A general systems approach to suicide prevention: lessons from cardiac prevention and control

The pathology of cardiac disease includes genetic, physical, biochemical, psychological, social, and environmental vectors. Factors contributing to suicide have been identified in these same areas. Survival from an acute cardiac event requires a systematized and multisectoral response. Communities that do not have systematized response capabilities to acute cardiac events have poorer survival outcomes. Suicide prevention and control may also be responsive to an integrated community response system. This paper examines the development of a community cardiac care model, explores potential parallels for a community suicide prevention and control model, and outlines a general systems theory framework for a suicide prevention and control system.     

Conflicting processes in the extinction of conditioned taste aversion: behavioral and molecular aspects of latency,apparent stagnation,and spontaneous recovery

The study of experimental extinction and of the spontaneous recovery of the extinguished memory could cast light on neurobiological mechanisms by which internal representations compete to control behavior. In this work, we use a combination of behavioral and molecular methods to dissect subprocesses of experimental extinction of conditioned taste aversion (CTA). Extinction of CTA becomes apparent only 90 min after the extinction trial. This latency is insensitive to muscarinic and β-adrenergic modulation and to protein synthesis inhibition in the insular cortex (IC). Immediately afterwards, however, the extinguishing trace becomes sensitive to β-adrenergic blockade and protein synthesis inhibition. The subsequent kinetics and magnitude of extinction depend on whether a spaced or massed extinction protocol is used. A massed protocol is highly effective in the short run, but results in apparent stagnation of extinction in the long-run, which conceals fast spontaneous recovery of the preextinguished trace. This recovery can be truncated by a β-adrenergic agonist or a cAMP analog in the insular cortex, suggesting that spontaneous overtaking of the behavioral control by the original association is regulated at least in part by β-adrenergic input, probably operating via the cAMP cascade, long after the offset of the conditioned stimulus. Hence, the performance of the subject in experimental extinction is the sum total of multiple, sometimes conflicting, time-dependent processes.     

Adaptive learning and forgetting in an unconventional experimental routine

Forgetting is often thought of as the inability to remember, but remembering and forgetting allow behavior to adapt to a changing environment in distinct and separable ways. Learning and forgetting were assessed concurrently in two pigeon experiments that involved the same unconventional routine where the schedule of reinforcement changed every session. Sessions were run back-to-back with a 23-h mid-session break such that in a single visit to the testing chamber, a pigeon completed the second half of one session and the first half of the next. The beginning of a new session was either signaled or unsignaled. Experiment 1 involved concurrent variable–interval variable–interval schedules with four possible reinforcer ratios. Response allocation was sensitive to the richer schedule and was retained through the mid-session break. Experiment 2 involved peak interval schedules of varying durations. Temporal discrimination was rapidly acquired before and after the mid-session break, but not retained. Signaling the session change decreased control by past contingencies in both experiments, demonstrating that learning and forgetting can be investigated separately. These results suggest that the temporal structure of training, such as multiple short daily sessions instead of one long session, can meaningfully impact measurement of animals’ capacity to forget and remember.     

Alcohol Counseling in Hospital Trauma: Examining Two Brief Interventions

Hospital trauma centers intervene with patients who incur alcohol‐related injuries. This prospective study, using professional counselors and trainees, investigated brief counseling interventions (BCIs). Participants were randomized to either a conventional BCI examining quantity and frequency of drinks or a personalized BCI exploring overintoxication. No statistically significant difference between risky drinkers randomized to either intervention in a hospital trauma center was observed. Findings indicate that a personalized BCI may be an alternative to a quantitative BCI in reducing risky alcohol consumption.     

Areas of Interest as a Signal Detection Problem in Behavioral Eye‐Tracking Research

Decision researchers frequently analyze attention to individual objects to test hypotheses about underlying cognitive processes. Generally, fixations are assigned to objects using a method known as area of interest (AOI). Ideally, an AOI includes all fixations belonging to an object while fixations to other objects are excluded. Unfortunately, due to measurement inaccuracy and insufficient distance between objects, the distributions of fixations to objects may overlap, resulting in a signal detection problem. If the AOI is to include all fixations to an object, it will also likely include fixations belonging to other objects (false positives). In a survey, we find that many researchers report testing multiple AOI sizes when performing analyses, presumably trying to balance the proportion of true and false positive fixations. To test whether AOI size influences the measurement of object attention and conclusions drawn about cognitive processes, we reanalyze four published studies and conduct a fifth tailored to our purpose. We find that in studies in which we expected overlapping fixation distributions, analyses benefited from smaller AOI sizes (0° visual angle margin). In studies where we expected no overlap, analyses benefited from larger AOI sizes (>.5° visual angle margins). We conclude with a guideline for the use of AOIs in behavioral eye‐tracking research. Copyright © 2015 John Wiley & Sons, Ltd.     

Establishing standards for the assessment of suicide risk among callers to the national suicide prevention lifeline

The National Suicide Prevention Lifeline was launched in January 2005. Lifeline, supported by a federal grant from the Substance Abuse and Mental Health Services Administration, consists of a network of more than 120 crisis centers located in communities across the country that are committed to suicide prevention. Lifeline's Certification and Training Subcommittee conducted an extensive review of research and field practices that yielded the Lifeline's Suicide Risk Assessment Standards. The authors of the current paper provide the background on the need for these standards; describe the process that produced them; summarize the research and rationale supporting the standards; review how these standard assessment principles and their subcomponents can be weighted in relation to one another so as to effectively guide crisis hotline workers in their everyday assessments of callers to Lifeline; and discuss the implementation process that will be provided by Lifeline.     

Call of the Wild

Freud described "wild analysis" as an undisciplined version of psychoanalysis; but the new Penguin series of Freud's writings collects many of his papers under the title Wild Analysis, challenging the differentiation. This paper traces wild elements at the core of psychoanalytic thought, crediting Groddeck, Ferenczi, and Winnicott for bringing them to the open. The image of the wild analyst can serve us as the image of the deeply involved, personally motivated analyst, whose work is intense and emotionally risky. This is the opposite of the "civilized" analyst who uses well-defined existing paths, takes no personal risks, and therefore stays at an emotional distance from his/her patients. Every analyst's capacity to develop a unique analytic self, based on his/her genuine life experience and worldview, is endangered if stepping out of line is slandered as "wild analysis" or as insanity. The relevance of these issues for contemporary psychoanalytic thought and education is demonstrated.