Examining the Course of Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors in Outpatient and Inpatient Adolescents

Suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) among youth are major public health concerns. Although a growing body of research has focused on the complex association between nonsuicidal and suicidal self-injury, the temporal relationship between these two classes of behaviors is unclear. The current study addresses this empirical gap by examining the course of SITBs in adolescents receiving outpatient (N = 106; 82.1 % female) and inpatient (N = 174; 75.9 % female) treatment. SITBs (co-occurrence, age-of-onset, and time lag between SITBs) and major psychiatric disorders were assessed at a single time point with well-validated structured interviews. Adolescents in both clinical samples reported high co-occurrence of SITBs: most adolescents reported both lifetime nonsuicidal self-injury (NSSI) and suicidal thoughts. A similar temporal pattern of SITBs was reported in the two samples: thoughts of NSSI and suicide ideation had the earliest age-of-onset, followed by NSSI behaviors, suicide plans, and suicide attempts. However, the age-of-onset for each SITB was younger in the inpatient sample than in the outpatient sample. In terms of time lag between SITBs, suicide ideation occurred on average before initial engagement in NSSI, suggesting that pathways to NSSI and suicidal behavior may occur simultaneously rather than in succession from nonsuicidal to suicidal self-injury. Results also indicated that the time to transition between SITBs was relatively fast, and that a key period for intervention and prevention is within the first 6–12 months after the onset of suicidal thinking. Taken together, these findings have important implications for understanding the time-lagged relationship between nonsuicidal and suicidal self-injury.     

Chronic suicidality and borderline personality

Suicidal ideation is a complex clinical event. In this article, acute suicidal ideation is compared with chronic suicidal ideation, specifically their different meanings, relationships with Axis I and Axis II disorders, intrapsychic functions, approaches to assessment, and interventions. The potential risks of acute hospitalization of the chronically suicidal borderline personality disorder patient are discussed as well as a longitudinal, multidimensional treatment strategy for the chronically suicidal individual.     

Shedding Light on the Relationship Between Personal Standards and Psychopathology: The Case for Contingent Self-Worth

Previous research has revealed some puzzling inconsistencies in the relationship of Personal Standards (PS) to measures of psychopathology. This study was designed to explore the hypothesis that setting high Personal Standards will relate to psychopathology only when meeting these standards is a necessary condition for a sense of self-worth. We generated items that reflected a sense of conditional self-worth based on the meeting of Personal Standards and named this measure the Contingent Self-Worth Scale (CSWS). Factor analysis of the CSWS and the PS subscale of the Multidimensional Perfectionism Scale yielded three types of Personal Standards: Pure Personal Standards," Success-Based Self-Worth," and Activity-Based Self-Worth." Two of the original PS items did not load on the Pure Personal Standards scale. Correlational analyses revealed that Pure Personal Standards was related to measures of adaptive outcome whereas both measures of Contingent Self-Worth were related to more maladaptive functioning, although with some small differences. We call for further research to explore the relationship of PS to the construct of perfectionism.     

Operationalizing the "vulnerability" and "stress" components of the hopelessness theory of depression: a multi-wave longitudinal study

The current study tested of the diathesis-stress component of the hopelessness theory (HT) using (1) a "weakest link" approach towards operationalizing vulnerability (e.g., an individual is as vulnerable to depression as his/her most depressogenic inferential style-DIS) and (2) an idiographic approach towards operationalizing high levels of stress. The procedure involved an initial assessment during which participants completed measures assessing DISs and depressive symptoms. The procedure also involved a series of eight follow-up assessments, occurring every 6 weeks, during which depressive symptoms and hassles were assessed. Hypotheses were tested in two samples of adults (i.e., adults diagnosed with a current MDE and adults diagnosed with a past MDE at Time 1). In line with hypotheses, in both samples, depressogenic weakest links were associated with greater elevations in depressive symptoms following elevations in hassles. At the same time, equally strong support was obtained for the HT when stress was operationalized from a nomothetic perspective and when vulnerability was operationalized as a DIS about causes (but not consequences or self).     

