Building Models for the Relationship Between Attitudes Toward Suicide and Suicidal Behavior: Based on Data from General Population Surveys in Sweden,Norway, and Russia

Our aim was to build a model delineating the relationship between attitudes toward suicide and suicidal behavior and to assess equivalence by applying the model on data from different countries. Representative samples from the general population were approached in Sweden, Norway, and Russia with the Attitudes Toward Suicide (ATTS) questionnaire. Data on experience of suicidal behavior among significant others and self‐reported suicidal expressions were also collected. Structural equation modeling resulted in gender and country specific models where experience of suicidal behavior among significant others and self‐reported suicidal expressions earlier in life predicted attitudes, and attitudes predicted current suicidal expressions. The models included the attitude factors acceptance of suicide, condemnation, and preventability; age and level of education were also incorporated. The different models reveal possible ways to better understand gender and culture‐specific paths between attitudes and suicidal behaviors, and their relevance in a suicide prevention context is considered.     

A Review of “Suicidal Intent” Within the Existing Suicide Literature

The results of a systematic literature review that investigated suicide intent are presented. Of the 44 relevant articles identified, 17 investigated the relationships between various suicide risk factors and suicide intent and 25 publications investigated the relationships between suicide intent and various suicide outcomes. Despite recent advancements in the definition and nomological validity of suicide intent, a high degree of variability in the empirical measurement and analysis of suicide intent was found. Such variability limits future research related to measuring suicidal risk and outcomes, reporting suicide intent, or the meaningful comparison of diagnostic approaches or treatments across multiple studies.     

Prognosis after Adolescent Suicide Attempt: Mental Health,Psychiatric Treatment,and Suicide Attempts in a Nine‐Year Follow‐up Study

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow‐up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide attempters had received a substantial amount of treatment. One third had received inpatient treatment, and 78% psychiatric treatment, despite low compliance shortly after the index suicide attempt. At follow‐up, repeated suicide attempts were found in 44% of the sample, and half of those had an affective or personality disorder.     

Interpretation and method

Abstract

Interpretation started as the central tool of psychoanalytic theory, but it has undergone changes, just as the theory it was based on has evolved. Not only have these significant changes been determined by cultural trends, but different authors have also contributed to their evolution through their approaches to various other pathologies besides neurosis. Today, the cure process is divided between those who believe that therapeutic efficiency should be based on the different interpretation models, and those who maintain that it can be only sustained by the modifying capacity of the therapeutic relationship. Both positions are supposedly upheld by the results of tests that both models believe are sufficient proof but that, in the current author's opinion, lead back to the type of pathology they arose from, although they may at times attempt to cover the entire theoretical spectrum. The position upheld by Gedo—who considers that the psychoanalyst's intervention will depend on the degree of evolution that the pathology has achieved—is of great interest for specific practice. Hence, the more primitive levels require a treatment founded on holding, whereas more evolved pathologies require a more classic level of interpretation. This implies that the stages of a particular patient's evolution may require interventions at different levels, even though these may be founded on different theoretical models. This model, which we may brand as eclectic, is basically the one we find underpinning different theoretical models, which effectively appear to integrate others.     

The uses of humor in life,neurosis and in psychotherapy: Part 2

Abstract

The first part of the paper focused on the dynamics of wit in life, literature, and psychoanalysis; the second part of this paper is devoted to the use of humor in therapy. The central concept is Freud's psychoanalytic method, as distinguished from Freud's various theories of disorder, or neurosis, with a further elaboration of Freud's inherently interpersonal conception of the analytic process, already present in the cathartic phase of the therapeutic technique. The cathartic, or discharge, function of humor is connected to reciprocal free association (a term coined by the author) to define the mutual and reciprocal free association in analysand and analyst, playing an essential role in the genesis of insight and interpretation. Humor has its role in loosening repression, facilitating the emergence of unconscious emotions and ideas, bringing to light character defenses, and thus driving the process of analysis.     

Different origins and meanings of acute acting-out in an inpatient psychotherapeutic setting

In this paper I describe four different sources of acute acting-out behaviour as may be observed in long-term hospitalised patients suffering from severe personality disorders. I hope to demonstrate that acute psychological distress does not happen in a vacuum, but that specific intrapsychic and interpersonal dynamics within the hospital setting are at the root of what appears overtly as nonspecific emotional and behavioural disturbance. I argue that the hospital team's correct insight into the factors underlying acute acting-out is crucial to the implementation of therapeutic interventions aimed to decrease the patient's disturbed state of mind.     

Remembering and repeating in multiple personality

This paper is a case-history of a student in his early twenties tortured by different personalities of different ages and sexes vying for control of his body. Guilt over an incestuous relationship with his mother is uncovered and understood in the context of his whole life. Confusion between memories of fantasies, memories of sleep dreams, memories of daydreams, and memories of actual memories are described, the elucidation of which lead to clearer thinking and memory, and more tolerance for the previously distorted affectladen situations of his past. Thus his belief that he was experimented on in an alien spaceship becomes the memory of an operating-room diagnostic experience.

A hypothesis is put forward that the separate personalities in the multiple personality are not simply the products of ego splits, but are at the instant they are formed a ‘doubling’ of the personality that is being copied. Immediately thereafter, splitting mechanisms create differences between the two separate personalities, using projective and introjective mechanisms. Integration of the various personalities, the ultimate goal in treatment, is made difficult by the patient's fear of loss of self through fragmentation, when the self is felt to be in danger of being intruded upon.     

On some types of hallucinatory experience

There are types of non-visual hallucinatory experience which occur in the psychoses other than those which have a critical and derogatory content. Wish-fulfilment plays an important part in the formation of the content of these hallucinations. In others, ‘persecutory’ anxiety also occurs. A comparison is made between hallucinatory and dream content. An hypothesis is presented to account for the perceptual quality of these hallucinatory experiences. The therapeutic implications of these considerations concludes this presentation.