Acculturative stress and experiential avoidance: relations to depression,suicide, and anxiety symptoms among minority college students

Although college campuses represent strategic locations to address mental health disparity among minorities in the US, there has been strikingly little empirical work on risk processes for anxiety/depression among this population. The present investigation examined the interactive effects of acculturative stress and experiential avoidance in relation to anxiety and depressive symptoms among minority college students (n = 1,095; 78.1% female; M_age = 21.92, SD = 4.23; 15.1% African-American (non-Hispanic), 45.3% Hispanic, 32.5% Asian, and 7.1% other races/ethnicities. Results provided empirical evidence of an interaction between acculturative stress and experiential avoidance for suicidal, social anxiety, and anxious arousal symptoms among the studied sample. Inspection of the significant interactions revealed that acculturative stress was related to greater levels of suicidal symptoms, social anxiety, and anxious arousal among minority college students with higher, but not lower, levels of experiential avoidance. However, in contrast to prediction, there was no significant interaction for depressive symptoms. Together, these data provide novel empirical evidence for the clinically-relevant interplay between acculturative stress and experiential avoidance in regard to a relatively wide array of negative emotional states among minority college students.     

Suicide risk assessment: Clinicians’ confidence in their professional judgment

Suicide risk assessment is a critical component of mental health practice for which the stakes are high and the outcomes uncertain. This research examines the consistency with which clinicians make determinations of suicide risk and factors influencing clinical confidence. Seventy-one social workers interviewed two standardized patients performing in scenarios depicting suicidal ideation, judged whether the patient required hospitalization, and completed standardized suicide risk assessment measures. Self-ratings and qualitative interviews explored participants’ confidence in their judgment of risk. Participants had highly divergent views regarding whether or not the risk of suicide was sufficiently high to require hospitalization. However, regardless of the ultimate decision reached, participants were equally confident when recommending either clinical course of action. The variation in risk assessment appraisals in this study, despite at times high rates of confidence in risk appraisals, speaks to the need for ongoing training, consultation, and increased decision support strategies.     

New developments in transference focused psychotherapy

This paper will summarize recent clinical developments in the treatment of borderline patients at the Personality Disorders Institute at Cornell. The experiences under review will include the careful, ongoing monitoring of developments in the patient's life outside the sessions, and their consideration in diagnosing affective dominance during the hours. Other issues include the discussion of a ‘second chance’ approach to contract violations; the assessment and concern with the patient's assumption of responsibility for himself; the contradictions between actual behavior patterns and life goals, and between personality potentials and present functioning; the technical implications of particular constellations of regressive narcissistic features; drug dependence and antisocial behavior; and life goals and treatment goals.     

Late‐life Depression,Suicidal Ideation,and Attempted Suicide: The Role of Individual Differences in Maximizing,Regret, and Negative Decision Outcomes

Suicide rates are highest in adults of middle and older age. Research with psychiatric patients has shown that proneness to feel regret about past decisions can grow so intense that suicide becomes a tempting escape. Here, we examine the additional role of individual differences in maximizing, or the tendency to strive for the best decision, rather than one that is good enough. We provided individual‐difference measures of maximizing, regret proneness, and negative life decision outcomes (as reported on the Decision Outcome Inventory) to a nonpsychiatric control group, as well as three groups of psychiatric patients in treatment for suicide attempts, suicidal ideation, or non‐suicidal depression. We found that scores on the three individual‐difference measures were worse for psychiatric patients than for nonpsychiatric controls and were correlated to clinical assessments of depression, hopelessness, and suicidal ideation. More importantly, maximizing was associated with these clinical assessments, even after taking into account maximizers' worse life decision outcomes. Regret proneness significantly mediated those relationships, suggesting that maximizers could be at risk for clinical depression because of their proneness to regret. We discuss the theoretical relevance of our findings and their promise for clinical practice. Ultimately, late‐life depression and suicidal ideation may be treated with interventions that promote better decision making and regret regulation. Copyright © 2015 John Wiley & Sons, Ltd.     

