Worst-point suicidal plans: a dimension of suicidality predictive of past suicide attempts and eventual death by suicide

Among 440 psychiatric outpatients with current suicidal ideation, we examined the empirical distinction between the “plans” vs. “desire” dimensions of suicidality, focusing for conceptual and empirical reasons on a worst-point assessment strategy. Factor analyses were consistent with the distinction, but more importantly, among the current ideators included in this study, the worst-point “plans” dimension was the only predictor significantly related to both of two important indices, history of past attempt and eventual suicide. These findings bear on the trajectory of suicidal behavior over time, as well as inform the clinical assessment of suicidal patients.     

THE SORROWS OF YOUNG WERTHER AND GOETHE'S UNDERSTANDING OF MELANCHOLIA

The Sorrows of Young Werther (1774). By Johann Wolfgang von Goethe, translated by Elizabeth Mayer and Louise Bogan. 167 pp. In The Sorrows of Young Werther, and Novella. New York: Random House, 1971.     

Cross‐national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems.     

Validity and reactivity of a system of self-monitoring suicide ideation

The present study describes the rationale and validation of a self-monitoring approach for suicide ideation. A sample of 49 severely ideating 18- to 24-year-old college students volunteering for a treatment study for chronic ideators served as subjects. A three-item self-monitoring scale designed to assess the strength, duration, and level of control relative to suicide ideation was designed and utilized. Positive correlations with previously validated measures of suicide ideation support the validity of the use of self-monitoring. In addition, positive relationships with measures of depression and hopelessness provide evidence of concurrent validity. There was no evidence that self-monitoring and concomitant increased attention to ideation increased suicidality. In fact, decreases were noted in measures of suicide ideation following a 2-week period of self-monitoring. Together these findings support the addition of self-monitoring to the list of dependent measures for addressing suicidal behavior.     

Embryo genetic disorder analysis demonstration project: A model protocol

A demonstration project designed for couples at a minimum 25% risk for having a child with cystic fibrosis is being undertaken using embryo genetic disorder analysis within an organization proficient inin vitro fertilization techniques. Prior to offering the project to patients, issues were identified that needed to be addressed in order to improve the likelihood of success. We then developed a set of protocols that would enable us to introduce this new technology to our staff and to prospective patients in a consistent manner.     

Preliminary Evidence for the Effectiveness of Dialectical Behavior Therapy for Adolescents

This meta‐analysis evaluated the effectiveness of dialectical behavior therapy for adolescents in reducing symptoms of depression, anxiety, self‐injury, and suicide risk. Twelve between‐group studies (N = 834) were chosen that met the inclusion criteria. Results revealed small‐to‐medium Hedges's g effect sizes for all 4 symptoms compared with control and alternative treatment groups. However, the small number of effect sizes available for each analysis limited the generalizability of the findings. Implications and suggestions for future research are discussed.     

The concept of the death drive: A clinical perspective

This paper discusses Freud 's theory of the death drive in the light of clinical experience with severely self-destructive personality disorders, and contemporary object relations theory. Repetition compulsion, sadism and masochism, negative therapeutic reaction, suicide in depressed and in non-depressed patients, and destructive group processes are explored from this perspective. The paper concludes that the concept of the death drive is clinically relevant, but that this condition needs to be traced to the general dominance of aggressive affects as the primary etiological factor; only under severely pathological circumstances does this dominance lead to a focused drive to self-destruct.     

Suicide Intervention Training for K–12 Schools: A Quasi‐Experimental Study on ASIST

This quasi‐experimental study investigated differences between 104 school personnel who received a standardized suicide awareness and prevention training (i.e., Applied Suicide Intervention Skills Training) and 45 control group participants. Pre‐ and posttraining data included experimental and control group participants' (a) suicide intervention skills; (b) attitudes toward suicide; (c) knowledge of suicide; and (d) comfort, competence, and confidence in responding to individuals at risk of suicide. Results indicated a significant positive effect for training on all measures. Implications for training of school personnel and future research are discussed.