The Course of Post‐Crisis Suicidal Symptoms: How and for Whom Is Suicide “Cathartic”?

We investigated suicide "catharsis" as evidenced by decreased suicidality following a suicide attempt. Past research has examined this issue with mixed results (Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985). In the present study, we examined Modified Scale for Suicide Ideation (MSSI) scores for 198 suicidal men during suicidal crisis, prior to entry into a treatment study, and again at 1-month and 12-month follow-ups. Patients were divided into ideators, single attempters, and multiple attempters. We found evidence for decreased suicidality, but interpreted it as the gradual action of interpersonal support, rather than as emotional catharsis. Also, multiple attempt status affected the long-term course of post-crisis suicidality.     

Establishing standards for the assessment of suicide risk among callers to the national suicide prevention lifeline

The National Suicide Prevention Lifeline was launched in January 2005. Lifeline, supported by a federal grant from the Substance Abuse and Mental Health Services Administration, consists of a network of more than 120 crisis centers located in communities across the country that are committed to suicide prevention. Lifeline's Certification and Training Subcommittee conducted an extensive review of research and field practices that yielded the Lifeline's Suicide Risk Assessment Standards. The authors of the current paper provide the background on the need for these standards; describe the process that produced them; summarize the research and rationale supporting the standards; review how these standard assessment principles and their subcomponents can be weighted in relation to one another so as to effectively guide crisis hotline workers in their everyday assessments of callers to Lifeline; and discuss the implementation process that will be provided by Lifeline.     

Bias and Accuracy of Children's Perceptions of Peer Acceptance: Prospective Associations with Depressive Symptoms

Are depressive symptoms in middle childhood associated with more or less realistic social self-perceptions? At the beginning and end of the school year, children in grades 3 through 5 (n=667) rated how much they liked their classmates, predicted the acceptance ratings they would receive from each of their classmates, and completed self-report measures of perceived acceptance and depressive symptoms. Accuracy of perceived acceptance was indexed by the mean difference between pairs of predicted and received ratings (absolute values). Standardized residual scores created by regressing self-reported perceived acceptance (either predicted ratings or children's responses to a questionnaire measure of perceived peer acceptance) onto peer acceptance ratings formed two measures of bias. Bi-directional associations were found for accuracy of perceived acceptance and depressive symptoms; inaccurate perceptions predicted increases in depressive symptoms and depressive symptoms predicted decreased accuracy. Neither measure of bias predicted changes in depressive symptoms. Depressive symptoms predicted increases in negatively biased perceptions as assessed via questionnaire.     

Health Perceptions and Anxiety Sensitivity in Patients with Panic Disorder

Separate lines of research indicate that patients with panic disorder display negative perceptions of physical health and elevated fear of autonomic arousal. Because health perceptions and anxiety sensitivity may be related, the present study evaluated the degree to which these constructs can be distinguished in patients meeting DSM-IV criteria for panic disorder (N = 44). Perceived health, anxiety sensitivity, and the clinical features of panic disorder were assessed at pretreatment and following 12 sessions of cognitive–behavioral treatment. Findings consistently indicated that perceived health and anxiety sensitivity can be meaningfully differentiated. Perceived physical health was only moderately associated with anxiety sensitivity, and each was uniquely associated with pretreatment symptomatology and posttreatment end-state functioning. Perceived physical health appears to be a clinically useful index in the overall evaluation of panic disorder and is readily distinguishable from anxiety sensitivity.     

Vulnerability to depressive symptomatology: a prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at T1 and again at T2, 5 weeks later. Naturally occurring stressors were assessed at T2 (covering the T1-T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis x Stress (CD x S) interaction predicted onset of depressive symptoms from T1 to T2. In contrast, the CD x S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD x S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed.     

Are Happy People Healthier? The Specific Role of Positive Affect in Predicting Self-Reported Health Symptoms

Previous empirical work sought to establish relationships between psychological variables and physical health. Research investigating the associations between positive and negative affectivity and physical health have produced mixed results, often suggesting that negative affectivity generally is more strongly associated with health symptoms. We investigated the role of both positive and negative affectivity in predicting self-reported health symptoms. Positive affectivity emerged as a significant predictor of good health, while negative affectivity failed to predict changes in health symptoms. Results are discussed in terms of the benefits of positive emotions in promoting health and improving physical health via psychological interventions.     

Development and Validation of a Brief Self-Report Measure of Agitation: The Brief Agitation Measure

Emerging evidence indicates that agitation is an ominous precursor to imminent death by suicide, yet measures of it are few, and to our knowledge, no self-report measure of agitation exists. To fill this gap, we have developed the Brief Agitation Measure (BAM), which is designed as a brief measure to assess agitation. In this article, we provide preliminary evidence from 2 studies examining the reliability and validity of the BAM in an undergraduate sample as well as a clinical sample. We close with a discussion of the limitations of the studies and implications of our findings.     

Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire

The present study examined the psychometric properties and construct validity of scores derived from the Interpersonal Needs Questionnaire (INQ) using latent variable modeling with 5 independent samples varying in age and level of psychopathology. The INQ was derived from the interpersonal theory of suicide and was developed to measure thwarted belongingness and perceived burdensomeness-both proximal causes of desire for suicide. Results support that thwarted belongingness and perceived burdensomeness are distinct but related constructs and that they can be reliably measured. Further, multiple-group analyses were consistent with invariance for young versus older adults and nonclinical versus clinical populations, thereby supporting the relevance of these constructs to diverse populations. Finally, both constructs demonstrated convergent associations with related interpersonal constructs-including loneliness and social support for belongingness and social worth and death ideation for burdensomeness--as well as prospective associations with suicidal ideation.     

Construct validity of a measure of acculturative stress in African Americans

The properties of the main measure of acculturative stress have not been systematically examined. The authors conducted a study of the construct validity of the Social, Attitudinal, Familial, and Environmental Acculturative Stress Scale (A. M. Padilla, Y. Wagatsuma, & K. J. Lindholm, 1985) in a sample of 248 African American university students (156 of whom attended a historically Black college). After controlling for general life stress, the authors found that the relations of acculturative stress to depressive and anxious (but not suicidal) symptoms remained. Also, African American students at a historically Black college reported less acculturative stress than African American students at a large state university. These findings clarify the nature of a key construct and measure of acculturative stress.     

Examining a psychosocial interactive model of binge eating and vomiting in women with bulimia nervosa and subthreshold bulimia nervosa

The current study tested a psychosocial interactive model of perfectionism, self-efficacy, and weight/shape concern within a sample of women with clinically significant bulimic symptoms, examining how different dimensions of perfectionism operated in the model. Individuals with bulimia nervosa (full diagnostic criteria or subthreshold) completed measures of bulimic symptoms, multidimensional perfectionism, self-efficacy, and weight/shape concern. Among those who were actively binge eating (n=180), weight/shape concern was associated with binge eating frequency in the context of high perfectionism (either maladaptive or adaptive) and low self-efficacy. Among those who were actively vomiting (n=169), weight/shape concern was associated with vomiting frequency only in the context of high adaptive perfectionism and low self-efficacy. These findings provide support for the value of this psychosocial interactive model among actively binge eating and purging samples and for the importance of considering different dimensions of perfectionism in research and treatment related to bulimia nervosa.