Development of the AAS Statement on “Suicide” and “Physician Aid in Dying”

In August 2017, the American Association of Suicidology board passed a statement titled “Suicide” is not the same as “Physician aid in dying,” which was developed partly in response to the fact that aid in dying is now legal in a number of jurisdictions. In Phase 1, eight members of the AAS who had indicated interest in this issue were asked to independently draft such a statement; the convener consolidated these drafts and comments into an initial statement. In Phase 2, five additional experts who might be expected to object were asked for their independent input; the convener consolidated these with the previous draft. No one objected to the statement altogether; extensive copyediting and rewording suggestions focused primarily on issues of overlap between “suicide” and “physician aid in dying.” The resulting document represents an effort to try to accommodate the basic concerns of all participants. The document does not speak for or against legalization of this practice, but it may have bearing on whether suicide prevention professionals have an obligation to try to prevent such deaths and whether they may serve as consultants for psychological or psychiatric evaluations as sometimes required under US state law.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model

Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families’ engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.     

The Infant mental health specialist in newborn pediatric rounds: A systems approach

This article describes a special program wherein infant mental health specialists participate in hospital rounds with pediatric residents. The purpose of the program is described in terms of medical awareness of psycho-social needs of the family and improved clinical services. Examples are given of the way in which “rounding” contributes to the meeting of infants' and families' medical and psychological needs. Note is made of the multilevel impact of this collaboration.     

Measuring Feeling of Knowing: Comment on Schraw (1995)

Schraw compares two coefficients for the 2×2 contingency tables resulting from many feeling of knowing (FOK) studies: Hamann's coefficient and Goodman and Kruskal's γ. He favours Hamann's coefficient and gives examples where Hamann's coefficient produces what might be considered the more intuitive result. Further scrutiny reveals that these examples are not as convincing as Schraw makes them out to be. Because Hamann's coefficient depends on the row and column marginals, it does not map onto FOK ability as well as Goodman and Kruskal's γ, which is a direct measure of the diagnostic worth of FOK ratings.     

Providing noncontingent,alternative, functional reinforcers during delays following functional communication training

Functional Communication Training (FCT) involves arranging extinction for problem behavior and reinforcement for a more desirable, functionally equivalent, communicative response (FCR). Although effective under ideal arrangements, the introduction of delays to reinforcement following the FCR can result in increased problem behavior. Austin and Tiger (2015) showed that for individuals whose problem behavior was sensitive to multiple sources of reinforcement, providing access to alternative, functional reinforcers during delays mitigated this increase in problem behavior during delay fading. The current study replicated the procedures of Austin and Tiger with 2 individuals displaying multiply controlled problem behavior. Providing alternative functional reinforcers reduced problem behavior during 10-min delays for both participants without requiring delay fading.