Introduction to the Special Issue on Interoception and Suicidality

Empirically informed theories of suicide highlight the importance of identifying factors that lead from suicide ideation to suicidal behavior. Interoceptive dysfunction may be one such differentiating factor. Interoceptive dysfunction refers to a disconnection from the internal sensations of the body, which can cause difficulty in truly understanding and knowing one’s own body. Specifically, interoceptive dysfunction may lead to such disconnection from the self that the body comes to be seen as “other” and potentially even “nonhuman.” A burgeoning body of research supports these theoretical links and also highlights the need for methodologically rigorous studies that employ careful measurement of these constructs. Thus, this special section is devoted to articles that advance the understanding of the relationship between interoception and suicidality. A more nuanced understanding of the relationship between interoceptive dysfunction and suicidality is critical for improving suicide prevention and treatment efforts.     

Self-Reported Interoceptive Sensibility Does Not Moderate the Relationship Between Eating Disorder Symptoms and Suicidal Thoughts and Behaviors

Past research has demonstrated a strong relationship between eating disorders (EDs) and suicidality (i.e., suicidal thoughts, plans, and attempts), and preliminary work within the framework of the interpersonal psychological theory of suicide (Joiner, 2007) suggests that potentially painful ED behaviors (binge eating, purging, fasting, excessive exercise) may contribute to increased risk of suicide through heightened pain tolerance and increased capability of suicide. However, additional explanations are needed for why only some individuals with EDs actually engage in suicidal behaviors (i.e., attempt suicide), whereas others do not. A growing body of literature suggests that interoceptive deficits (a disconnection from one’s own bodily sensations and emotions; IDs) might be a factor linking eating disorders and suicide. To better understand this relationship, the current study tests the moderating effects of self-reported IDs on the relations between ED behaviors and suicidality and past suicide attempts in a transdiagnostic ED sample (N = 181). We hypothesized that ED behaviors would directly relate to suicidality, but that IDs would moderate the relationship between ED behaviors and past suicide attempts, such that those high in IDs would demonstrate a stronger relationship between ED behaviors and suicide attempts. Contrary to our hypothesis, IDs did not moderate the relationship; instead, fasting and purging had significant and strong main effects on suicidality and past suicide attempts without moderation effects. Results suggest that fasting and purging may be important ED behaviors to consider in the relationship between EDs and suicidality. Future directions include further examining the relationship between IDs, suicidality, and EDs using measures of IDs that better encompass physical (as opposed to emotional) aspects of IDs.     

The Influence of Acetaminophen and Observational Conditioning on the Acquired Capability for Suicide

The effects of acetaminophen and a reading task on physical pain tolerance and fearlessness about death were tested in 106 undergraduate students. Participants were randomized into four groups, each receiving either acetaminophen or no medication, along with either a control or experimental reading task. It was predicted that acetaminophen would increase pain tolerance and fearlessness about death, that the experimental reading task would decrease both outcomes, and that the interventions would interact (i.e., acetaminophen would dampen the effects of the reading task). Multivariate analysis of variance was used to test hypotheses. No significant interaction was found (p = .17) and there was no effect for acetaminophen (p = .56), but individuals administered the experimental reading task demonstrated significantly higher physical pain tolerance (p < .05).     

Self-Injurious Thoughts and Behaviors May Be More Common and Severe Among People Identifying as a Sexual Minority

Research indicates that people who identify as a sexual minority are at higher risk of numerous negative outcomes, including self-injurious thoughts and behaviors (SITBs). The minority stress model proposes that people identifying as a sexual minority are at higher risk of these behaviors due to sexual orientation-specific stressors—however, it does not clarify whether SITBs will be more severe among these individuals. The present study tested whether SITBs are more common and more severe among people identifying as a sexual minority using several metrics, including frequency of SITB engagement, age of onset of SITB, desire to discontinue SITB engagement, and likelihood of future SITBs. Four independent research samples were used to test this model. Results were then combined and tested in an internal meta-analysis. Findings converge to indicate a longer and more severe course of SITB engagement among people identifying as a sexual minority. Future research is needed to replicate these findings and to advance the understanding of why this imbalance in risk and severity might exist, and how it can be prevented.     

