The Struggle to Prevent and Evaluate: Application of Population Attributable Risk and Preventive Fraction to Suicide Prevention Researach

Population attributable risk (PAR) estimates have been used in suicide research to evaluate the impact of psychosocial and socioeconomic risk factors, including affective disorders, traumatic life events, and unemployment. A parallel concept of preventive fraction (PF), allowing for estimation of the impact of protective factors and effectiveness of preventive interventions, is practically unknown in suicidology. The study authors discuss the application of both concepts to suicide research and prevention, and review literature on the subject. Despite several methodological and conceptual limitations, both PAR and PF are valuable instruments to inform development and evaluation of suicide prevention programs.     

Coping with the exposure to torture

This paper describes approaches taken at the International Rehabilitation and Research Centre in Copenhagen to helping torture victims and their families cope with the exposure to and aftermath of torture.     

Divorce in the kibbutz: Past and present

In the kibbutz today, there are no ideological or economic barriers to prevent a couple from deciding to divorce. Both husband and wife are assured continued economic security and equal opportunities for co-parenting, thus reducing fears of disruption in the daily contact with the children. In spite of these favorable circumstances, marital breakups in the kibbutz are less frequent than in the larger cities in Israel. In recent years, however, at a time when a stronger and more intensive family life has gained legitimacy within the kibbutz structure, there is a marked tendency toward a rise in the rate of divorce. In this article we analyze the possible causes of the variations in the frequency of divorce within the kibbutz framework.The authors express appreciation to Esther Mivtzari, a psychologist on the staff of the Kibbutz Child and Family Clinic and a member of the religious kibbutz Ein-Tzurim, for assistance in gathering data on divorce in the religious kibbitzum.     

Personality characteristics of Divorce-Prone individuals: A preliminary clinical study

This study focuses on Divorce-Prone individuals and the question of why some persons fail in one marriage after another. The authors studied 12 individuals who had each been divorced two or more times. They found that the cases fell into one of three broad and overlapping groups. The groups have been called the Self-Involved Narcissists, the Compliant Depressed, and the Casualties of Life's Vicissitudes. The individuals and the groups demonstrate a different etiology, different treatment problems, and a very different prognosis.     

Family crisis intervention: fish or fowl?

This paper considers the status of family intervention as an area of interest defined by its literature (70 publications) and includes a brief history, assessment of present status, and recommendations for future development of family crisis intervention as a distinct field with concepts and goals that can be clearly defined, taught, researched, and repeated in treatment. Recommendations are made for the development of an explicit paradigm for intervention with a clear, common language of terms and concepts for family involvement. Suggested directions for developing the paradigm and language are explored.     

Variables differentiating affective interaction in a family therapy and a control group: Father-child welfare and mother-child emergency affect

In this study of 37 pre-therapy and 23 matched control families who never sought family therapy, father-child welfare affect and mother-child emergency affect were significantly higher in the control families. Control families were found generally to express more Welfare and Emergency emotion. Affective expression between parents did not significantly differentiate the groups.This study has been supported by Grant No. MA-4510 of the Medical Research Council of Canada and was presented at the annual meeting of the Canadian Psychiatric Association, Ottawa, Ontario, Canada, September 1983. The authors wish to express their thanks to Toby Schwartz, Harriet Gold-Kaats, and Terry Tannenbaum-Dascal, who acted as coders and research assistants; Joseph Beltempo, BSc, who helped in the statistical analysis; and James Robbins, PhD, who gave much valuable advice.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Menarche: A crossroads that previews developmental change

In recent years the developmental implications of menarche have garnered particular attention. Investigators have determined that this developmental event tends to affect three significant domains of the adolescent girl's function: psychological status, relationships with peers, and role in the family. This paper explores these issues and introduces a new technique, referred to as previewing, that may help the teenage girl acclimate to the status of sexual maturity. Derived from the early life interactions of caregiver and infant, previewing promotes representational skills and enhances self-esteem as the adolescent confronts developmental challenges.     

The self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.