Suicide Attempt Risk in Youths: Utility of the Harkavy–Asnis Suicide Scale for Monitoring Risk Levels

The Harkavy–Asnis Suicide Scale (HASS), one of the few self‐report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED) patients with suicidal behavior. The HASS and Diagnostic Interview Schedule for Children (DISC‐IV) were administered approximately 2 months after ED presentation. When compared with DISC‐IV ratings, sensitivity of the HASS SA items was excellent (100%), and overall classification accuracy was 72%. SA planning was the strongest predictor of SAs.     

Assessment of Suicidal Youth in the Emergency Department

Accurate evaluation of suicidal adolescents in the emergency department (ED) is critical for safety and linkage to follow‐up care. We examined self‐reports of 181 adolescents who presented to an ED with suicidal ideation (SI) or a suicide attempt (SA). Parents also completed self‐reports. Results showed fair agreement between parents and youth on the reason for the ED visit (e.g., SI vs. SA) and greater agreement between independent judges and youths than between judges and parents. In accordance with accepted definitions of suicide attempts (e.g., Crosby, Ortega, & Melanson, 2011; O'Carroll, Berman, Maris, Moscicki, Tanney, & Silverman, 1996, p. 237; Posner, Oquendo, Gould, Stanley, & Davies, 2007, p. 1035; Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007, p. 248), most youth with SA as the reason for the ED visit reported some intent to die associated with the attempt. Finally, youth presenting to the ED with SA did not differ clinically from youth presenting with SI, and almost half of youths with SI reported past suicide attempts. These results highlight the need to emphasize adolescents' reports in clinical decision making, suggest adolescents' defined suicide attempts similarly to published definitions, and show that assessment of past SAs, as well as present suicidal thoughts and behaviors, is critical in determining future risk.     

Listening to Somatosensory States in Psychoanalysis: Body,Trauma, and Poetry

ABSTRACT

The author starts from the apparently outdated James-Lange theory of emotion to rediscover elements of modernity for contemporary psychoanalysis: from James’ bodily-sensory dimension to Damasio’s “feeling of what happens,” to Bucci’s attention to the patient’s visceral narrative in session. William James stated that bodily sensations are the first elements on the path toward consciousness. Damasio emphasizes that “Consciousness is rooted in the representation of the body”. Bucci presents a framework for identifying linkages between bodily and symbolic states and to observe the various degrees of patients’ “visceral speech” in session. These parallels support a sensibility to listen to language as the voice of the body: the relationship between the patient’s narrative and the bodily-sensory dimension can be grasped through the patient’s “imagery” which may reference earlier somatic experience. Particular emphasis is given to the story-telling of trauma.