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.     

Abduction by Philosophers: Reorienting Philosophical Methodology

A reorientation is needed in methodological debate about the role of intuitions in philosophy. Methodological debate has lost sight of the reason why it makes sense to focus on questions about intuitions when thinking about the methods or epistemology of philosophy. The problem is an approach to methodology that focuses almost exclusively on questions about some evidential role that intuitions may or may not play in philosophers’ arguments. A new approach is needed. Approaching methodological questions about the role of intuitions in philosophy with an abductive model of philosophical inquiry in mind will help ensure the debate doesn't lose sight of what motivates the debate.     

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.     

Qualitative tools and experimental philosophy

Experimental philosophy brings empirical methods to philosophy. These methods are used to probe how people think about philosophically interesting things such as knowledge, morality, and freedom. This paper explores the contribution that qualitative methods have to make in this enterprise. I argue that qualitative methods have the potential to make a much greater contribution than they have so far. Along the way, I acknowledge a few types of resistance that proponents of qualitative methods in experimental philosophy might encounter, and provide reasons to think they are ill-founded.     

Reliable but not home free? What framing effects mean for moral intuitions

Various studies show moral intuitions to be susceptible to framing effects. Many have argued that this susceptibility is a sign of unreliability and that this poses a methodological challenge for moral philosophy. Recently, doubt has been cast on this idea. It has been argued that extant evidence of framing effects does not show that moral intuitions have an unreliability problem. I argue that, even if the extant evidence suggests that moral intuitions are fairly stable with respect to what intuitions we have, the effect of framing on the strength of those intuitions still needs to be taken into account. I argue that this by itself poses a methodological challenge for moral philosophy.     

Spinoza on Lying and Suicide

Spinoza is often taken to claim that suicide is never a rational act, that a ‘free’ person acting by the guidance of reason will never terminate his/her own existence. Spinoza also defends the prima facie counterintuitive claim that the rational person will never act dishonestly. This second claim can, in fact, be justified when Spinoza's moral psychology and account of motivation are properly understood. Moreover, making sense of the free man's exception-less honesty in this way also helps to clarify how Spinoza should, and indeed does, recognize the possibility of rational suicide.     

Religiousness,religious coping methods,and cognitive test anxiety among African-American college students

This study explored the roles of religiousness and religious coping methods in predicting cognitive test anxiety. A convenience sample of 121 African-American students (97 females and 24 males) ranging in age from 18 to 39 (M_age?=?20.16), attending a historically Black university completed an online questionnaire assessing demographic information, religiousness, religious coping methods, and cognitive test anxiety. Results showed that negative religious coping methods were significant factors in predicting cognitive test anxiety. These relationships may be pertinent for understanding salient factors that influence cognitive test anxiety in African-American college students.     

A rose by any other name: participants choosing research pseudonyms

How do researchers name people respectfully in research projects? In an interview study on aspects of aging, 38 participants were invited to choose their own pseudonyms for the research. The resulting discussions show that the common practice of allocating pseudonyms to confer anonymity is not merely a technical procedure, but renaming has psychological meaning to both the participants and the content and process of the research. The care and thought with which many participants chose their names, and the meanings or links associated with those names, illuminated the importance of the process of naming. There was evidence of rules and customs around naming that further confirmed its importance both within their sociocultural worlds, and as an act of research, affected by issues of power and voice, methodology, and research outputs. We invite researchers to consider a more nuanced engagement with participants regarding choosing pseudonyms in research.