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.     

Illicit Drug Use,Cognitive Distortions,and Suicidal Ideation Among Homeless Youth: Results From a Randomized Controlled Trial

Illicit drug use and cognitive distortions confer significant risks to youth suicidal thoughts and behaviors. However, there has been limited evidence regarding the efficacy of suicide prevention interventions with homeless youth, especially studies testing whether such interventions can reduce the risk for suicidal ideation associated with illicit drug use. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a drop-in center. Youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their illicit drug use, cognitive distortions, and suicidal ideation 4 times over 9 months. A multiple-group multilevel structural equation model showed that higher illicit drug use at baseline predicted a slower reduction in cognitive distortions and suicidal ideation in the TAU group. These associations were not found in the CTSP + TAU group, suggesting an interruption of such risk from illicit drug use. Findings suggest that CTSP can reduce the risk of illicit drug use as a treatment barrier towards cognitive distortions and suicidal ideation among homeless youth, with implications to improve treatment efforts and to reduce premature mortality in a vulnerable population.     

家庭功能与中学生自杀态度的关系

为考察抑郁、冲动性在家庭功能与中学生自杀态度关系中的链式中介效应,使用家庭功能问卷、抑郁自评量表、Barratt冲动性量表和自杀态度问卷对517名中学生进行调查。研究显示：（1）冲动性在家庭功能与中学生自杀态度之间具有中介作用;（2）抑郁在家庭功能与中学生冲动性之间具有中介作用。（3）抑郁在家庭功能与中学生自杀态度间具有中介作用。因此,抑郁和冲动性在家庭功能与中学生自杀态度之间起链式中介作用。     

校园氛围与青少年的自杀意念/企图：自尊的中介作用

尽管相当一部分青少年自杀发生于学校背景中,但目前较少有研究考察校园氛围是否会影响以及怎样影响青少年的自杀意念/企图。本研究旨在检验校园氛围的不同方面(教师支持、同学支持、自主机会)与青少年自杀意念/企图的关系,以及自尊在其中的中介作用。采用分层整群抽样的方法,选取广东省10所学校2758名初中生作为被试,匿名填写家庭功能问卷、社区问题问卷、校园氛围问卷、Rosenberg自尊量表、自杀意念与企图问卷。回归分析表明:(1)在控制了性别、年龄、社会经济地位、家庭功能和社区问题后,教师支持和同学支持均能显著负向预测自杀意念/企图,自主机会对自杀意念/企图的预测作用不显著;(2)自尊在教师支持和同学支持与自杀意念/企图之间起着中介作用。因此,实践工作中应重视教师支持和同学支持对青少年自尊的塑造作用,进而减少自杀意念/企图。     

‘THERE IS A WAR ON! SOMEONE IS GOING TO GET KILLED’

This paper describes the first three years of work providing consultation at the interface between adult mental health and children's services. It suggests that significant numbers of children, living with parents whose mental illness may be ‘severe and enduring’, remain hidden from services. The author applies psychoanalytic theory in an attempt to understand the unconscious factors, for organizations as well as for individuals, which may contribute to making it so difficult for services to work co‐operatively to recognize these children's existence and their emotional needs. She reviews some of the related fields in which the application of psychoanalytic thinking has occurred and also describes the context in which the work takes place. A series of vignettes demonstrate some of the difficulties encountered and the ways in which the presence of a neutral third or ‘other’ can contribute to their resolution. She suggests working relationships between adult's and children's services are profoundly affected by the psychotic processes operating in the minds of these parents and that the consultant acts as a container enabling staff to manage the fragmentation and splitting which would otherwise be inevitable.     

Emotional stressors among volunteers operating a diaconal suicide-prevention crisis line in Norway: a qualitative study

ABSTRACT

Despite the worldwide proliferation of suicide-prevention crisis-line networks, there is limited in-depth knowledge of how the volunteer call responders experience and manage emotional stressors. The study’s purpose was to explore emotional stressors related to operating a diaconal suicide-prevention crisis line, and how these are managed in daily operations. In this qualitative study, 27 volunteers were interviewed in four focus groups. The material was analysed using systematic text condensation. The participants experienced emotional stressors related to being unable to actively intervene, encountering traumatised callers and feeling uncertain about representing the Church. They used a combination of personal coping strategies and organisational support factors. Implications for training and practice are further discussed.     

Réflexions sur la fin de vie

The following reflections have to do with the "end of life" and are presented here as a lecture addressed to high school and preparatory school student attending a Parisian institute. They were developed with the aim of finding where a current citizens' debate called for by the executive branch and timeless, age-old questions might overlap. When we begin to ponder ultimates such as birth or death, we owe it to ourselves to take into consideration all the nuances involved; this is the only way to process the complexity of these topics. The goals of this course are, first of all, to situate the current debate within the ethical and juridical history of France, and then proceed towards making necessary conceptual distinctions. Finally, we will consider, as much as possible, what is at stake with the options at hand.     

A trainee psychotherapist’s heuristic exploration of losing a mother to suicide

ABSTRACT

Suicide bereavement is a newly developing field of research in the UK, yet over 6,600 people take their own lives here every year. This heuristic inquiry aims to explore the lived experiences of trainee psychotherapists bereaved by maternal suicide. It examines the lived experiences of the researcher and two participants, with data collected through interviews, dreams and journalling. The findings revealed five themes: 1) It’s not just about the suicide, 2) The pain continues – attachment, abandonment and fear, 3) Left with all the unprocessed feelings – “the shit”, 4) Trigger after trigger – complicated experiences of psychotherapy training, 5) A catastrophic loss that no one “gets”. Implications for the counselling and psychotherapy profession are discussed.     

The experiences of person-centred counsellors working with suicidal clients online through the medium of text

ABSTRACT

In this study, we attempt to provide an understanding of the experiences of four UK-based person-centred counsellors working with suicidal clients online using text-based therapies and the impact of their clients’ suicidal ideation upon their “way of being”. The counsellors were selected purposively; each was working as a person-centred counsellor online, was encountering suicidal ideation in their clients, and was a member of a professional organisation. A narrative approach was taken, using unstructured interviews and a stanza format of representation. We found that participants had developed a way of being online that may be distinct from their in-person practice. Challenges included being more directive, lacking physical presence, lacking confidence in assessing risk and questions about empathic understanding. Working online with risk raises specific challenges for person-centred practitioners in line with what is indicated in the little relevant research currently already available.