An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.     

Factors in the assessment of suicidality in youth

Suicide remains a leading cause of death among youth, and suicide ideation and behavior are relatively common in both normal and clinical populations. Clinicians working with young people must assess for the presence of suicidal ideation, suicidal behavior, and other risk factors, in order to determine the level of risk. This paper provides the clinician with a summary of risk factors for youth suicide, as well as providing standardized terminology to enhance assessment of suicidal ideation and behavior.     

Clarifying the paradigm for the ethics of donation and transplantation: Was 'dead' really so clear before organ donation?

Recent commentaries by Verheijde et al, Evans and Potts suggesting that donation after cardiac death practices routinely violate the dead donor rule are based on flawed presumptions. Cell biology, cardiopulmonary resuscitation, critical care life support technologies, donation and transplantation continue to inform concepts of life and death. The impact of oxygen deprivation to cells, organs and the brain is discussed in relation to death as a biological transition. In the face of advancing organ support and replacement technologies, the reversibility of cardiac arrest is now purely related to the context in which it occurs, in association to the availability and application of support systems to maintain oxygenated circulation. The 'complete and irreversible' lexicon commonly used in death discussions and legal statutes are ambiguous, indefinable and should be replaced by accurate terms. Criticism of controlled DCD on the basis of violating the dead donor rule, where autoresuscitation has not been described beyond 2 minutes, in which life support is withdrawn and CPR is not provided, is not valid. However, any post mortem intervention that re-establishes brain blood flow should be prohibited. In comparison to traditional practice, organ donation has forced the clarification of the diagnostic criteria for death and improved the rigour of the determinations.     

Revisiting the Stanford prison experiment: could participant self-selection have led to the cruelty?

The authors investigated whether students who selectively volunteer for a study of prison life possess dispositions associated with behaving abusively. Students were recruited for a psychological study of prison life using a virtually identical newspaper ad as used in the Stanford Prison Experiment (SPE; Haney, Banks & Zimbardo, 1973) or for a psychological study, an identical ad minus the words of prison life. Volunteers for the prison study scored significantly higher on measures of the abuse-related dispositions of aggressiveness, authoritarianism, Machiavellianism, narcissism, and social dominance and lower on empathy and altruism, two qualities inversely related to aggressive abuse. Although implications for the SPE remain a matter of conjecture, an interpretation in terms of person-situation interactionism rather than a strict situationist account is indicated by these findings. Implications for interpreting the abusiveness of American military guards at Abu Ghraib Prison also are discussed.     

Tolerant (In)civility? A Longitudinal Analysis of White Conservative Protestants’ Willingness to Grant Civil Liberties

Past research has found conservative Protestants to be less willing than most Americans to grant civil liberties to unpopular groups. In light of evidence of high and growing civility by Smith (2000) and Hunter (1984), there is good reason to believe that conservative Protestants are becoming less distinctive with regard to granting civil freedoms. We update and expand previous research on conservative Protestants and civil liberties by examining the civil liberties measures in the General Social Survey over a 26-year period, with special attention to explaining conservative Protestantism's rejection of civil liberties. In comparison to mainline Protestants and Catholics, we find that conservative Protestants are still less willing to grant civil liberties to unpopular groups, though important qualifications apply. Various explanations are examined.