Effects of Different Telephone Intervention Styles with Suicidal Callers at Two Suicide Prevention Centers: An Empirical Investigation

To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of Rogerian nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.     

The relationship between emotional clarity and suicidal ideation among trauma-exposed adolescents in inpatient psychiatric care: does distress tolerance matter?

ABSTRACT

The present investigation examined associations between low emotional clarity (the extent to which individuals are confused about the specific emotions they are experiencing) and suicidal ideation in a diverse sample of trauma-exposed inpatient adolescents, as well as the moderating role of distress tolerance (DT) in this association. Participants (N = 50; 52.0% female; M = 15.1 years, SD = .51; 44% White) completed measures of emotion dysregulation, posttraumatic stress disorder (PTSD), and suicidal ideation/attempts, as well as a behavioral measure of DT. Controlling for age, gender, presence of mood disorder, and past history of attempts, results revealed a significant interaction between DT and low emotional clarity in relation to suicidal ideation. Specifically, lower emotional clarity was related to suicidal ideation at higher, but not lower, levels of DT. Findings suggest that presence of suicidal ideation among traumatized youth with low emotion clarity is most likely when these emotional deficits are coupled with a high tolerance for cognitive/psychological distress. Given that the ability to withstand distress is arguably a key factor in transitioning individuals from ideation to lethal suicidal behavior, attention to the presence of this construct in the context of clinical practice may be warranted.     

Scandalous subwomen and sublime superwomen: exploring portrayals of female suicide bombers’ agency

When the terms ‘women’ and ‘violence’ are used, it is usually in the context of women as victims and rarely as perpetrators of violence, and yet women do behave aggressively – for instance, as female suicide bombers. An ethical analysis of this role, however, has tended to be somewhat overlooked, partly because of the gender stereotypes at play, with little (or spurious) focus on the agency and autonomy of the women. This has resulted in an incomplete understanding of the unique ways in which societies treat female political aggressions, and the consequences of this for their agency. This paper seeks to redress these issues by evaluating two different societal portrayals of female suicide bombers; that of the ‘scandalous subwoman’ and the ‘sublime superwoman’. It argues that violent women's agency is often distorted to extremes beyond that of their male counterparts, and that it is imperative to avoid misrepresenting them either as agentless victims (‘subwomen’) or wholly agentic (‘superwomen’) since, even in times of political instability, they can rarely be dichotomised in this binary way.     

Occupational Therapy Intervention in the Treatment of Alcoholics

The first section of this article will provide the rationale for all occupational therapists to learn extensively about the isease of alcoholism regardless of area of practice or type of agency where employed. It will offer su estions on how this learning can take place. The second section will take an historic look at occupational therapy literature documenting the use of occupational therapy in alcoholism rehabilitation from 1941 to the present. It will describe modalities currently being used by occupational therapists in alcoholism rehabilitation and discuss expansion of occupational therapy in this practice area.     

“自杀”：一个重要的伦理问题

自杀现已成为人类死亡十大原因之一 ,而且呈现出低龄化的趋势 ,越来越引起社会的关注。因而 ,从政治、经济、社会、疾病、文化等多视角来寻找自杀的外部原因 ,对探究这个重要的伦理问题是有益的。     

Living on a Slippery Slope

Our actions, individually and collectively, inevitably affect others, ourselves, and our institutions. They shape the people we become and the kind of world we inhabit. Sometimes those consequences are positive, a giant leap for moral humankind. Other times they are morally regressive. This propensity of current actions to shape the future is morally important. But slippery slope arguments are a poor way to capture it. That is not to say we can never develop cogent slippery slope arguments. Nonetheless, given their most common usage, it would be prudent to avoid them in moral and political debate. They are often fallacious and have often been used for ill. They are normally used to defend the moral status quo. Even when they are cogent, we can always find an alternate way to capture their insights. Finally, by accepting that the moral roads on which we travel are slippery, we become better able to successfully navigate them.     

有自杀意念大学生的内隐态度探析

该文结合Greenwald开创的内隐联想测验,自编IAT程序,对有自杀意念大学生的内隐态度进行了相关研究。结果显示,有自杀意念大学生较无自杀意念大学生的内隐态度对自杀类词语敏感等。家庭所在地为农村对有自杀意念大学生的内隐态度有显著性影响。     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Suicidal Adolescents' Social Support from Family and Peers: Gender-Specific Associations with Psychopathology

Perceptions of social support from family, non-family adults, and peers were examined in relation to the psychopathology reported by 220 suicidal adolescents (152 females) during a psychiatric hospitalization. Results of regression analyses showed that, among females, family support was negatively related to hopelessness, depressive symptoms, and suicidal ideation. Among males, peer support was positively associated with depressive symptoms and suicidal ideation. Across gender, more peer support was associated with more externalizing behavior problems; whereas, family support was negatively related to these problems and to alcohol/substance abuse. Paralleling normative findings, age was positively associated with peer support, and females perceived more peer support than did males. Findings extend previous research on social support to suicidal adolescents, and broaden the literature by examining extrafamilial support and a broader range of relevant psychopathology. That is, perceived social support relates to psychiatric impairment differentially by gender, and normative, age-related variations in perceptions of social support are detected even among highly impaired adolescents. Clinical implications and directions for future research are discussed.     

Meaning in life,emotional distress,suicidal ideation,and life functioning in an active duty military sample

The present study examined the relationship of meaning in life with emotional distress, suicidal ideation, and life functioning in a sample of 273 active duty Security Forces personnel assigned to two US Air Force bases. Results of regression analyses indicated that stronger meaning in life was significantly associated with less severe emotional distress (p?<?0.001, ΔR ²?=?0.047) and suicidal ideation (p?=?0.043, ΔR ²?=?0.017), and better functioning at work and in intimate relationships, nonfamily relationships, and recreational activities (p?<?0.001, ΔR ²?=?0.073). Meaning in life showed stronger associations with outcomes relative to other predictors and covariates and explained the relationship between belonging and life functioning. Findings suggest that meaning in life is associated with less emotional distress and suicide risk, and greater success and performance across multiple domains in life among military personnel.