Suicide Ideation in Adolescents Following Inpatient Hospitalization: Examination of Intensity and Lability Over 6 Months

Understanding suicide ideation (SI) in adolescents, especially during the high‐risk time following hospitalization for a suicidal event, is a crucial component of improving risk assessment. Most studies rely on single assessments of SI, despite the potential for SI to vary considerably over time. This study examined how indices of SI intensity (mean values) and lability (mean squared successive difference values) over a 6‐month period predict suicide attempts (SAs) and self‐harm, as well as how they relate to psychosocial risk factors and affective functioning, in a sample of 103 adolescents hospitalized for a SA or significant SI. Across the sample, SI intensity, but not lability, was associated with SAs and nonsuicidal self‐injury at 6‐month follow‐up. SI intensity performed similarly to single time point SI assessments, and its relations were not moderated by SI lability. SI intensity was also associated with borderline personality disorder criteria and a history of sexual abuse. In contrast, SI lability was associated with greater negative affect intensity and lability. These findings suggest that intensity of SI may confer more risk posthospitalization, and provide support for using these statistical methods to capture two distinct parameters of SI.     

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.     

Trauma‐Related Guilt Mediates the Relationship between Posttraumatic Stress Disorder and Suicidal Ideation in OEF/OIF/OND Veterans

Posttraumatic stress disorder (PTSD) and trauma‐related guilt are risk factors for suicidal ideation (SI) in veterans. Components of trauma‐related guilt were examined as serial mediators of the relationship between PTSD and SI. In a sample of 53 OEF/OIF/OND combat veterans, PTSD had an indirect effect on SI through a serial mediation chain of guilt cognitions, distress, and global guilt, suggesting that trauma‐related guilt via cognitions, distress, and global guilt is a pathway from PTSD to SI. Attention should be given to assessing and addressing trauma‐related guilt in veterans experiencing PTSD to prevent SI.     

Understanding the emotional aspects of escalation of commitment: the role of negative affect

Despite the importance of understanding the emotional aspects of organizational decision making, prior research has paid scant attention to the role of emotion in escalation of commitment. This article attempts to fill this gap by examining the relationship between negative affect and escalation of commitment. Results showed that regardless of whether negative affect was measured as a dispositional trait (Neuroticism) in Studies 1 and 2 or as a transient mood state in Study 3, it was negatively correlated with escalation tendency when one was personally responsible for a prior decision. This pattern of results is consistent with the predictions derived from the coping perspective, suggesting that people seek to escape from the unpleasant emotions that are associated with escalation situations.     

Unfamiliar Untrained Observers’ Ratings of Adolescent Safety Behaviors Within Social Interactions with Unfamiliar Peer Confederates

Adolescents experiencing social anxiety often engage in safety behaviors―covert avoidance strategies for managing distress (e.g., avoiding eye contact)―that factor into the development and maintenance of their concerns. Prior work supports the psychometric properties of the Subtle Avoidance Frequency Examination (SAFE), a self-report survey of safety behaviors. Yet, we need complementary methods for assessing these behaviors within contexts where adolescents often experience concerns, namely, interactions with unfamiliar peers. Recent work indicates that, based on short, direct social interactions with adolescents, individuals posing as unfamiliar peers (i.e., peer confederates) and without assessment training can capably report about adolescent social anxiety. We built on prior work by testing whether we could gather valid SAFE reports from unfamiliar untrained observers (UUOs), who observed adolescents within archived recordings of these short social interactions. A mixed clinical/community sample of 105 adolescents self-reported on their functioning and participated in a series of social interaction tasks with peer confederates, who also provided social anxiety reports about the adolescent. Based on video recordings of these tasks, trained independent observers rated adolescents’ observed social skills, and an additional set of UUOs completed SAFE reports of these same adolescents. Unfamiliar untrained observers’ SAFE reports (a) related to adolescents’ SAFE self-reports, (b) distinguished adolescents on clinically elevated social anxiety concerns, (c) related to trained independent observers’ ratings of adolescent social skills within interactions with peer confederates, and (d) related to adolescents’ self-reported arousal within these same interactions. Our findings support use of unfamiliar observers’ perspectives to understand socially anxious adolescents’ interpersonal functioning.     

Spatial updating relies on an egocentric representation of space: Effects of the number of objects

Models of spatial updating attempt to explain how representations of spatial relationships between the actor and objects in the environment change as the actor moves. In allocentric models, object locations are encoded in an external reference frame, and only the actor’s position and orientation in that reference frame need to be updated. Thus, spatial updating should be independent of the number of objects in the environment (set size). In egocentric updating models, object locations are encoded relative to the actor, so the location of each object relative to the actor must be updated as the actor moves. Thus, spatial updating efficiency should depend on set size. We examined which model better accounts for human spatial updating by having people reconstruct the locations of varying numbers of virtual objects either from the original study position or from a changed viewing position. In consistency with the egocentric updating model, object localization following a viewpoint change was affected by the number of objects in the environment.