EMILE,OR ON DEVASTATION: WHEN VIRTUAL BOUNDLESSNESS MEETS INNER EMPTINESS

The author's starting point is a psychoanalysis conducted with Emile, a teenager who was unable to form close relationships and was living in a virtual world, planning a school massacre. For him, virtual reality functioned as a bottomless container in which he was no longer a victim of bullying but rather a god. When the boundlessness of cyberspace encounters a “black hole” in the psyche, any fantasies can be put into virtual realization and actions. By recounting his wickedness, violence, destructiveness, and perversion, Emile could start restoring his self boundaries and create his own autobiographical narrative. Unable to sustain the pain of mourning his envelope of invulnerability and omnipotence, however, he prematurely terminated analysis.     

辅助生殖技术的现代性反思——基于传统儒家文化的视角

在现代性语境中,对辅助生殖技术引发的医学现代性危机进行反思无疑具有重要意义.从本质上而言,辅助生殖技术所产生的一系列问题与挑战,深刻地反映出人与自然、人与人、人与社会之间内在的冲突与矛盾.基于传统儒家文化的视角,寻求现代生命技术与传统儒家文化之间相互冲突、交汇、融合、嵌入的对接点,并有针对性地提出应战机制,从而进一步探讨现代性与传统之间的绵延不断的相互作用,深入挖掘传统中蕴含的现代性因素,现代性中间的传统,以更为开放包容的心灵,重视传统与现代性的结合,让科技为人类造福.     

Impact of educational intervention on willingness-to-pay for suicide prevention: a quasi-experimental study among university students in Japan

Many individuals show negative attitudes toward the use of taxes for suicide prevention. Activities that enhance knowledge and awareness of suicide and suicide prevention may increase willingness to pay (WTP) for suicide prevention. WTP is the amount that a consumer will pay for a product or service. The present study examined the influence of educational activities on enhancing knowledge and awareness of suicide and its prevention on WTP. We conducted a quasi-experimental study to examine the influence of lectures on suicide by comparing the amount of change in WTP between two groups over the same period: an intervention group (n = 92) comprising students who participated in the lectures and a control group (n = 128) comprising general university students recruited through an Internet-based survey. A t-test showed that the amount of change was significantly larger in the intervention group (t (152.31) = 2.25, p = .026). Ordinal logistic regression analysis showed that increased WTP was significantly correlated with an annual household income of JPY 4–6 million or higher. It may be appropriate to conclude that participation in lectures about suicide is effective in increasing WTP for suicide prevention.     

Suicide risk in the detachment from reality: failures in the quest for love that saves

Suicide is among the leading causes of death worldwide, accounting for almost one million annual deaths globally. The author presents an exploration into the suicidal mind using Freud's cathexis and decathexis theory. This model describes the patient’s withdrawal from reality and the need to gratify libidinal and aggressive drives in the internal world. Theories and beliefs of other authors are used to introduce the importance of early disturbed relationships with parental figures. Working with the particular subtype of suicidal patient described in this essay may be a challenge for clinicians. A psychodynamic approach may help in the understanding of the patient’s complex and private world of psychological pain. If unresolved, the patient’s conflicts may precipitate suicide.     

A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.     

Engagement With Personalized Feedback for Emotional Distress Among College Students at Elevated Suicide Risk

Depression and suicidal ideation have substantially increased among college students, yet many students with clinically significant symptoms do not perceive their distress as warranting mental health services. Personalized feedback (PF) interventions deliver objective data, often electronically, comparing an individual’s reported symptoms or behaviors to a group norm. Several studies have shown promise for PF interventions in the context of mood and depression, yet little is known regarding how, and for whom, mood-focused PF interventions might be best deployed. The primary aim of this study was to examine the sociodemographic, clinical, and treatment-seeking factors associated with reviewing PF reports on emotional distress among college students (N = 1,673) screening positive for elevated suicide risk and not receiving mental health treatment. Results indicated that PF engagement was greatest among those with higher depression scores, and those reporting privacy/stigma concerns as barriers to treatment. Sexual minority students were more likely to review their PF than heterosexual students. Taken together, PF interventions may be a useful tool for engaging those with greater clinical acuity, and those hesitant to seek in-person care. Further research is warranted to examine the circumstances in which PF interventions might be used in isolation, or as part of a multitiered intervention strategy.