals thinking about suicide are capable of transitioning from ideation to attempt. We summarize extant evidence for specific capability‐centered approaches (e.g., means safety) and propose other options for improving our ability to address this largely overlooked variable. We also note that population‐level approaches in this regard would represent an important opportunity to decrease risk in individuals who either lack access to evidence‐based care or underreport suicidal ideation, as a reduced capability for suicide would theoretically diminish the potency of suicidal desire and, in this sense, lower the odds of a transition from ideation to attempt.     

Suicide Exposure in the Population: Perceptions of Impact and Closeness

Recent studies of people exposed to suicide point to a continuum of effects moderated by a perception of closeness to the deceased. We investigated the importance of perception of impact of the death on mental health outcomes of those exposed to suicide. Female sex, younger age, and multiple exposures to suicide were associated with greater risk for poorer outcomes. Suicide exposed with high impact was more likely to have depression, anxiety, posttraumatic stress disorder, prolonged grief, and suicide ideation. Findings can help focus postvention resources for suicide‐exposed individuals.     

Predictors of PTSD Improvement with Cognitive/Exposure Group Interventions in Operation Enduring Freedom/Operation Iraqi Freedom Female Veterans

Predictors of successful PTSD outcome have been examined through individually delivered treatments. We examined predictors using a group protocol with cognitive, exposure, and skills modules. Assessments included self-report and interview (CAPS, SCID-I/II) measures at baseline, post, and six months; treatment was a 16-week, three-member group for 32 OEF/OIF women Veterans. A regression analysis showed major depressive disorder and no baseline psychiatric medication predicted PTSD improvement. PTSD improvement predicted fewer outpatient medical visits at follow-up. The results supported past research and challenged other findings (e.g., sexual assault predicts less improvement). An additional unique contribution was examining predictors in a group treatment format.     

Metacognition of agency across the lifespan

Metacognitions of agency were investigated using a computer task in which X’s and O’s streamed from the top of a computer screen, and the participants moved the mouse to get the cursor to touch the X’s and avoid the O’s. After each 15 s trial, participants made judgments of agency and judgments of performance. Objective control was either undistorted, or distorted by (1) Turbulence (i.e., random noise), (2) a Lag between the mouse and cursor movements (of 250 or 500 ms), or (3) ‘Magic,’ (i.e., an increased radius around the X’s for which credit was given). In Experiment 1, college students’ judgments of agency showed that they were sensitive to all three manipulations. They also indicated that they felt more in control in the Lag conditions, where there was a rule on which they could potentially capitalize, than in the matched Turbulence conditions. In Experiment 2, older adults were also sensitive to all three manipulations, but less so than the college students. They were not sensitive to the difference between the Lag and Turbulence manipulations. Finally, in Experiment 3, 8–10 year-old children were sensitive to their loss of control equally in the Lag and Turbulence conditions. However, when performance was artificially improved, in the Magic condition, children took full credit and showed no evidence that they realized that the results were due to an external variable. Together, these findings suggest that people’s metacognition of agency changes in important ways across the lifespan.     

Sex differences in children's discrepant perceptions of peer acceptance

Sex differences in children's play patterns during middle childhood are thought to promote greater awareness of social acceptance among girls compared with boys. The present study posited that girls are more discerning of peer acceptance than are boys; however, these sex differences were predicted to vary depending on how discrepant perceptions were assessed (i.e., inaccuracy versus bias). Additional differences were expected if children perceived acceptance by same- versus opposite-sex peers. Participants were 912 third through fifth graders (420 girls and 492 boys). Consistent with predictions, boys were more inaccurate than girls, but only for perceived acceptance by same-sex peers. As expected, girls were more negatively biased than boys, but only for perceived acceptance by opposite-sex peers. Results did not support the hypothesis that boys have more positively biased perceptions of peer acceptance than girls. Overall, these findings raise important issues regarding the evaluation of children's discrepant self-perceptions of peer acceptance.     

Psychology's contributions to understanding and addressing global climate change

Global climate change poses one of the greatest challenges facing humanity in this century. This article, which introduces the American Psychologist special issue on global climate change, follows from the report of the American Psychological Association Task Force on the Interface Between Psychology and Global Climate Change. In this article, we place psychological dimensions of climate change within the broader context of human dimensions of climate change by addressing (a) human causes of, consequences of, and responses (adaptation and mitigation) to climate change and (b) the links between these aspects of climate change and cognitive, affective, motivational, interpersonal, and organizational responses and processes. Characteristics of psychology that cross content domains and that make the field well suited for providing an understanding of climate change and addressing its challenges are highlighted. We also consider ethical imperatives for psychologists' involvement and provide suggestions for ways to increase psychologists' contribution to the science of climate change.     

Existential Assessment

Present day psychological assessment stems from a philosophy of sicence that values objectivity but fails to comprehend the existence of the person being evaluated. A humanistic-existential model shifts the focus from omnipotence to encounter and encourages client responsibility. The vehicle for this conceptualization is the nature and meaning of the encounter between clinician and client. New questions are posed for the assessor by altering the assessment goals, the stance toward interpretation, and the criterion for validation.     

The relationship between teacher ratings of kindergarten classroom skills and second-grade achievement scores: An analysis of gender differences

The Kindergarten Performance Profile, a criterion-referenced teacher rating scale, was developed by a multidisciplinary group of public school teachers, child development specialists, and evaluators. The present study analyzed the social and work skill areas of the rating scale, focusing on the relationship of classroom skills in the fall and spring of kindergarten to second-grade achievement scores. Gender differences, as well as the impact of assessing children's skills in the fall versus the spring of kindergarten were explored. Results indicated that kindergarten work skills were significantly related to California Achievement Test scores for both boys and girls; however, kindergarten social skills were related to achievement scores for girls but not boys. Teacher ratings from either the fall or the spring were predictive of achievement test scores for girls, although different girls were identified as having problems at the two time periods: whereas spring evaluations were more strongly related to boys' later achievement. The implications of these findings for assessment programs are discussed.