Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

Policy makers and researchers have worked to explain the perplexing rise in U.S. military suicides since 2001, with little progress in explaining this widespread phenomenon. This article synthesizes several literatures to highlight the role of emotion dysregulation in military suicidality. After considering advances in suicidal ideation‐to‐action frameworks and the factors that contribute to the prevalence of emotion dysregulation in the modern U.S. military, it explores how military service provides for two distinct circumstances in which such emotion dysregulation may facilitate the transition from suicidal ideation to behavior. The first circumstance is high distress tolerance, wherein the effects of disproportionately high rates of adverse childhood experiences (ACEs) among service‐members may increase vulnerability to suicidal behavior. The second circumstance is preexisting acquired capability with lethal means paired with executive functioning degradation. Empirically associated with military environments, such degradation may undermine the effectiveness of top‐down emotion regulation strategies—thereby allowing acquired familiarity with lethal means to assist the transition from suicidal ideation to action. Thus, emotion dysregulation’s unique relationship with the U.S. military may help to explain the powerful correlation between service and suicide since 2001—suggesting that enhancing emotion regulation skills may present a key leverage point for effectively addressing the issue.     

Prevalence of dating violence and victimization: regional and gender differences

This report examines (1) the prevalence of dating violence victimization from a national sample of rural adolescents and (2) patterns by gender and region. Analyses are based on 20,274 adolescents who reported violence victimization using the Community Drug and Alcohol Survey. The relationship of dating violence with gender and region was assessed with HLM5 using Bernoulli's logistic regression. Approximately 16% of adolescents reported being a victim of dating violence. Females reported higher incidence of victimization than males. Dating violence is more prevalent in the South. While it is important to address the underlying values in society that may contribute to dating violence, it is equally productive to include regional and cultural values.     

Evaluations of capacity to waive Miranda rights: a survey of practitioners' use of the Grisso instruments

Minimal information is available regarding the frequency with which practitioners conduct evaluations of capacity to waive Miranda rights or what approaches they use in doing so. Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights are the only published instruments designed specifically to assist practitioners in these evaluations. The instruments have been criticized for limited normative data in the test manual and the minimal guidance offered for interpreting results. A survey of practitioners was conducted to determine the nature and frequency of the use of these instruments. Of 401 respondents, 91% were engaged in forensic practice, and 26% had conducted evaluations of one's capacity to waive Miranda rights. Of those conducting Miranda evaluations, 44% had used Grisso's Miranda instruments. Practitioners' responses regarding the ways the instruments are used are reported. Suggestions are offered for informed practice, and related strengths and weaknesses of the instruments are identified.     

Legal abortion worldwide: incidence and recent trends

CONTEXT: Information on abortion levels and trends can inform research and policies affecting maternal and reproductive health, but the incidence of legal abortion has not been assessed in nearly a decade. METHODS: Statistics on legal abortions in 2003 were compiled for 60 countries in which the procedure is broadly legal, and trends were assessed where possible. Data sources included published and unpublished reports from official national reporting systems, questionnaires sent to government agencies and nationally representative population surveys. The completeness of country estimates was assessed by officials involved in data collection and by in-country and regional experts. RESULTS: In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each on average in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world's legal abortions in 1996. Trends in the abortion rate differed across age-groups in some countries. CONCLUSIONS: The abortion rate varies widely across the countries in which legal abortion is generally available and has declined in many countries since the mid-1990s.     

Modified TC for MICA offenders: crime outcomes

The study randomly assigned male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders to either modified therapeutic community (MTC) or mental health (MH) treatment programs. On their release from prison, MICA inmates who completed the prison MTC program could enter the MTC aftercare program. The results, obtained from an intent-to-treat analysis of all study entries, showed that inmates randomized into the MTC group had significantly lower rates of reincarceration compared with those in the MH group. The results also show that differences between the MTC + aftercare and comparison group across a variety of crime outcomes (i.e. any criminal activity, and alcohol or drug related criminal activity) are consistent and significant, and persist after an examination of various threats to validity (e.g. initial motivation, duration of treatment, exposure to risk). This study provides some support for the effectiveness of the prison TC only condition. The findings are encouraging and consonant with other studies of integrated prison and aftercare TC programs for substance abusing non-MICA offenders, although qualified by the possibility that selection bias (i.e. differences in motivation on entry into aftercare) may be operating. Nevertheless, given the available evidence and the need for effective programming for MICA offenders, program and policy makers should strongly consider developing integrated prison and aftercare modified TC programs for MICA offenders.     

