Specificity of Depressive Symptoms and Suicidality in a Juvenile Delinquent Population

Research which has related scores on the Children's Depression Inventory (CDI) to suicidality have generally neglected to examine the possibility that specific depressive factors within the CDI may be more predictive of suicidality than the full scale score. Knowledge of such factors would help to explain the relationship between depression and suicidality and improve the prediction of suicidal behavior. The current study examined the relationship of depressive factors to suicidality in a sample of 200 incarcerated juvenile delinquents. The published factor structure for the CDI and one derived from the delinquent population were compared. Results revealed two factors from the derived solution, hopelessness and low self-esteem, to be more powerful predictors of suicidal ideation than the full-scale CDI score. These results suggest that symptoms such as low self-esteem and hopelessness may be responsible for the well-documented relationship between depression and suicidality. Furthermore, it appears that the prediction of suicidality may be improved by examining specific depressive factors in suicide research as opposed to full-scale scores from depression inventories such as the CDI.     

Assisted Suicide,Suffering and the Meaning of a Life

The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would relieve suffering without causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others.     

Two Distinctive Personality Configurations: Understanding the Therapeutic Context with Suicidal Individuals

Recent theory and research have associated different levels and types of suicide risk with particular personality dimensions, focusing particularly on the distinction between introjective and anaclitic personality orientations. This distinction is discussed in relation to our general understanding of the therapeutic context with those who have attempted, or may be at risk for, suicidal behavior. Individuals characterized as predominantly introjective/self-critical or as anaclitic/dependent seem to represent relatively homogenous subgroups of suicidal individuals, with distinct concerns, vulnerabilities, and behaviors. Our conclusion is that persons in these subgroups seem to warrant different intervention and therapeutic strategies. Implications for the psychotherapeutic process are discussed.     

Targeting Perceived Burdensomeness to Reduce Suicide Risk

Perceived burdensomeness (PB), defined by an intractable perception of burdening others, often reflects a false mental calculation that one’s death is worth more than one’s life and has been supported as a significant risk factor for suicide. Because PB often reflects a distorted cognition, it may serve as a corrective and promising target for the intervention of suicide. More work on PB is needed in clinically severe and in military populations. Sixty-nine (Study 1) and 181 (Study 2) military participants at high baseline suicide risk engaged in interventions targeting constructs relating to PB. Baseline and follow-up measures (at 1, 6, 12, 18, and 24 months) of suicidal ideation were administered, and various statistical approaches—including repeated-measures ANOVA, mediation analyses, and correlating standardized residuals—explored whether suicidal ideation decreased specifically by way of PB. In addition to utilizing a larger sample size, Study 2 included an active PB-intervention arm (N = 181) and a control arm (N = 121), who received robust care as usual. In both studies, participants improved considerably regarding baseline to follow-up suicidal ideation. The results of Study 2 mirrored those of Study 1, corroborating a potential mediational role for PB in treatment-related improvements in suicidal ideation in military participants. Effect sizes ranged from .07–.25. Interventions tailored at decreasing levels of perceived burdensomeness may be uniquely and significantly effective in reducing suicidal thoughts.     

The Burden of Not Belonging: A Qualitative Study of the Applicability of the Interpersonal Theory of Suicide Constructs of Belongingness and Burdensomeness to Ethnocultural Minoritized Youth

Guided by the Interpersonal Theory of Suicide (IPTS), this study aims to understand the applicability of the constructs of belongingness and burdensomeness and their relevance to suicide risk and mental health among ethnocultural minoritized youth. A qualitative exploratory study was conducted using five focus groups with 29 self-identified Latinx and Black adolescents aged 13–17 years to explore the meaning they ascribed to belongingness and burdensomeness. Views of social media related to these constructs were also explored. Template analysis was used to analyze the data. Themes highlighted dimensions such as caring, self-worth, and liability, congruent with the IPTS dimensions of belongingness and burdensomeness. Notably, new themes emerged reflecting the distinctive experiences of these populations, such as the importance of being true to themselves, the burden of not belonging to families, and cultural aspects of liability, highlighting dimensions not found in the existing IPTS theoretical constructs. Consideration of the diverse experiences of ethnocultural minoritized youth can strengthen theoretical constructs, clinical practice, and aid in developing intervention strategies to increase protective factors and decrease risk factors for suicide behaviors relevant to such youth.     

The Many Faces of Physician-Assisted Suicide

Physician-assisted suicide is a complex and controversial issue that touches on standards of medical practice, the balance between individual rights and the rights of the state, and our fears of death and pain. Supporters of assisted suicide propose it as an alternative to a lingering, highly technological death, and define it as the act of a physician who prescribes a lethal dose of a medication for a terminally ill patient, with the knowledge that the patient intends to commit suicide. The recent U.S. Supreme Court ruling upheld prohibitions against assisting in a suicide, but left open the possibility that in certain specific cases assisted suicide might be constitutionally protected. The Supreme Court's refusal to extend constitutional protection to assisted suicide was done in part to insure that public debate and legislative fact-finding would continue. As stated in Justice Rehnquist's majority opinion, ...Americans are engaged in an earnest and profound debate about the morality, legality and practicality of physician-assisted suicide (Washington v. Glucksberg, 96-110—Opinion, 1997, p. 26). As researchers, policy makers, and health care providers, we have an obligation to insure that political debate and empirical research are continuing and productive, and that this issue becomes more than just an occasion to play out ideological or personal differences.     

Physician-assisted suicide reconsidered: dying as a Christian in a post-Christian age.

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society.     

Psychological Factors Associated with Support for Suicide Bombing in the Muslim Diaspora

A robust literature on ingroup versus outgroup conflict suggests that perceived discrimination may be an important factor in intergroup aggression. Yet, to date, no studies have tested the hypothesis that the perception of being the victim of anti‐Muslim discrimination might be associated with support for anti‐Western political violence. We undertook an analysis of two Pew Global Attitudes Surveys: (1) a 2006 data set surveying 1,627 adult Muslim residents of Great Britain, France, Germany, and Spain and (2) a 2007 data surveying 1,050 adult Muslim residents of the United States. Our analyses support the conclusions that younger age and perceived discrimination are both associated with support of suicide bombing in these Muslim diaspora populations. Study 1 found that a bad experience of discrimination increased the odds of justifying suicide bombing among European Muslims by a factor of 3.4. Study 2 found that experienced discrimination was associated with justification of suicide bombing among American Muslims. If further investigations confirm that perceived discrimination is a risk factor for support for political violence, initiatives to reduce discrimination would theoretically reduce the risk of terrorism. We discuss the challenge of breaking the vicious cycle of intergroup prejudice and radicalization.