Accuracy of Clinician Predictions of Future Self‐Harm: A Systematic Review and Meta‐Analysis of Predictive Studies

Assessment of a patient after hospital‐treated self‐harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self‐harm. Through systematic review and a series of meta‐analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18–0.50), specificity 0.85 (0.75–0.92), positive predictive value 0.22 (0.21–0.23), and negative predictive value 0.89 (0.86–0.92). Clinician classification was too inaccurate to be clinically useful. After‐care should therefore be allocated on the basis of a needs rather than risk assessment.     

Poisoning Severity Associated with a Range of Medications in Suicide Attempts by Ingestion

There are limited data on the medical severity of suicide attempts by intentional self‐poisoning (ISP) associated with ingestion of differing classes of medications and meager data on specific agents. The purpose of the study was to address these gaps. This was an analysis of a consecutive series of ISP cases ages 13 to 65 treated at a U.S. university medical center (N = 671). The outcome, poisoning severity, was dichotomized as “moderate‐severe” and “low” (reference) based on a standard measure. Class of medication (e.g., opiate) and specific agents ingested were the predictors of interest. Covariates were age, sex, and the ingestion of multiple classes of medications. Data were analyzed using multivariate logistic regression models. At the class level, ingestion of opiate was uniquely associated with increased risk for moderate‐severe ISP at a statistically significant level, adjusted odds ratio (95% CI) = 2.97 (1.69, 5.21), p = .0002. Several specific agents were also associated with moderate‐severe ISP. Along with the key role of opiate medications in unintentional overdose morbidity and mortality, opiate medications may also play an important and largely unrecognized role in medically serious suicidal behavior. Results also underscore the variability in toxicity of specific agents within drug classes.     

Models of recognition: A review of arguments in favor of a dual-process account

The majority of computationally specified models of recognition memory have been based on a single-process interpretation, claiming that familiarity is the only influence on recognition. There is increasing evidence that recognition is, in fact, based on two processes: recollection and familiarity. This article reviews the current state of the evidence for dual-process models, including the usefulness of the remember/know paradigm, and interprets the relevant results in terms of the source of activation confusion (SAC) model of memory. We argue that the evidence from each of the areas we discuss, when combined, presents a strong case that inclusion of a recollection process is necessary. Given this conclusion, we also argue that the dual-process claim that the recollection process is always available is, in fact, more parsimonious than the single-process claim that the recollection process is used only in certain paradigms. The value of a well-specified process model such as the SAC model is discussed with regard to other types of dual-process models.     

Does incongruence of lexicosemantic and prosodic information cause discernible cognitive conflict?

We are often required to interpret discordant emotional signals. Whereas equivalent cognitive paradigms cause noticeable conflict via their behavioral and psychophysiological effects, the same may not necessarily be true for discordant emotions. Skin conductance responses (SCRs) and heart rates (HRs) were measured during a classic Stroop task and one in which the emotions conveyed by lexicosemantic content and prosody were congruent or incongruent. The participants’ task was to identify the emotion conveyed by lexicosemantic content or prosody. No relationship was observed between HR and congruence. SCR was higher during incongruent than during congruent conditions of the experimental task (as well as in the classic Stroop task), but no difference in SCR was observed in a comparison between congruence effects during lexicosemantic emotion identification and those during prosodic emotion identification. It is concluded that incongruence between lexicosemantic and prosodic emotion does cause notable cognitive conflict. Functional neuroanatomic implications are discussed.     

Retrieval-induced facilitation: initially nontested material can benefit from prior testing of related material

Classroom exams can assess students' knowledge of only a subset of the material taught in a course. What are the implications of this approach for long-term retention? Three experiments (N = 210) examined how taking an initial test affects later memory for prose materials not initially tested. Experiment 1 shows that testing enhanced recall 24 hr later for the initially nontested material. This facilitation was not seen for participants given additional study opportunities without initial testing. Experiment 2 extends this facilitative effect to a within-subjects design. Experiment 3 demonstrates that this facilitation can be modulated by conscious strategies. These results have implications for educational practice and the theoretical developments of the testing effect, associative memory, and retrieval inhibition.     

Rhythm deficits in 'tone deafness'

It is commonly observed that 'tone deaf' individuals are unable to hear the beat of a tune, yet deficits on simple timing tests have not been found. In this study, we investigated rhythm processing in nine individuals with congenital amusia ('tone deafness') and nine controls. Participants were presented with pairs of 5-note sequences, and were required to detect the presence of a lengthened interval. In different conditions the sound sequences were presented isochronously or in an integer-ratio rhythm, and these were either monotonic or varied randomly in pitch. It was found that the 'tone deaf' participants exhibited inferior rhythm analysis for the sequences that varied in pitch compared to those that did not, whereas the controls obtained equivalent thresholds for these two conditions. These results suggest that the rhythm deficits in congenital amusia result from the pitch-variations in music.     

Which cues are available to 24-month-olds? Evidence from point-of-gaze measures during search

In previous research 2-year-olds have failed to show knowledge of solidity in a search task in which a ball rolled behind a screen and was stopped by a barrier. The screen had four doors and the barrier was visible above the door hiding the ball. To establish what cues 2-year-olds might be using, precise point-of-gaze measures were taken during the hiding event. A transparent screen with opaque doors provided two cues: (1) the ball could be tracked until it failed to emerge, and (2) the barrier's position could indicate the correct door. Point-of-gaze measures revealed that children failed to use the more indirect cue of the barrier, which requires reasoning and spatial integration. Their search success was predicted only by the more immediate cue of actively tracking the ball. These findings support the claim that children use best those cues directly related to the object's disappearance, while failing to use cues that entail higher cognitive demands.