The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near‐term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide‐Severity Rating Scale (C‐SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C‐SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near‐term suicidal risk factor.     

Excellence‐Prior Eudaimonism

Eudaimonism is often regarded as egoistic. If it recommends that agents pursue their own good because it is their own good, it is guilty as charged. But excellence‐prior eudaimonism offers a non‐egoistic alternative to this welfare‐prior eudaimonism. Excellence‐prior eudaimonism recommends that an agent live in a way that is in fact good for the agent, but it does not regard the agent’s own good as necessarily that for the sake of which the agent acts, nor does it regard living well as justified by the fact that it is good for the agent, but simply because it is good. The Christian eudaimonisms of Augustine and Aquinas are best understood as deepened forms of excellence‐prior eudaimonism.     

Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model

Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families’ engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.     

Are high levels of religiosity inconsistent with a high valuation of science? Evidence from the United States,China and Iran

We asked whether high levels of religiosity are inconsistent with a high valuation of science. We explored this possibility in three countries that diverge markedly in the relation between the state and religion. Parents in the United States (n = 126), China (n = 234) and Iran (n = 77) completed a survey about their personal and parental stance towards science. The relation between religiosity and the valuation of science varied sharply by country. In the U.S. sample, greater religiosity was associated with a lower valuation of science. A similar but weaker negative relation was found in the Chinese sample. Parents in the Iranian sample, by contrast, valued science highly, despite high levels of religiosity. Given the small size of our United States and Iranian samples, and the non-probabilistic nature of our samples in general, we caution readers not to generalise our findings beyond the current samples. Despite this caveat, these findings qualify the assumption that religiosity is inconsistent with the valuation of science and highlight the role of sociocultural context in shaping adults' perception of the relation between religion and science.     

Coping and Mental Health in Early Adolescence during COVID-19

Research on Child and Adolescent Psychopathology - The current longitudinal study examines changes in overall mental health symptomatology from before to after the COVID-19 outbreak in youth from...