Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.     

Conversation and Behavior Games in the Pragmatics of Dialogue

In this article we present the bases for a computational theory of the cognitive processes underlying human communication. The core of the article is devoted to the analysis of the phases in which the process of comprehension of a communicative act can be logically divided: (1) literal meaning, where the reconstruction of the mental states literally expressed by the actor takes place: (2) speaker's meaning, where the partner reconstructs the communicative intentions of the actor; (3) communicative effect, where the partner possibly modifies his own beliefs and intentions; (4) reaction, where the intentions for the generation of the response are produced; and (5) response, where an overt response is constructed. The model appears to be compatible with relevant facts about human behavior. Our hypothesis is that, through communication, an actor tries to exploit the motivational structures of a partner so that the desired goal is generated. A second point is that social behavior requires that cooperation be maintained at some level. In the case of communication, cooperation is, in general, pursued even when the partner does not adhere to the actor's goals, and therefore no cooperation occurs at the behavioral level. This important distinction is reflected in the two kinds of game we introduce to account for communication. The main concept implied in communication is that two agents overtly reach a situation of shared mental states. Our model deals with sharedness through two primitives: shared beliefs and communicative intentions.     

Emotions and decision making: Regulatory focus moderates the influence of anticipated emotions on action evaluations

We investigate the moderating effects of self-regulatory foci (Higgins, 1996a) on the impact of anticipated emotions in decision making. We hypothesise that regulatory focus moderates the relationships between anticipated emotions of success and failure of performing an act and evaluations of the act. A promotion focus should highlight the role of dissatisfaction-satisfaction emotions in predicting evaluations, whereas a prevention focus should emphasise the impact of relaxation-agitation emotions. Hypotheses were investigated in two studies. In the first, chronic self-regulatory orientations were assessed; in the second, self-regulatory concerns were manipulated. Results support the moderating effects of regulatory foci on the impact of negative anticipated emotions: Anticipated agitation induces more favourable action evaluations under a prevention focus; and anticipated dejection leads to more favourable action evaluations under a promotion focus. No interaction was detected involving positive emotions, suggesting that an asymmetry may exist in motivational regulation of emotional information.     

Suicide Attempts in Major Depressed Patients with Personality Disorder

Suicide attempters who met criteria for borderline personality disorder (BPD) comorbid with major depressive disorder (MDD) were compared to both suicide attempters suffering from MDD alone and to attempters with comorbid MDD and other personality disorders (PD). Participants were 239 (158 patients with comorbid PD and 81 patients with MDD without comorbidity) inpatients consecutively admitted after a suicide attempt made in the last 24 hours. Suicide attempters with comorbid MDD and BPD had more frequent previous suicide attempts and were more likely to have a history of aggressive behaviors and alcohol and drug use disorders compared with patients suffering from MDD without Axis II comorbidity.     

Finite Mixtures of Hidden Markov Models for Longitudinal Responses Subject to Drop out

Abstract

Drop out is a typical issue in longitudinal studies. When the missingness is non-ignorable, inference based on the observed data only may be biased. This paper is motivated by the Leiden 85+ study, a longitudinal study conducted to analyze the dynamics of cognitive functioning in the elderly. We account for dependence between longitudinal responses from the same subject using time-varying random effects associated with a heterogeneous hidden Markov chain. As several participants in the study drop out prematurely, we introduce a further random effect model to describe the missing data mechanism. The potential dependence between the random effects in the two equations (and, therefore, between the two processes) is introduced through a joint distribution specified via a latent structure approach. The application of the proposal to data from the Leiden 85+ study shows its effectiveness in modeling heterogeneous longitudinal patterns, possibly influenced by the missing data process. Results from a sensitivity analysis show the robustness of the estimates with respect to misspecification of the missing data mechanism. A simulation study provides evidence for the reliability of the inferential conclusions drawn from the analysis of the Leiden 85+ data.