Suicidology: A Look Backward and Ahead

Using the metaphor of “a long run’ to describe our progress in suicidology, the author looks back to discuss important concepts that have become well established, such as clues to suicide, ambivalence, crisis services, suicide consultations, and psychological autopsies. An example is the psychological autopsy of Marilyn Monroe. Follow-up studies of crisis center clients have indicated that chronically suicidal clients are at the greatest risk of suicide. Recommendations for the long-term treatment of such patients are provided. Research on youth suicide is reported. Finally, the author looks ahead toward new developments in training and treatment.     

Single‐Case Experimental Designs for the Evaluation of Treatments for Self‐Injurious and Suicidal Behaviors

Single‐case experimental designs (SCEDs) provide a time‐ and cost‐effective alternative to randomized clinical trials and offer significant advantages in terms of internal and external validity. A brief history and primer on SCEDs is provided, specifically for use in suicide intervention research. Various SCED methodologies, such as AB, ABAB, multiple baseline, and changing criterion designs, are described. Advantages and disadvantages of their use specifically for intervention research for suicidal and self‐injurious behaviors are detailed.     

Age and Gender Differences in the Use of Various Poisoning Methods for Deliberate Parasuicide Cases Admitted to Loghman Hospital in Tehran (2000–2004)

Different methods of poisoning used by individuals with the diagnosis of parasuicide admitted to the Loghman Hospital, Tehran, from 2000 to 2004 were investigated, with particular focus on gender and age differences. Drugs, pesticides, and other agricultural chemicals (women: 12.7%, men: 9%) were the most commonly used methods. In males, the percentage of use of drugs increased with age, but the frequency of pesticides use decreased with age. In females, drugs were most often used in the youngest age group, whereas the use of pesticides was lowest in the youngest age category. Females outnumbered males, especially in the youngest age group of 10 to 19 years olds. Drugs and pesticides were the substances used most often for parasuicide in each age group regardless of gender.     

The Benefit of Forgetting Suicidal Ideation

In a sample of young adult Australians, those who had had suicidal ideation but who did not acknowledge ever having had it when asked 4 years later, were experiencing better mental health, as demonstrated by significantly better functioning on a range of psychometric measures, than those who recalled it. These results are consistent with several recent reports and indicate that forgetting painful events such as suicidal ideation is an adaptive defense mechanism. This has implications in terms of therapy focusing on contemporaneous events and the future, rather than on the past.     

Interventions for Suicidal Youth: A Review of the Literature and Developmental Considerations

Suicidal behavior is developmentally mediated, but the degree to which interventions for suicidal behaviors have been developmentally tailored has varied widely. Published controlled studies of psychosocial treatment interventions for reducing adolescent suicidal behavior are reviewed, with a particular emphasis on the developmental nuances of these interventions. In addition, developmental considerations important in the treatment of suicidal adolescents are discussed. There are insufficient data available from controlled trials to recommend one intervention over another for the treatment of suicidal youth, but interventions that are sensitive to the multiple developmental contexts have potential for greater effectiveness in reducing adolescent suicidal behavior.     

Self-guided behavioral skills training: A public health approach to promoting nurturing care environments

The World Health Organization identified the promotion of “Nurturing Care Environments” as a global health priority. Responsive caregiving, 1 of 5 domains describing nurturing care, is critical for healthy child development. Relatively little research has evaluated population-level interventions aimed to increase responsive caregiving during the first 1,000 days of an infant's life. In this pilot study, we evaluated an intervention designed for population-level dissemination that targeted responsive caregiving. The self-guided behavioral skills training aimed to teach mothers to imitate infant vocalizations. The intervention was delivered within an on-line asynchronous training. All 3 mothers increased vocal imitative behavior following training without receiving coaching or behavior-specific feedback from an implementer. The results offer a preliminary proof of concept with implications for population-level intervention design and evaluation.     

What Does Psychological Autopsy Study Tell Us About Charcoal Burning Suicide—A New and Contagious Method in Asia?

Charcoal burning suicides in Hong Kong between 2002–2004 in the 15 to 59‐year‐old age group were investigated using the psychological autopsy method. The psychopathological profiles of charcoal burning suicides (N = 53) were compared against “other suicides” (N = 97). The two groups did not differ significantly in the prevalence of DSM‐IV axis I diagnoses with the exception of schizophrenic spectrum disorder which was less frequently associated with charcoal burning suicides. Score on “neuroticism” in the NEO‐five Factor Inventory (NEO‐FFI) was significantly higher in victims of charcoal burning suicide. There was also a trend toward higher score on “conscientiousness” in the NEO‐FFI among charcoal burners than victims of other suicide.     

Interpretation bias in preschool children at risk for anxiety: a prospective study

A story-stem paradigm was used to assess interpretation bias in preschool children. Data were available for 131 children. Interpretation bias, behavioral inhibition (BI), and anxiety were assessed when children were aged between 3 years 2 months and 4 years 5 months. Anxiety was subsequently assessed 12 months, 2 years, and 5 years later. A significant difference in interpretation bias was found between participants who met criteria for an anxiety diagnosis at baseline, with clinically anxious participants more likely to complete the ambiguous story-stems in a threat-related way. Threat interpretations significantly predicted anxiety symptoms at 12-month follow-up, after controlling for baseline symptoms, but did not predict anxiety symptoms or diagnoses at either 2-year or 5-year follow-up. There was little evidence for a relationship between BI and interpretation bias. Overall, the pattern of results was not consistent with the hypothesis that interpretation bias plays a role in the development of anxiety. Instead, some evidence for a role in the maintenance of anxiety over relatively short periods of time was found. The use of a story-stem methodology to assess interpretation bias in young children is discussed along with the theoretical and clinical implications of the findings.