Project HOPE: Implementing Sensory Experiences for Suicide Prevention in a Native American Community

Suicide remains a significant problem for Native American populations; however, culturally appropriate interventions are lacking (Suicide Prevention Resource Center, 2011 Suicide Prevention Resource Center . ( 2011 ). Suicide Among American Indians/Alaska Natives. Retrieved from http://www.sprc.org/library/ai.an.facts.pdf  [Google Scholar]). Occupational therapy practitioners can aid in suicide prevention and intervention (American Occupational Therapy Association, 2005). This study presents a culturally appropriate program and research project following a community-based participatory research design that explores the impact of a sensory curriculum for suicide prevention on Native American youth. The perceptions of the young peoples' sensory experiences are explored. Evidence from the study demonstrates the value of exploring the use of occupational therapy intervention in Native American communities to address significant health concerns.     

An Examination of the Impact of Minority Status Stress and Impostor Feelings on the Mental Health of Diverse Ethnic Minority College Students

This study examined differences in minority status stress, impostor feelings, and mental health in a sample of 240 ethnic minority college students. African Americans reported higher minority status stress than Asian Americans and Latino/a Americans, whereas Asian Americans reported higher impostor feelings. Minority status stress and impostor feelings were examined as predictors of mental health. Impostor feelings were stronger predictors of mental health than minority status stress. Counseling implications for ethnic minority students are discussed. Este estudio examinó las diferencias en estrés por estatus de minoría, sentimientos de impostor, y salud mental en una muestra de 240 estudiantes universitarios pertenecientes a minorías étnicas. Los afroamericanos comunicaroun un estrés por estatus de minoría más alto que los asiático‐americanos y los latinoamericanos, mientras que los asiático‐americanos comunicaron sentimientos de impostor más elevados. Se examinaron el estrés por estatus de minoría y los sentimientos de impostor como predictores de salud mental. Los sentimientos de impostor fueron predictores más fuertes de salud mental que el estrés por estatus de minoría. Se discuten las implicaciones en consejería para estudiantes de minorías étnicas.     

A Kantian Moral Duty for the Soon-to-be Demented to Commit Suicide

It has been argued that, on Kantian grounds, pedophiles, rapists and murderers are morally obligated to take their own lives prior to committing a violent action that will end their moral agency. That is, to avoid destroying the agent's moral life by performing a morally suicidal action, the agent, while he still is a moral agent, should end his body's life. Although the cases of dementia and the morally reprehensible are vastly different, this Kantian interpretation might be useful in the debate on the permissibility of suicide for those facing dementia's effects. If moral agents have a duty to act as moral agents, then those who will lose their moral identity as moral agents have an obligation to themselves to end their physical lives prior to losing their dignity as persons.     

Adult Children and Elderly Parents: The Worlds of the New Testament

ABSTRACT

Mental health problems, especially depression and dementia, are common among the elderly. The faith community is well positioned to assist elders with these disorders, but to do so, clergy will need to recognize these disorders and know when to refer. Studies have shown that religious faith allows elders to cope more effectively with mental health problems     

Existential themes in the treatment of people at suicide risk. Understandings and practices of specialist healthcare professionals

ABSTRACT

This qualitative study focuses on the ways in which existential themes were understood and addressed in therapeutic relationships with patients who had attempted suicide. Health care professionals (HCP) from Norway specialist healthcare participated in focus groups. The interviews were transcribed and analysed by systematic text-condensation through a four-step procedure. We found that the HCPs emphasised the context-specific functions of their departments. They considered these conversations essential but demanding. They indicated existential themes of hope/hopelessness, loneliness, meaning, life/death, shame, religion and suicide. The HCPs’ understandings of themes deemed to be existential and how they should be addressed were primarily based on clinical experience. This appeared to exacerbate the pressure on their personal involvement, leading to the question of whether patients’ existential needs are tackled or instead disappear into a conversational vacuum. The study suggests that HCPs' professional competence of existential themes pertaining to patients at suicide risk needs to be strengthened.     

Hungry for love: the influence of self-regulation on infidelity

The current research examines the effect of self-regulation on the likelihood of committing infidelity. Thirty-two college students in exclusive romantic relationships interacted through a private chat room with an opposite-sex confederate. Prior to this interaction, a food-restriction task depleted half the participants of self-control. As predicted, depleted levels of self-regulation increased the likelihood of infidelity. Specifically, depleted participants were more likely to both accept a coffee date from and supply a personal telephone number to the confederate than non-depleted participants. Weakened self-control may be one potential cause for the levels of infidelity occurring in romantic partnerships today.