What’s the Harm in Asking About Suicidal Ideation?

Both researchers and oversight committees share concerns about patient safety in the study-related assessment of suicidality. However, concern about assessing suicidal thoughts can be a barrier to the development of empirical evidence that informs research on how to safely conduct these assessments. A question has been raised if asking about suicidal thoughts can result in iatrogenic increases of such thoughts, especially among at-risk samples. The current study repeatedly tested suicidal ideation at 6-month intervals for up to 2-years. Suicidal ideation was measured with the Suicidal Ideation Questionnaire Junior, and administered to adolescents who had previously received inpatient psychiatric care. Change in suicidal ideation was tested using several analytic techniques, each of which pointed to a significant decline in suicidal ideation in the context of repeated assessment. This and previous study outcomes suggest that asking an at-risk population about suicidal ideation is not associated with subsequent increases in suicidal ideation.     

Parental Stress and Children’s Social and Behavioral Outcomes: The Role of Abuse Potential over Time

Parental stress is a well-established risk factor for adverse child outcomes, including the development of aggression, externalizing behavior problems, and anxiety, as well as compromised emotional coping, impaired social cognition, and diminished treatment response. Abuse potential represents a mechanism by which parental stress may impact child social competence and behavior; evidence links parental stress to abuse potential, and abuse potential to a range of negative child social competence and behavioral outcomes. The current study assessed relationships between parental stress, abuse potential, and child social and behavioral outcomes over time. Parents of children ages 2–6 years (N?=?610, 44% girls) reported on perceived parental stress and attitudes towards abuse and neglect, as well as child social competence and behavior problems, before and after a caregiver-directed, community-based intervention. Changes in parental stress, abuse potential, and child social and behavioral outcomes were examined using panel analyses, while controlling for intervention effects and demographic variables. Parental stress predicted child social competence, anxiety/withdrawal, and anger/aggression over time; while the links between stress and anxiety/withdrawal, and stress and social competence, were mediated by child abuse potential, the link between stress and anger/aggression was not mediated by child abuse potential. Findings suggest that abuse potential represents a mechanism by which parental stress and child social and behavioral outcomes are linked. Further, screening for child social competence deficits may identify children at risk for abuse, as well as parents in need of services to reduce stress.     

A Latent Profile Analysis of Co-occurring Youth Posttraumatic Stress and Conduct Problems Following Community Trauma

Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study examined PTS and CP symptom profiles among affected Boston-area youth following the 2013 Boston Marathon bombing. This study used latent profile analysis to identify distinct PTS and CP symptom profiles among Boston-area youth ages 4–19 years (N?=?344) affected by the Boston Marathon bombing events. PTS and CPs were measured using the UCLA-PTSD-RI and the SDQ parent reports, respectively. Analyses identified 3 distinct profiles: presentations characterized by (a) low PTS, low CPs, (b) moderate PTS, low CPs, and (c) high PTS, elevated CPs. The profile characterized by the highest PTS was the only profile with elevated CPs; hyperarousal and emotional numbing/avoidance symptoms showed the greatest distinguishing properties among profiles with and without elevated CP. Types of traumatic exposure experienced by youth were differentially associated with profiles. Specifically, direct (but not relational) exposure distinguished youth classified in the profile showing elevated CPs. Findings suggest interventions following violent manmade disasters may do well to incorporate CP modules when working with youth showing the greatest hyperarousal and emotional numbing, and/or who have directly witnessed the most violence.     

Effects of unit formation on the perception of a changing sound

The effects of subunit formation on adult listeners' ability to notice changes in a continuous spectral gradient of sound were studied. Results of this experiment support the idea that the auditory system processes information differently within a unit, and that this processing does not occur unless the perceptual system detects unit boundaries. In this experiment, silences were inserted into a continuously changing sound to cause the formation of short units. Listeners noticed the change earlier in conditions with silences inserted than in to conditions where the transition was either unbroken or broken by loud noise bursts. Results are discussed in terms of two processes, one that accentuates stimulus properties present at moments of onset and offset, and a second that uses onsets and offsets to signal the beginnings and ends of units and reduces the change perceived within units.     