Convergent and discriminative validity of interview and questionnaire measures of personality disorder in mentally disordered offenders: a multitrait-multimethod analysis using confirmatory factor analysis

Measures of personality disorder from the International Personality Disorder Examination, Personality Diagnostic Questionnaire, and Millon Clinical Multiaxial Inventory (MCMI-II) were obtained from detained male mentally disordered offenders (N = 156), and convergent and discriminant validity were examined by confirmatory factor analysis of the multitrait-multimethod matrix. Hierarchical comparisons of models varying in their specification of trait and method variance established the appropriateness of a model supporting both convergence and discrimination across methods, but these were variable across constructs and measures. Convergence was good for avoidant, schizoid, and antisocial disorders, but poor for histrionic, narcissistic, and obsessive-compulsive disorders. Avoidant, schizoid, and schizotypal disorders were not clearly distinguishable from each other. Measurement error attributable to method variance was substantial for all instruments and for most disorders. The commonly alleged superiority of interview over questionnaire methods was not supported, and the MCMI-II demonstrated proportionately more "true" variance. However, assessment methods may be differentially sensitive to different kinds of personality disorder problems.     

Sex, race/ethnicity, and romantic attractions: multiple minority status adolescents and mental health

This study examined the association between multiple minority statuses and reports of suicidal thoughts, depression, and self-esteem among adolescents. Data from the National Longitudinal Study of Adolescent Health were used to examine mental health outcomes across racial/ethnic groups for same-sex-attracted youths and female youths. Hispanic/Latino, African American, and White female adolescents reported more suicidal thoughts, higher depression, and lower self-esteem compared with male adolescents in their racial/ethnic group. Same-sex-attracted youths did not consistently demonstrate compromised mental health across racial/ethnic groups. Follow-up analyses show that White same-sex-attracted female adolescents reported the most compromised mental health compared with other White adolescents. However, similar trends were not found for racial/ethnic minority female youths with same-sex attractions.     

Sacrifice as a predictor of marital outcomes

We investigated the prospective associations between attitudes about sacrifice and marital outcomes in 38 married couples. Specifically, a measure of satisfaction with sacrifice was proposed to be a potent longitudinal predictor of marital adjustment and distress based on existing cross-sectional studies and also to mediate the association between commitment and marital adjustment. Results demonstrated that attitudes about sacrifice discriminated between couples who would become distressed versus nondistressed over time. Sacrifice attitudes also predicted the maintenance of relationship adjustment over time even better than earlier relationship adjustment. Finally, sacrifice attitudes mediated the link between commitment and relationship adjustment for husbands, but not wives. Implications for intervention are discussed.     

Age-related effects of attentional and oculomotor capture by onsets and color singletons as a function of experience

The present experiment examined the degree to which experience with different stimulus characteristics affects attentional capture, particularly as related to aging. Participants were presented with onset target/color singleton distractor or color singleton target/onset distractor pairs across three experimental sessions. The target/distractor pairs were reversed in the second session such that the target in the first session became the distractor in the second and third sessions. For both young and old adults previous experience with color as a target defining feature influenced oculomotor capture with task-irrelevant color distractors. Experience with sudden onsets had the same effect for younger and older adults, although capture effects were substantially larger for onset than for color distractors. Experience-based capture effects diminished relatively rapidly after target and distractor-defining properties were reversed. The results are discussed in terms of top-down and stimulus-driven effects on age-related differences in attentional control.     

Stimulus control of cocaine self-administration

Environmental stimuli that set the occasion wherein drugs are acquired can "trigger" drug-related behavior. Investigating the stimulus control of drug self-administration in laboratory animals should help us better understand this aspect of human drug abuse. Stimulus control of cocaine self-administration was generated here for the first time using multiple and chained schedules with short, frequently-alternating components--like those typically used to study food-maintained responding. The procedures and results are presented along with case histories to illustrate the strategies used to produce this stimulus control. All these multicomponent schedules contained variable-interval (VI) components as well as differential-reinforcement-of-other-behavior (DRO) or extinction components. Schedule parameters and unit dose were adjusted for each rat to produce stable, moderate rates in VI components, with minimal postreinforcement (infusion) pausing, and response cessation in extinction and DRO components. Whole-body drug levels on terminal baselines calculated retrospectively revealed that all rats maintained fairly stable drug levels (mean, 2.3 to 3.4 mg/kg) and molar rates of intake (approximately 6.0 mg/kg/hr). Within this range, no relation between local VI response rates and drug level was found. The stimulus control revealed in cumulative records was indistinguishable from that achieved with food under these schedules, suggesting that common mechanisms may underlie the control of cocaine- and food-maintained behavior.