Group-based problem-solving therapy in self-poisoning females: A pilot study

Aims: The treatment of suicidal behaviour remains limited in efficacy. This pilot study assessed the effectiveness of a time-limited, group-based problem-solving therapy intervention compared with a treatment as usual control group, in females who self-poison. Method: A total of 18 clients were equally randomised to treatment or control groups. All clients were assessed using standardised questionnaires for depression, hopelessness, suicidal ideation and social problem-solving skills, at pre-treatment, post-treatment and two months follow-up. Results: The treatment group experienced significant reductions in levels of depression, hopelessness, suicidal ideation and improvements in self-assessed social problem-solving skills. Improvements in mental health and aspects of self-assessed problem-solving skills for the treatment group continued to be evident at two months follow-up. The control group did not change significantly over time on mental health measures or social problem solving abilities. Conclusion: Although limited by small sample size, the results suggest that group-based problem-solving therapy is effective in the management of deliberate self-poisoning. This paper is a unique contribution in that it examines the implementation of problem solving therapy with a homogenous population and in a group format. Methodological concerns and directions for future research are discussed.     

Testing an App-Assisted Treatment for Suicide Prevention in a Randomized Controlled Trial: Effects on Suicide Risk and Depression

Suicide is a global public health problem and effective psychological interventions are needed. The objective of the present study was to evaluate the effect of an app-assisted suicide prevention treatment on suicide risk and depression. One hundred twenty-nine participants were randomized to treatment as usual (TAU), consisting of psychotherapy adhering to the framework of Collaborative Assessment and Management of Suicidality (CAMS), with (TAU + APP, N = 60) or without (TAU, N = 69) access to a mobile application (i.e., LifeApp’tite). Suicide risk and symptoms of depression were assessed pre- and posttherapy, and at 4-month follow-up. The TAU + APP group showed a smaller decrease on self-reported suicide risk at the end of treatment, corresponding to a medium between-group effect size (p = .008, d = 0.46). At the 4-month follow-up this was the case only at the trend level, where the effect size was also of a smaller magnitude (p = .057, d = 0.30). No differences between the treatment groups were observed on self-reported depressive symptoms, either immediately following treatment (p = .732, d = 0.05) or at follow-up (p = .467, d = 0.11). The unexpected negative effect concerning suicide risk points to crucial consideration of issues pertaining to timing, dosing, and content when adding new technology to existing treatments both in this and other populations.     

A comparison of blocked and mixed‐trial methods for teaching auditory–visual discriminations

Behavior analysts typically teach conditional discriminations in a mixed‐trial format but may switch to a blocked‐trial format for learners displaying limited acquisition. No known research has shown that mixed‐trial methods are more effective or efficient than blocked‐trial methods for teaching discriminations, so it is not clear why this format has been adopted as the “first‐line” intervention. We compared blocked and mixed‐trial formats for teaching novel auditory–visual discriminations to three adults with intellectual and developmental disabilities (IDD). Results show blocked‐trial methods resulted in faster skill acquisition in all cases, suggesting this format may be a preferable starting point for instruction.     

Normativity in the Philosophy of Science

This paper analyzes what it means for philosophy of science to be normative. It argues that normativity is a multifaceted phenomenon rather than a general feature that a philosophical theory either has or lacks. It analyzes the normativity of philosophy of science by articulating three ways in which a philosophical theory can be normative. Methodological normativity arises from normative assumptions that philosophers make when they select, interpret, evaluate, and mutually adjust relevant empirical information, on which they base their philosophical theories. Object normativity emerges from the fact that the object of philosophical theorizing can itself be normative, such as when philosophers discuss epistemic norms in science. Metanormativity arises from the kind of claims that a philosophical theory contains, such as normative claims about science as it should be. Distinguishing these three kinds of normativity gives rise to a nuanced and illuminating view of how philosophy of science can be normative.     

