Sleep deprivation in Air National Guard medical personnel responding to simulated disaster-training exercises

National Guard personnel remain largely unstudied within the sleep research community, despite their unique and important role. In response, the purpose of this study was to investigate the extent of sleep deprivation in National Guard medical personnel from two separate Air Force Bases (AFBs) responding to simulated disaster-training exercises. National Guard medical personnel (N = 77) were fitted with wrist activity monitors (actigraphy) to objectively measure their sleep for 4 days of their civilian time (baseline), followed by a 4-day transition period from civilian to military duty, and a 3–5-day disaster-training exercise. Differences in sleep quantity, quality, and “cognitive effectiveness” were analyzed using generalized linear mixed models. Participants’ sleep quantity was significantly reduced from civilian to disaster-training periods, and their cognitive effectiveness also dropped significantly. National Guard medical personnel were sleep-deprived during a simulated disaster-training exercise, which, although a valid proxy for real-world disasters, is likely to be a conservative approximation of the stress and fatigue National Guard personnel experience during crisis response. As such, the need for targeted fatigue-related interventions to safeguard our service members during these critical times is clear.     

Sociodemographic and Clinical Differences Between Suicide Ideators and Attempters: A Study of Mood Disordered Patients 50 Years and Older

Our study sought to characterize mood disordered suicide ideators and attempters 50 years and older admitted to a psychiatric ward either for a recent suicide attempt or for ongoing suicidal ideation. We enrolled 50 patients with suicide ideation consecutively admitted to an inpatient department and 50 patients admitted for a suicide attempt made in the last 48 hours. Suicide attempters more frequently had low social support and an age of onset of mood disorder of 46 years and older, and less frequently had a history of suicidal behaviors in the family members and pharmacological treatment, despite the fact that the groups did not differ with regard to antidepressants prescribed. The groups were not distinguishable based on several variables assumed to be risk factors for suicide behavior, such as proximal life events and stressors or alcohol use disorders. In both samples, comorbidity with organic diseases, the presence of stressful life events in the past 12 months, and a diagnosis of major depression were frequently reported. In conclusion, the presence of low social support and the absence of a pharmacotherapy may increase suicidal behaviors in patients at risk.     

Modification of the Reactive Attitudes

In ‘Freedom and Resentment’ P. F. Strawson argues that reactive attitudes like resentment and indignation cannot be eliminated altogether, because doing so would involve exiting interpersonal relationships altogether. I describe an alternative to resentment: a form of moral sadness about wrongdoing that, I argue, preserves our participation in interpersonal relationships. Substituting this moral sadness for resentment and indignation would amount to a deep and far‐reaching change in the way we relate to each other – while keeping in place the interpersonal relationships, which, Strawson rightfully believes, cannot be eliminated.     

Stepfamily Communication Strengths

This study used systems theory to examine the communication strategies that differentiate “strong” stepfamilies from stepfamilies having more difficulty, inductively deriving a composite of stepfamily “communication strengths.” A total of 90 in‐depth interviews were conducted with stepparents, parents, and stepchildren from 30 stepfamilies. The stepfamilies, regardless of their strength, faced 7 primary challenges in their development: “feeling caught,” regulating boundaries with a noncustodial family, ambiguity of parental roles, “traumatic bonding,” vying for resources, discrepancies in conflict management styles, and building solidarity as a family unit. However, the communicative tactics used to manage them differed according to the strength of the stepfamily. In general, strong stepfamilies reported using everyday talk, more openness, spending time together as a family, communicating clear rules and boundaries, engaging in family problem solving, promoting a positive image of the noncustodial parent, and more consistency in perceptions about the severity of their problems. Implications for appropriate boundary integration in stepfamilies are discussed.     

Couple Identity Gaps,the Management of Conflict,and Biological and Self‐Reported Stress in Romantic Relationships

This study investigates the role of couple identity gaps in romantic partners' communicative and physiological management of stress during a conflict‐inducing discussion task. A total of 118 couples participated in a laboratory study in which they engaged in a conflict‐inducing discussion. Perceptions of intra‐ and extrarelationship couple identity gaps were associated with greater self‐reported anxiety and stress for men and greater negativity for women during the conversation. Extrarelationship identity gaps were also significantly associated with heightened cortisol and (salivary alpha‐amylase) sAA reactivity and delayed recovery, especially for women. The study extends the research on couple identity by introducing the concept of identity gaps into relational contexts to help explain why couples vary in their ability to manage stress.     

Suicide Attempts in Major Depressed Patients with Personality Disorder

Suicide attempters who met criteria for borderline personality disorder (BPD) comorbid with major depressive disorder (MDD) were compared to both suicide attempters suffering from MDD alone and to attempters with comorbid MDD and other personality disorders (PD). Participants were 239 (158 patients with comorbid PD and 81 patients with MDD without comorbidity) inpatients consecutively admitted after a suicide attempt made in the last 24 hours. Suicide attempters with comorbid MDD and BPD had more frequent previous suicide attempts and were more likely to have a history of aggressive behaviors and alcohol and drug use disorders compared with patients suffering from MDD without Axis II comorbidity.