Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: The Importance of Active Engagement,Active Rescue,and Collaboration Between Crisis and Emergency Services

In 2012, the SAMHSA‐funded National Suicide Prevention Lifeline (Lifeline) completed implementation of the first national Policy for Helping Callers at Imminent Risk of Suicide across its network of crisis centers. The policy sought to: (1) provide a clear definition of imminent risk; (2) reflect the state of evidence, field experience, and promising practices related to reducing imminent risk through hotline interventions; and (3) provide a uniform policy and approach that could be applied across crisis center settings. The resulting policy established three essential principles: active engagement, active rescue, and collaboration between crisis and emergency services. A sample of the research and rationale that underpinned the development of this policy is provided here. In addition, policy implementation, challenges and successes, and implications for interventions to help Lifeline callers at imminent risk of suicide are detailed.     

Practical Applications of Generalizability Theory for Designing,Evaluating, and Improving Psychological Assessments

In this article, we illustrate how generalizability theory (G-theory) can extend traditional assessment methods for designing, improving, and evaluating results from both objectively and subjectively scored measures of individual differences. Our illustrations include quantification of multiple sources of measurement error, derivation of unique indexes of consistency for norm- and criterion-referenced interpretations of scores, estimation of score consistency when changing a measurement procedure, and disattenuation of correlation coefficients for measurement error. We also expand G-theory analyses beyond the item level to include parcels and split measures and highlight linkages among G-theory, classical test theory, and structural equation modeling. Computer code and sample data are provided in online supplements to help readers apply the demonstrated techniques to their own assessments.     

SBNR Identity: The Role of Impersonal God Representations,Individualistic Spirituality,and Dissimilarity With Religious Groups

We conducted two studies investigating the extent to which self-identification as Spiritual but not Religious (SBNR) was associated with (H1) the development of idiosyncratic religious beliefs and exposure to religious diversity and/or (H2) negative attitudes toward organized religion and being hurt by members of a religious group. In Study 1, SBNRs scored higher than religious and nonreligious participants on belief in God as an impersonal cosmic force (but not as a personal being) and individualistic spirituality. Although SBNRs had positive attitudes toward religion, they were less positive than those identifying as religious. Exposure to religious diversity and hurt by religious groups were not significant predictors of SBNR. We replicated these results in Study 2 using a multi-item measure of God representations and also found that SBNRs’ attitudes toward religion were predicted by a perceived dissimilarity with religious groups over and above individualism, secular group participation, perceptions of Christianity as too structured, and liberalism.     

Primary Care for the Elderly Bereaved: Recommendations for Medical Education

The aim of this study was to explore the current practices of primary care physicians (PCPs) in providing bereavement care to elderly patients, with implications for medical education. A total of 63 PCPs answered a brief online survey about their typical practices, barriers, comfort level with bereavement, and confidence in their ability to diagnose prolonged grief disorder (PGD). They were recruited through an online newsletter and contacts of one of the authors. The results found that two-thirds of the PCPs do not routinely screen their elderly patients for recent losses, nor do they refer to mental health clinicians when loss is identified. Barriers included not learning of the deaths in patients’ lives and lack of time during clinic visits. Those PCPs who had experienced their own losses were significantly more comfortable in speaking to patients about recent losses and more confident in their ability to diagnose PGD. We recommend bereavement education be incorporated into the medical school curriculum from the outset, utilizing the psychological principle of graded exposure to bereaved individuals.