A Review of “Suicidal Intent” Within the Existing Suicide Literature

The results of a systematic literature review that investigated suicide intent are presented. Of the 44 relevant articles identified, 17 investigated the relationships between various suicide risk factors and suicide intent and 25 publications investigated the relationships between suicide intent and various suicide outcomes. Despite recent advancements in the definition and nomological validity of suicide intent, a high degree of variability in the empirical measurement and analysis of suicide intent was found. Such variability limits future research related to measuring suicidal risk and outcomes, reporting suicide intent, or the meaningful comparison of diagnostic approaches or treatments across multiple studies.     

Prognosis after Adolescent Suicide Attempt: Mental Health,Psychiatric Treatment,and Suicide Attempts in a Nine‐Year Follow‐up Study

The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow‐up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide attempters had received a substantial amount of treatment. One third had received inpatient treatment, and 78% psychiatric treatment, despite low compliance shortly after the index suicide attempt. At follow‐up, repeated suicide attempts were found in 44% of the sample, and half of those had an affective or personality disorder.     

Productive Failure in Learning Math

When learning a new math concept, should learners be first taught the concept and its associated procedures and then solve problems, or solve problems first even if it leads to failure and then be taught the concept and the procedures? Two randomized‐controlled studies found that both methods lead to high levels of procedural knowledge. However, students who engaged in problem solving before being taught demonstrated significantly greater conceptual understanding and ability to transfer to novel problems than those who were taught first. The second study further showed that when given an opportunity to learn from the failed problem‐solving attempts of their peers, students outperformed those who were taught first, but not those who engaged in problem solving first. Process findings showed that the number of student‐generated solutions significantly predicted learning outcomes. These results challenge the conventional practice of direct instruction to teach new math concepts and procedures, and propose the possibility of learning from one's own failed problem‐solving attempts or those of others before receiving instruction as alternatives for better math learning.     

Jumping to conclusions, a lack of belief flexibility and delusional conviction in psychosis: a longitudinal investigation of the structure, frequency, and relatedness of reasoning biases

Two reasoning biases, jumping to conclusions (JTC) and belief inflexibility, have been found to be associated with delusions. We examined these biases and their relationship with delusional conviction in a longitudinal cohort of people with schizophrenia-spectrum psychosis. We hypothesized that JTC, lack of belief flexibility, and delusional conviction would form distinct factors, and that JTC and lack of belief flexibility would predict less change in delusional conviction over time. Two hundred seventy-three patients with delusions were assessed over twelve months of a treatment trial (Garety et al., 2008). Forty-one percent of the sample had 100% conviction in their delusions, 50% showed a JTC bias, and 50%-75% showed a lack of belief flexibility. Delusional conviction, JTC, and belief flexibility formed distinct factors although conviction was negatively correlated with belief flexibility. Conviction declined slightly over the year in this established psychosis group, whereas the reasoning biases were stable. There was little evidence that reasoning predicted the slight decline in conviction. The degree to which people believe their delusions, their ability to think that they may be mistaken and to consider alternative explanations, and their hastiness in decision making are three distinct processes although belief flexibility and conviction are related. In this established psychosis sample, reasoning biases changed little in response to medication or psychological therapy. Required now is examination of these processes in psychosis groups where there is greater change in delusion conviction, as well as tests of the effects on delusions when these reasoning biases are specifically targeted.     

Interpretation and method

Abstract

Interpretation started as the central tool of psychoanalytic theory, but it has undergone changes, just as the theory it was based on has evolved. Not only have these significant changes been determined by cultural trends, but different authors have also contributed to their evolution through their approaches to various other pathologies besides neurosis. Today, the cure process is divided between those who believe that therapeutic efficiency should be based on the different interpretation models, and those who maintain that it can be only sustained by the modifying capacity of the therapeutic relationship. Both positions are supposedly upheld by the results of tests that both models believe are sufficient proof but that, in the current author's opinion, lead back to the type of pathology they arose from, although they may at times attempt to cover the entire theoretical spectrum. The position upheld by Gedo—who considers that the psychoanalyst's intervention will depend on the degree of evolution that the pathology has achieved—is of great interest for specific practice. Hence, the more primitive levels require a treatment founded on holding, whereas more evolved pathologies require a more classic level of interpretation. This implies that the stages of a particular patient's evolution may require interventions at different levels, even though these may be founded on different theoretical models. This model, which we may brand as eclectic, is basically the one we find underpinning different theoretical models, which effectively appear to integrate others.     

The uses of humor in life,neurosis and in psychotherapy: Part 2

Abstract

The first part of the paper focused on the dynamics of wit in life, literature, and psychoanalysis; the second part of this paper is devoted to the use of humor in therapy. The central concept is Freud's psychoanalytic method, as distinguished from Freud's various theories of disorder, or neurosis, with a further elaboration of Freud's inherently interpersonal conception of the analytic process, already present in the cathartic phase of the therapeutic technique. The cathartic, or discharge, function of humor is connected to reciprocal free association (a term coined by the author) to define the mutual and reciprocal free association in analysand and analyst, playing an essential role in the genesis of insight and interpretation. Humor has its role in loosening repression, facilitating the emergence of unconscious emotions and ideas, bringing to light character defenses, and thus driving the process of analysis.     

Different origins and meanings of acute acting-out in an inpatient psychotherapeutic setting

In this paper I describe four different sources of acute acting-out behaviour as may be observed in long-term hospitalised patients suffering from severe personality disorders. I hope to demonstrate that acute psychological distress does not happen in a vacuum, but that specific intrapsychic and interpersonal dynamics within the hospital setting are at the root of what appears overtly as nonspecific emotional and behavioural disturbance. I argue that the hospital team's correct insight into the factors underlying acute acting-out is crucial to the implementation of therapeutic interventions aimed to decrease the patient's disturbed state of mind.     

Remembering and repeating in multiple personality

This paper is a case-history of a student in his early twenties tortured by different personalities of different ages and sexes vying for control of his body. Guilt over an incestuous relationship with his mother is uncovered and understood in the context of his whole life. Confusion between memories of fantasies, memories of sleep dreams, memories of daydreams, and memories of actual memories are described, the elucidation of which lead to clearer thinking and memory, and more tolerance for the previously distorted affectladen situations of his past. Thus his belief that he was experimented on in an alien spaceship becomes the memory of an operating-room diagnostic experience.

A hypothesis is put forward that the separate personalities in the multiple personality are not simply the products of ego splits, but are at the instant they are formed a ‘doubling’ of the personality that is being copied. Immediately thereafter, splitting mechanisms create differences between the two separate personalities, using projective and introjective mechanisms. Integration of the various personalities, the ultimate goal in treatment, is made difficult by the patient's fear of loss of self through fragmentation, when the self is felt to be in danger of being intruded upon.