Physical Disability and Suicidal Ideation: A Community‐Based Study of Risk/Protective Factors for Suicidal Thoughts

Although the significance of poor physical health for suicide risk is well established, the potential relevance of physical disability, as distinct from diseases and traumas that give rise to disability, has received little attention. Prior evidence suggests the possible utility of the stress process theoretical model for understanding variations in risk for suicide ideation and the contribution of physical disability to such risk. In this article, we examine the independent and joint explanatory significance of physical disability and components of the stress process model for risk of suicide ideation. Data from an ethnically diverse and representative sample of disabled and nondisabled adults (n = 1,768) reveal that physical disability is associated with a greater risk of lifetime suicidal ideation.     

Expectancy priming of smoking cessation messages enhances the placebo effect of tailored interventions.

OBJECTIVE: Previous research (Webb, Simmons, & Brandon, 2005) suggested that smokers' reactions to self-help materials were more positive if they believed that the materials had been personally tailored to their individual characteristics and if they held expectancies that tailored interventions are superior to standard, or generic, interventions. The authors' objective in the current study was to replicate and extend this research by testing the efficacy expectancy priming before intervention delivery. DESIGN: In a 2 x 2 factorial experiment, 210 smokers (M = 23 cigarettes/day) recruited from the community (62% female; 92% Caucasian; mean age = 49) were randomly assigned to 1 of 4 conditions: placebo-tailored intervention/no priming, placebo-tailored intervention/priming, standard intervention/no priming, or standard intervention/priming. The tailoring-related expectancies of participants' in the priming conditions were primed before they were presented with the respective intervention booklets. MAIN OUTCOME MEASURES: Content evaluations, readiness to quit smoking, cessation self-efficacy, smoking-related knowledge, and progress toward quitting (behavior changes). Assessments occurred by mail at baseline and at 1-month postintervention. RESULTS: Similar to the earlier study, the placebo-tailored booklets produced superior evaluations and smoking-related cognitive and behavioral changes. Moreover, the pretreatment expectancy priming successfully altered participants' tailoring-related expectancies and also produced superior evaluations and outcomes. CONCLUSION: Findings support a causal role of tailoring-related expectancies on the efficacy of tailored interventions and suggest that interventions can be enhanced via expectancy priming.     

A Community of Psychotherapists

Services for chronic mental patients in this era of deinstitutionalization present a major challenge to clinicians and planners alike. The complexity of these patients' clinical and other programmatic needs requires that an array of viable comprehensive services be made available to them. Following certain established principles of service planning will help facilitate patients' longitudinal, psychological, financial, and geographical access to care.