Suicide Risk Assessment and Risk Formulation Part II: Suicide Risk Formulation and the Determination of Levels of Risk

The suicide risk formulation (SRF) is dependent on the data gathered in the suicide risk assessment. The SRF assigns a level of suicide risk that is intended to inform decisions about triage, treatment, management, and preventive interventions. However, there is little published about how to stratify and formulate suicide risk, what are the criteria for assigning levels of risk, and how triage and treatment decisions are correlated with levels of risk. The salient clinical issues that define an SRF are reviewed and modeling is suggested for an SRF that might guide clinical researchers toward the refinement of an SRF process.     

Avoiding Misinformation: Reinstating Target Modality

Explanations of the misinformation effect were considered in an experiment using a reversed eyewitness suggestibility design (Lindsay & Johnson, 1989b). Forty-eight subjects read a narrative describing a photograph that they subsequently viewed. For half the subjects, the narrative contained misinformation. Recognition tests for objects appearing in the photograph were administered in either a verbal or a pictorial modality. A misinformation effect was found in the verbal condition, as found by Lindsay and Johnson. With pictorial probes there was no misinformation effect, indicating that reinstatement of the appropriate modality cues can eliminate the influence of misleading post-event information upon memory and permit the retrieval of the target memory. The experiment was conceived of and discussed within the headed records framework.     

The Place of Suicide Prevention in the Spectrum of Intervention: Definitions of Critical Terms and Constructs

The authors trace the evolution of prevention models and conceptual foundations for the prevention of disorders starting with the public health/medical model and concluding with the contemporary model recently proposed by the Institute of Medicine of the National Academy of Sciences. They compare and contrast the contributions of each model toward the theoretical reduction of suicide in the general population. Risk and protective factors as they relate to suicidal behaviors are identified. The paper explores conceptual frameworks used to understand population-level risk factors and moves toward a discussion of how to target individuals at risk for suicidal behaviors. First-order and second-order targets of change in prevention efforts are defined and examples provided.