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.     

Clinical utility of the MMPI in the evaluation of adolescent suicide attempters

MMPI profiles of female adolescents hospitalized on a general pediatrics floor following a suicide attempt were compared to a control group of medically hospitalized, female adolescents referred for psychiatric evaluation. The suicide attempters had only a lower score on the K scale when compared to the control group. Results do not suggest that a single MMPI profile differentiates suicide attempters from a comparison group of adolescents with emotional difficulties. Implications of these findings are discussed.     

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.     

Spelunking as a manifestation of a counterclaustrophobia

Material is presented from the case history of a patient whose interest in spelunking (cave exploration) was found to be an unconscious expression of a type of counterclaustrophobia. Both oedipal and preoedipal determinants of the claustrophobic anxieties are delineated. Of particular note in this instance is the testicular element in the genesis of the patient's claustrophobia. His confusion of the movements of his testicles into his inguinal canals during childhood defecation with the movements of the feces themselves lent an special intensity to his fear of being flushed away from the mother by an expulsive anal birth from the claustrum. Childhood anxiety aroused when his testicles would become trapped in the inguinal canals was an important forerunner of the adult fear of being trapped in confined spaces. A counterphobic element of the spelunking per se was his enjoyment in hanging suspended by a rope in caves. In this manner, he was able to act out (by virtue of his body-testicle equation) his identification with, and control over, the disappearing testicles in the setting of a claustrophilic union with the mother.     

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.