Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self‐reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence‐based components—entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre‐suicidal mental state, regardless of their self‐reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.     

Treating Traumatized Children: Somatic Memories and Play Therapy

Drawing on psychoanalytic theories of infant development and children’s preverbal memories, this article explores the somatic memories in young children who experienced trauma and the level interventions necessary to facilitate the transformation of these traumas from concrete to symbolic representations. The clinical case of a 3-year-old boy who experienced hospitalizations and multiple surgeries prior to the age of 2 is used to illustrate the efficacy of play therapy for traumatized children. We argue that children do remember traumas from their infancy, and interventions geared toward re-enacting the traumas through play are necessary to help these children symbolize their experiences and alleviate their trauma symptoms.     

The missing link? Testing a schema account of unitization

Unitization refers to the creation of a new unit from previously distinct items. The concept of unitization has been used to explain how novel pairings between items can be remembered without requiring recollection, by virtue of new, item-like representations that enable familiarity-based retrieval. We tested an alternative account of unitization – a schema account – which suggests that associations between items can be rapidly assimilated into a schema. We used a common operationalization of “unitization” as the difference between two unrelated words being linked by a definition, relative to two words being linked by a sentence, during an initial study phase. During the following relearning phase, a studied word was re-paired with a new word, either related or unrelated to the original associate from study. In a final test phase, memory for the relearned associations was tested. We hypothesized that, if unitized representations act like schemas, then we would observe some generalization to related words, such that memory would be better in the definition than sentence condition for related words, but not for unrelated words. Contrary to the schema hypothesis, evidence favored the null hypothesis of no difference between definition and sentence conditions for related words (Experiment 1), even when each cue was associated with multiple associates, indicating that the associations can be generalized (Experiment 2), or when the schematic information was explicitly re-activated during Relearning (Experiment 3). These results suggest that unitized associations do not generalize to accommodate new information, and therefore provide evidence against the schema account.     

Getting a Life: Gender Differences in Postwar Recovery

This study examined gender differences in stress symptoms and recovery one year after the end of war, among two Israeli samples (adults n?=?870 and adolescents n?=?810). MANOVA analysis indicated that females reported higher levels of stress symptoms and lower levels of postwar recovery compared to males. Adolescents reported lower levels of stress and higher levels of recovery compared to adults. Path analysis supported the following: Gender associated negatively with family support and sense of danger. Sense of danger associated positively with symptoms and negatively with recovery, while family support associated with these variables in the opposite direction. Mediation test indicated that family support and sense of danger served as mediators between gender and recovery and between gender and stress symptoms.     

Managing terror: differences between Jews and Arabs in Israel

Using telephone surveys, we examined exposure to terror, coping, and mental health response in randomly selected Jewish-Israelis (n = 100) and Arab-Israelis (n = 100) living in five Israeli cities affected by terrorism. Jewish-Israelis and Arab-Israelis were randomly selected for study participation and completed telephone surveys in May 2002, following an extended string of terror attacks and hostilities. Although terrorism is designed to target Jewish-Israelis, the rates of exposure were similar in the two groups. Arab-Israelis reported using a wider array of coping strategies, yet also endorsed more frequent PTSD and more severe depression symptoms than Jewish-Israelis. We examined a variety of demographic, ethnic, and religious predictors of different coping styles and found varying results. For example, acceptance coping was best predicted by Arab-Israeli ethnicity, being female, greater religiosity, and lower education. Predictors of mental health response to terror were also examined, with Arab-Israeli ethnicity, being female, adaptation coping and collaborative coping best predicting PTSD and depression symptoms. Arab-Israelis may not have the same access to overarching sources of patriotic support that are readily available to their Jewish compatriots, and civilian and economic inequity experienced by the Arab minority may add to a sense of diminished resources. Our findings justify outreach efforts to overlooked minorities at risk for posttraumatic distress. Women seem to be at particular risk for the development of mental health symptoms following terrorism, which should also be noted for outreach purposes.