Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Parent–Child Relationships and the COVID-19 Pandemic: An Exploratory Qualitative Study with Parents in Early,Middle, and Late Adulthood

The impact of the COVID-19 pandemic on families is currently unknown. Parents and children have experienced a variety of changes as public health interventions have been implemented to slow the spread of the virus. The current exploratory qualitative study recruited parents (n?=?365) in early (ages 20–34), middle (ages 35–64), and late (ages 65 and older) adulthood to understand how the early weeks of the pandemic influenced their parent–child relationships. Participants completed an online survey between March 21 and 31, 2020. Three themes emerged through qualitative content analysis: (1) relational steadiness, (2) navigating COVID-19 challenges in relationships, and (3) relational enhancement.

     

The relation of prosocial behavior to the development of aggression and psychopathology

The development of prosocial behavior is traced from middle childhood to adulthood in a 22-year longitudinal study of 800 children first seen at age 8 and is compared to the development of aggression over the same period. Prosocial behavior and aggression seem to represent opposite ends of a single dimension of behavior since they are consistently negatively related to each other and relate in opposite ways to correlated variables both synchronously and over time. Both are stable forms of behavior with good predictability over the time span studied and both are related to the quality of the parent-child relationship. The most important deterrent to the development of antisocial behavior and the encouragement of prosocial behavior is probably a close identification between the child and his/her parents.     

The effects of gormone manipulations on aggressive target-biting in mice

Aggressive biting of an inanimate target by mice was studied. Males attacked the bite-target more frequently than females, but this difference disappeared after castration when the response rate of the males approached that of the females. Ovariectomizing the females had little effect on their bite-attack frequencies. Subsequent androgen injections restored the biting-attack frequency of the castrated males to preoperative levels but had little effect on the intact males. Estrogen had little effect on the response frequency of the females, whereas androgen produced a slight increase in their bite-attack frequency. Results indicate that androgen is critical for the maintenance of this aggressive response and that the single subject paradigm utilized in this study was a sensitive measure of aggressive tendencies in mice.     

The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder

This study examined the persistence of attention-deficit/hyperactivity disorder (ADHD) into young adulthood using hyperactive (N = 147) and community control (N = 71) children evaluated at ages 19-25 years. ADHD was rare in both groups (5% vs. 0%) based on self-report but was substantially higher using parent reports (46% vs. 1.4%). Using a developmentally referenced criterion (+2 SD), prevalence remained low for self-reports (12% vs. 10%) but rose further for parent reports (66% vs. 8%). Parent reports were more strongly associated with major life activities than were self-reports. Recollections of childhood ADHD showed moderate correlations with actual parent ratings collected in childd hood, which suggests some validity for such recollections. The authors conclude that previous follow-up studies that relied on self-reports might have substantially underestimated the persistence of ADHD into adulthood.     

A Rorschach study of oral dependence in alcoholics and depressives

Despite the strong association between alcoholism and orality in psychoanalytic theory, use of the Rorschach Inkblot Test to provide empirical support for such a link has yielded decidedly mixed results. However, Masling's Rorschach Oral-Dependency (ROD) scale has shown twice that people with alcoholism give more oral-dependent responses on the Rorschach than matched comparison groups (Bertrand & Masling, 1969; Weiss & Masling, 1970), which is supportive of classical analytic theory. In this study, we investigated alcohol groups, depression groups, and "normal" undergraduates with the ROD scale and found that the 2 clinical groups produced higher ROD scores than the undergraduates. In addition, recent studies by Duberstein and Talbot (1993) and Fowler, Hilsenroth, and Handler (1996) provide evidence for an object relations model of dependency that suggests that a balance between anaclitic dependence and complete independence, in which dependency needs are acknowledged but are not overwhelming, is most adaptive. This model of dependency was evaluated; it was found that a simple difference in group means provided a better fit with the data, although some evidence of an object relations model also was found. Finally, Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) levels of general defensiveness and primary process manifestations in Rorschach content were investigated to assess whether participants were responding defensively to the testing and whether there were any differences in the nature of oral-dependent responses between the clinical groups.     

Variability in aphasic patients' response times

Response time studies of acquired language disorders are plagued by tremendous variability in patients' response times. In this brief report we demonstrate how variability itself may provide informative data. Lexical decision response times, generated by nine patients, illustrate how within-patient variability may estimate stability in cognitive dynamics.