Women and “body-isms” in television beer commercials

Research on women in print advertisements has shown that pictures of women's bodies and body parts (body-isms) appear more often than pictures of men's bodies. Men's faces (face-isms) are photographed more often than their bodies. This present study is the first to confirm this finding for television commercials. Results showed that men appear twice as often as women in beer commercials. The body-isms of women significantly outnumbered the body-isms of men. Women also appeared in swimwear more often than men, thus increasing the photo opportunities for body-isms. This study raises concerns about the dehumanizing influence of these images in beer commercials, and their association with alcohol use and the violence in the televised sporting events during which beer commercials are frequently aired.     

Initial Reliability and Validity of the Life Satisfaction Scale for Problem Youth in a Sample of Drug Abusing and Conduct Disordered Youth

Responses to Life Satisfaction Scale for Problem Youth (LSSPY) items were examined in a sample of 193 substance abusing and conduct disordered adolescents. In responding to the LSSPY, youth endorse their percentage of happiness (0 to 100%) in twelve domains (i.e., friendships, family, school, employment/work, fun activities, appearance, sex life/dating, use of drugs, use of alcohol, money/material possessions, transportation, control of one's life). Results indicated that the LSSPY yielded three factor structures (i.e., Social Satisfaction, External Obligations Satisfaction, Substance Use Satisfaction), demonstrated good initial psychometric properties, and appears to be a useful instrument in the evaluation of treatment outcome in problem youth. Males were more satisfied in the Social and External Obligations domains than females, although no gender differences were indicated in Substance Use Satisfaction. Caucasian, African-American, and Hispanic youths responded to LSSPY items similarly. Future directions are discussed in light of these results.     

Attitudes of African Americans Toward Participation in Medical Research

The underrepresentation of African Americans in medical research is problematic for several reasons, including disparities in health outcomes, differences in metabolism of pharmacological agents, and accurate assessment of health needs and costs. This paper investigates factors contributing to African Americans' lower likelihood of consenting to participation in medical research. In Study 1, three focus groups were conducted to assess concerns about research participation and to generate further hypotheses for questionnaire development. Study 2 presented a hypothetical clinical trial and collected questionnaire data on attitudes about participation. Both studies revealed a greater likelihood to mistrust the medical establishment among African American students. However, suspicion did not contribute to a decreased likelihood of participation. Several recommendations are offered regarding the recruitment of African Americans in research.     

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly strict regulatory control. Over a thousand randomized trials have been conducted with antidepressants. Statistically significant benefits have been repeatedly demonstrated and the medical literature is flooded with several hundreds of "positive" trials (both pre-approval and post-approval). However, two recent meta-analyses question this picture. The first meta-analysis used data that were submitted to FDA for the approval of 12 antidepressant drugs. While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. "Negative" trials were either left unpublished or were distorted to present "positive" results. The average benefit of these drugs based on the FDA data was of small magnitude, while the published literature suggested larger benefits. A second meta-analysis using also FDA-submitted data examined the relationship between treatment effect and baseline severity of depression. Drug-placebo differences increased with increasing baseline severity and the difference became large enough to be clinically important only in the very small minority of patient populations with severe major depression. In severe major depression, antidepressants did not become more effective, simply placebo lost effectiveness. These data suggest that antidepressants may be less effective than their wide marketing suggests. Short-term benefits are small and long-term balance of benefits and harms is understudied. I discuss how the use of many small randomized trials with clinically non-relevant outcomes, improper interpretation of statistical significance, manipulated study design, biased selection of study populations, short follow-up, and selective and distorted reporting of results has built and nourished a seemingly evidence-based myth on antidepressant effectiveness and how higher evidence standards, with very large long-term trials and careful prospective meta-analyses of individual-level data may reach closer to the truth and clinically useful evidence.