Advancing prevention research on the role of culture in suicide prevention

Despite evidence of considerable racial/ethnic variation in adolescent suicidal behavior in the United States, research on youth of European American descent accounts for much of what is know about preventing adolescent suicide. In response to the need to advance research on the phenomenology and prevention of suicidal behavior among ethnic minority populations, NIMH co-sponsored the "Pragmatic Considerations of Culture in Preventing Suicide" workshop to elicit through interdisciplinary dialogue how culture can be considered in the design, development, and implementation of suicidal behavior prevention programs. In this discussion paper we consider the three ethnic minority suicide prevention efforts described in the articles appearing in this issue, along with workshop participants' comments, and propose six major areas where issues of culture need to be better integrated into suicidal behavior research.     

When to offer cognitive behavioural or psychoanalytic psychotherapy in an integrated psychotherapy service: Are everyday allocation decisions theoretically congruent?

Different modes of psychotherapy can be an effective form of treatment for a range of mental health problems. Psychotherapy provision in the NHS is organised in a variety of ways, with patient entry to various modes of therapy determined by a range of factors including evidence‐based guidelines and patient or referrer preference. The methods by which patients arrive at a particular mode of psychotherapy are largely unreported. This paper aims to describe this process in one UK NHS psychotherapy service offering cognitive behavioural and psychoanalytic psychotherapy, and provides data to inform a discussion on the theoretical congruence of these allocation decisions.     

Women's Cognitive,Affective, and Physiological Reactions to a Male Coworker's Sexist Behavior1

Empirical research has documented the attitudinal and behavioral consequences of sexual harassment, but has not examined the physiological consequences. In the present study, we monitored women's autonomic physiological activity while they performed a word‐association task with a male confederate who was either harassing, egalitarian, or submissive. Subsequently, we examined the women's cognitive, affective, and physiological reactions as they prepared and delivered a speech to the same confederate. Results indicate that harassment led to greater cardiovascular reactivity during the word‐association task and to greater cognitive, negative affective, and cardiovascular reactions during the subsequent speech compared with other conditions. Subgroups of harassed women who confronted their coworker, or who blamed themselves for his behavior, also exhibited greater cardiovascular reactivity during both tasks compared to women who did not use these coping responses. We integrate our laboratory results with those obtained in field settings.     

Non-organizational Religious Participation,Subjective Religiosity,and Spirituality among Older African Americans and Black Caribbeans

This study utilizes data from the National Survey of American Life to examine the sociodemographic and denominational correlates of religious involvement and spirituality among older African Americans and Black Caribbeans. Eleven measures of non-organizational religious participation, subjective religiosity, and spirituality are utilized. The findings indicate significant gender, income, region, marital status, denominational, and immigration status differences in religiosity and spirituality. Among older Black Caribbeans, income was a consistent correlate of religious participation and spirituality. The findings are discussed in relation to prior work in the area of religious involvement among older adults.     

Subject‐Involving Luck

In recent years, philosophers have tended to think of luck as being a relation between an event (taken in the broadest sense of the term) and a subject; to give an account of luck is to fill in the right‐hand side of the following biconditional: an event e is lucky for a subject S if and only if ____. We can call such accounts of luck subject‐relative accounts of luck, since they attempt to spell out what it is for an event to be lucky relative to a subject. This essay argues that we should understand subject‐relative luck as a secondary phenomenon. What is of philosophical interest is giving an account of subject‐involving luck, i.e., filling in the right‐hand side of this biconditional: it is a matter of luck that S ?s iff ____. The essay argues that one of the upshots of focusing on subject‐involving luck is that lack of control accounts of luck (LCALs) become more attractive. In particular, a range of counterexamples to LCALs of subject‐relative luck do not apply to LCALs of subject‐involving luck.     

Friendship cliques: a comparison of the motivational traits of lower/upper track algebra students

This project examined the relationships among the motivation and cognitive profiles of adolescent friendship cliques and peripheral (outside the clique group) students in lower and upper track algebra classes. Two hundred and thirty students from two high schools completed a motivation and cognitive engagement instrument as well as a peer group nomination survey form. Twelve teachers were also asked to complete peer group nomination survey forms. This project used socio-metric and correlational techniques based on previous research traditions in exploring friendship and peer group research to examine these relationships. The results were consistent with theoretically driven predictions and extend previous findings of the impact of friendship cliques in lower grade levels to those of adolescents in the high school setting. Future research in adolescent friendship/clique group research is also discussed.     

How effective are minimally trained/experienced volunteer mental health counsellors? Evaluation of CORE outcome data

Background: Existing research findings indicate that minimally trained/experienced paraprofessional counsellors can be as effective as professionally trained and experienced counsellors. More research into the effectiveness of paraprofessionals with specific client populations is required to determine the conditions under which they can be most effective. Aims: To evaluate the effectiveness of a group of 12 minimally trained/experienced volunteer mental health counsellors. Method: Data were collected over a one year period on 118 clients referred to a voluntary sector counselling agency. The CORE-OM was used to measure clients' levels of distress on a session-by-session basis. Clients and counsellors also completed a range of additional self-report measures. A benchmarking strategy was used to evaluate the outcomes achieved by participants in this study against three benchmark studies selected from published literature. Results: Paraprofessionals in this study were less effective than their professional counterparts. Results showed that participants in this study achieved an effect size of .70 compared to effect sizes of 1.36, 1.39 and 1.42 in the selected benchmark studies. Implications: Findings suggest that minimally trained/experienced paraprofessional counsellors working in mental health settings may benefit from longer and more targeted training programmes before engaging in practice. Conclusions: The benchmarking strategy provided a valuable and practical means of evaluating the comparative effectiveness of paraprofessional and professional counsellors. Findings should be interpreted cautiously as the selected benchmarks are not precise measurements and may not reflect the organisational factors operating within voluntary sector counselling agencies.