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

Policy makers and researchers have worked to explain the perplexing rise in U.S. military suicides since 2001, with little progress in explaining this widespread phenomenon. This article synthesizes several literatures to highlight the role of emotion dysregulation in military suicidality. After considering advances in suicidal ideation‐to‐action frameworks and the factors that contribute to the prevalence of emotion dysregulation in the modern U.S. military, it explores how military service provides for two distinct circumstances in which such emotion dysregulation may facilitate the transition from suicidal ideation to behavior. The first circumstance is high distress tolerance, wherein the effects of disproportionately high rates of adverse childhood experiences (ACEs) among service‐members may increase vulnerability to suicidal behavior. The second circumstance is preexisting acquired capability with lethal means paired with executive functioning degradation. Empirically associated with military environments, such degradation may undermine the effectiveness of top‐down emotion regulation strategies—thereby allowing acquired familiarity with lethal means to assist the transition from suicidal ideation to action. Thus, emotion dysregulation’s unique relationship with the U.S. military may help to explain the powerful correlation between service and suicide since 2001—suggesting that enhancing emotion regulation skills may present a key leverage point for effectively addressing the issue.     

SHORES: A Practical Mnemonic for Suicide Protective Factors

Guidelines for addressing and managing client suicide risk include discussing and conceptualizing protective factors. Counselors should be able to recall and discuss suicide protective factors that are applicable across client populations. SHORES, a suicide protective factors mnemonic that is supported by the literature, has applications for risk assessment and crisis intervention across settings, preventative care, strengths‐based management, and counselor training. A case example and discussion serve to illustrate the wide‐ranging application of SHORES in counseling practice.     

Spirituality in adolescence and young adulthood: A method for a qualitative study

This paper discusses an ongoing research project on contemporary forms of youth and young adult spirituality, highlighting issues in the history and definition of spirituality and in development of appropriate qualitative methods of investigation. Previous research on the topic has been bedevilled by difficulties of definition. 'Spirit' and 'spirituality' have a long history in both philosophy and religion and surviving senses of the terms include both religious and non-religious meanings. This paper suggests that 'lexical' definitions based on usage prove unwieldy because of widely varying and conflicting contents. Only a 'stipulative' definition will serve to provide a research project with a clear focus; our definition of spirituality as 'a conscious way of life based on a transcendent referent' is explained and defended. Next, we outline the distinctive features of our methodology: no direct mention of the term spirituality, an emphasis on personal narration and the use of evocative techniques. We conclude by outlining the 10 dimensions of spirituality which we have developed from our initial investigations.     

Palestinian suicide bombers

The factors underlying the development of Palestinian suicide bombers are explored through a review of published studies and drawing on interviews with five bombers caught before they detonated the bombs they were carrying. The concomitants of becoming a suicide bomber are explored through political, social and psychological processes, including religious and ideological belief systems and personal characteristics. It is argued that there is no single cause or explanation for taking on this role, but that it comes out of a mixture of circumstances, which varies from individual to individual. The current review challenges the common assumption that all suicide bombers are teenage religious fanatics and shows that less extreme personality characteristics can lead to a person deciding to kill him/herself for a cause, given other circumstances. The implications of these findings as well as the weaknesses in the current study are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Suicide without explicit precursors: a state of secret despair?

Although it is usually assumed that all those who commit suicide give some prior indication of their intention to take their own life, there is growing evidence that a small but significant proportion of suicides occur without any clear, explicit indicators. It is proposed that these suicides share similar pathways to other suicides but that the despair involved is not expressed so clearly, often being kept secret. In order to identify such suicides and potential suicides it is helpful to have an indicator of the dominant sub‐sets of constituents that are precursors to suicide. A 14‐item Suicide Precursors Scale (SPS) was therefore developed. This was applied to 128 cases of suicide that occurred between January 1997 and December 2000 in Stockport (South Manchester, UK). A very high alpha coefficient of 0.98 supported the reliability and homogeneity of the SPS. A Multi‐Dimensional Scaling (MDS) analysis of the SPS revealed three prototypical sub‐sets of expressions of suicidal actions—illness, life circumstances, and depressive history. These are offered as coherent themes in the life of potential suicides, which may be of assistance both in determining whether an equivocal death is suicide or not, and in alerting caring agencies to the potential for suicide even when the despair is kept secret. Copyright © 2004 John Wiley & Sons, Ltd.