Internet chat room use, satisfaction with life, and loneliness

In this study, 50 chat room users responded online to the Satisfaction With Life Scale, the Revised UCLA Loneliness Scale, and demographic questions which included time spent per week in Internet chat rooms. Time spent in chat rooms was positively correlated with loneliness but only weakly and negatively related to satisfaction with life.     

The utility of psychological testing in assessing emotional damages in personal injury litigation

Psychological testing and assessment instruments frequently play a small but important role when psychologists assist the courts as emotional damage experts in personal injury matters. However, examiners frequently, if sometimes inadvertently, mislead the court with test interpretations that are based on clinical rather than forensic populations and that fail to appreciate the lack of robustness of clinical measures in this forensic context. Whereas published computerized interpretations repeatedly remind experts that personality test results should only be used as a method to generate hypotheses about the examinee that are to be subjected to further investigation and consideration, experts all too often inform the courts of test interpretations as if the test results were measures of clinical constructs rather than plaintiffs' self-reports of symptoms.     

Lexical characteristics of words used in emotional Stroop experiments

Validity of the emotional Stroop task hinges on equivalence between the emotion and the control words in terms of lexical features related to word recognition. The authors evaluated the lexical features of 1,033 words used in 32 published emotional Stroop studies. Emotion words were significantly lower in frequency of use, longer in length, and had smaller orthographic neighborhoods than words used as controls. These lexical features contribute to slower word recognition and hence are likely to contribute to delayed latencies in color naming. The often-replicated slowdown in color naming of emotion words may be due, in part, to lexical differences between the emotion and control words used in the majority of such studies to date.     

Using fMRI to study recovery from acquired dysphasia

We have used functional magnetic resonance imaging (fMRI) to characterize brain activations associated with two distinct language tasks performed by a 28-year-old woman after partial recovery from dysphasia due to a left frontal hemispheric ischemic stroke. MRI showed that her ischemic lesion extended posteriorly from the left inferior frontal to the perisylvian cortex. fMRI scans of both language tasks revealed substantial differences in activation pattern relative to controls. The nature of this difference was task-specific. During performance of a verbal semantic decision task, the patient, in contrast to controls, activated a network of brain areas that excluded the inferior frontal gyrus (in either hemisphere). A second task involving rhyme judgment was designed to place a heavier cognitive load on language production processes and activated the left inferior frontal gyrus (Broca's area) strongly in normal controls. During this task, the most prominent frontal activation in the patient occurred in the right homologue of Broca's area. Subsequent analysis of this data by methods able to deal with responses of changing amplitude revealed additional, less sustained recruitment by the patient of cortex adjacent to the infarct in the region inferior to Broca's area during rhyming. These results suggest that in addition to changes in cognitive strategy, recovery from dysphasia could be mediated by both the preservation of neuronal networks in and around the infarct and the use of homologous regions in the contralateral hemisphere.     

Handedness in a virtual haptic environment: Assessments from kinematic behavior and modeling

This study evaluated hand asymmetries in performance of a dexterous, controlled task under haptic feedback. Participants punctured a virtual membrane with a pushing or pulling movement, using the left or right hand. For pulling movements, the dominant (right) hand exhibited faster average stopping latency and shorter skidding distance. When the kinematic data were fit to a three-phase model previously applied to this task (Klatzky et al., 2013), the right hand exhibited faster force decay attributable to biomechanical factors. Analyses of the aggregated performance measures and model parameters showed that the left and right hands are associated with two different distributions, supporting handedness effects. Furthermore, while the majority of participants expressed right-hand dominance, which was consistent with their self-reported hand preferences, others showed partial or no dominance. This approach could potentially be extended to quantify and differentiate individuals with difficulties in manual behavior due to abnormal motor control (e.g., dyspraxia), progressive deterioration (e.g., Parkinson's syndrome) or improvement (neural regrowth after transplant).