Demographic,Clinical, and Service Utilization Factors Associated with Suicide‐Related Visits among Alaska Native and American Indian Adults

Alaska Native and American Indian people (AN/AIs) are disproportionately affected by suicide. Within a large AN/AI health service organization, demographic, clinical, and service utilization factors were compared between those with a suicide‐related health visit and those without. Cases had higher odds of a behavioral health diagnosis, treatment for an injury, behavioral health specialty care visits, and opioid medication dispensation in the year prior to a suicide‐related visit compared to gender‐, age‐, and residence‐ (urban versus rural) matched controls. Odds of a suicide‐related visit were lower among those with private insurance and those with non‐primary care ambulatory clinic visits.     

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.     

Effects of Response Blocking and Programmed Stimulus Control on Motor Stereotypy: A Pilot Study

We evaluated response blocking with programmed stimulus control, wearing tennis wrist bands, to reduce motor stereotypy in a student with autism. Response blocking was effective and subsequent analysis revealed that wearing the tennis wrist bands alone maintained low frequency stereotypy. Results suggest that controlling effects from a procedure such as response blocking can be transferred to a programmed stimulus in the absence of physical intervention.     

A Brief Group Intervention Using Video Games to Teach Sportsmanship Skills to Children With Autism Spectrum Disorders

Impaired social skills represent a fundamental deficit for children with Autism Spectrum Disorders (ASD). Despite the potential importance of “good sportsmanship,” this social skill has received relatively little attention in the literature. The current study utilized a Behavioral Skills Training (BST) approach to teach three sportsmanship skills (i.e., complimenting, turn taking, and being a good sport) during video game play (Wii Sports). Six children with ASD completed this study. Findings suggest BST can be used effectively to teach sportsmanship skills to children with ASD. The use of video-game technology as part of social skills intervention programs is also discussed.     

Medically Documented Suicide Ideation Among U.S. Army Soldiers

We used administrative data to examine predictors of medically documented suicide ideation (SI) among Regular Army soldiers from 2006 through 2009 (N = 10,466 ideators, 124,959 control person‐months). Enlisted ideators (97.8% of all cases) were more likely than controls to be female, younger, older when entering service, less educated, never or previously deployed, and have a recent mental health diagnosis. Officer ideators were more likely than controls to be female, younger, younger when entering service, never married, and have a recent mental health diagnosis. Risk among enlisted soldiers peaked in the second month of service and declined steadily, whereas risk among officers remained relatively stable over time. Risk of SI is highest among enlisted soldiers early in Army service, females, and those with a recent mental health diagnosis.     

College Students' Responses to Suicidal Content on Social Networking Sites: An Examination Using a Simulated Facebook Newsfeed

Although Facebook has a peer‐initiated suicide prevention protocol, little is known about users' abilities to notice, recognize, and appropriately interpret suicidal content or about their willingness to intervene. In this study, 468 college students were randomly assigned to interact with a simulated Facebook newsfeed containing content reflecting various suicide risk levels. A larger proportion of those exposed to content reflecting moderate and severe suicide risk noticed, recognized, appropriately interpreted, and endorsed taking action to intervene, as compared to those exposed to content representing no or low risk. Overall, results indicate that college students are responsive to suicidal content on Facebook.     

Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under‐reporting increased the total cost to $93.5 billion or $298 per capita, 2.1–2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit–cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients.