Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide

A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow‐up (n = 168; 57%). Fifty‐three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide.     

The Changing Nature of Adolescent Friendships Longitudinal Links With Early Adolescent Ego Development

Although success in managing evolving peer relationships is linked to critical adolescent outcomes, little is known about the specific factors that lead to success or failure in peer relationship development across adolescence. This longitudinal study examines the role of adolescents' level of ego development as a predictor of the future course of several facets of friendship development in early adolescence. Ego development was assessed in a community sample of adolescents at age 13. Several facets of adolescent friendship were also assessed at 13 and then reassessed 1 year later, including adolescent intimate behavior during a supportive interaction with their best friends, adolescent reports of psychological security in their friendships, and peer-rated popularity. As predicted, ego development not only explained concurrent levels of peer functioning but also predicted markers of change over time in each of the assessed domains of peer functioning. Implications for ego development in increasing our understanding of individual differences in adolescent friendship development are discussed.     

Patterns of Presentation for Attempted Suicide: Analysis of a Cohort of Individuals Who Subsequently Died by Suicide

All suicides and related prior attempts occurring in Northern Ireland over two years were analyzed, focusing on number and timing of attempts, method, and mental health diagnoses. Cases were derived from coroner's records, with 90% subsequently linked to associated general practice records. Of those included, 45% recorded at least one prior attempt (with 59% switching from less to more lethal methods between attempt and suicide). Compared with those recording one attempt, those with 2+  attempts were more likely to have used less lethal methods at the suicide (OR = 2.77: 95% CI = 1.06, 7.23); and those using less lethal methods at the attempts were more likely to persist with these into the suicide (OR = 3.21: 0.79, 13.07). Finally, those with preexisting mental problems were more likely to use less lethal methods in the suicide: severe mental illness (OR = 7.88: 1.58, 39.43); common mental problems (OR = 3.68: 0.83, 16.30); and alcohol/drugs related (OR = 2.02: 0.41, 9.95). This analysis uses readily available data to highlight the persisting use of less lethal methods by visible and vulnerable attempters who eventually complete their suicide. Further analysis of such conditions could allow more effective prevention strategies to be developed.     

Temporal Fictionalism for a Timeless World

Current debate in the metaphysics of time ordinarily assumes that we should be realists about time. Recently, however, a number of physicists and philosophers of physics have proposed that time will play no role in a completed theory of quantum gravity. This paper defends fictionalism about temporal thought, on the supposition that our world is timeless. We argue that, in the face of timeless physical theories, realism about temporal thought is unsustainable: some kind of anti-realism must be adopted. We go on to provide an argument against eliminativism about temporal thought. While it doesn't follow from this argument that fictionalism about temporal thought is true, we suggest that this nonetheless shows that fictionalism should be regarded as the preferred view.