The association between bankruptcy and hospital-presenting attempted suicide: a record linkage study

The associations between admissions to an emergency department following attempted suicide and personal bankruptcy in the preceding and subsequent 2 years were evaluated. Records from a level 1 trauma center (June 1993-December 2002) in Seattle, WA, were linked with case files from the local U.S. District Bankruptcy Court (June 1991 onward). Univariable and multivariable logistic regression models were used to examine the risk of bankruptcy in (i) the 2 years after and (ii) the 2 years before a suicide attempt using a violent method, compared to patients admitted for any other reason. After adjusting for several confounders, patients who had attempted suicide were more likely than other patients to experience bankruptcy in the following 2 years (OR = 2.10, 95% CIs: 1.29, 3.42). A somewhat weaker association was seen with bankruptcy in the preceding 2 years (OR = 1.68, 95% CIs 1.06; 2.67). Attempted suicide is therefore associated with bankruptcy in the preceding and following 2 years. Changes to legislation, improved mental health counselling for those in financial difficulty, and provision of financial advice to those admitted to hospital following a suicide attempt may reduce future cases of serious self-harm and completed suicide.     

Anxiety sensitivity and distress tolerance typologies and relations to posttraumatic stress disorder: A cluster analytic approach

A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in Veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed Veterans (N = 250). A cluster analytic approach was used to identify AS/DT profiles, and a series of multivariate analyses of variance with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a 3-cluster solution including a high AS/low DT “at risk” profile, a low AS/high DT “resilient” profile, and an average AS/DT “intermediate” profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT “at risk” profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.     

Exposure to Community Violence: Defining the Problem and Understanding the Consequences

Exposure to community violence has emerged as a major risk factor for the development of emotional and behavioral problems in children and adolescents. In the past decade, there has been a proliferation of research within the fields of medicine, sociology, and psychology documenting the rates and consequences of exposure to community violence. This interdisciplinary growth has led to a great deal of variability within the field of exposure to community violence, making it difficult to glean general conclusions regarding rates and impact of exposure. This review advances the current understanding of exposure to community violence by integrating findings across disciplines as well as reviewing the few studies that have provided initial explanatory information regarding mediators and moderators of the relationship between exposure to community violence and its associated outcomes.     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

The Influence of Spiritually-based Learning Opportunities on Personal Faith and Denominational Loyalty in Seventh-Day Adventist Academies

This study examined how Bible teachers, involvement in leadership in school-wide spiritual activities, and personal school-sponsored spiritual activities were related to students’ relationship with God and their denominational loyalty. Data were obtained from seniors in 19 Seventh-day Adventist academies. Students’ intention to remain in the Seventh-day Adventist church after they finish high school or leave their parents’ home (denominational loyalty) was explained by their involvement and leadership in school-sponsored spiritual activities and the influence of their Bible teacher. However, the effect of these variables on denominational loyalty was primarily due to the extent that they affected the students’ relationship with God.