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.     

Common problems and coping strategies II: Findings with adolescent suicide attempters

This study investigated the most common precipitants of adolescent suicide attempts and the strategies used to cope with such problems. Adolescent suicide attempters were compared with both distressed and nondistressed nonsuicidal adolescents on problems reported and coping strategies utilized. All three groups reported four problems as occurring most frequently: school, parents, friends, or boyfriend/girlfriend. The suicide attempters and distressed controls reported problems with parents more frequently than did nondistressed controls, while this latter group reported problems at school more frequently than did suicide attempters or distressed controls. Suicide attempters used social withdrawal, problem solving, and emotional regulation more than did nondistressed controls, but not more frequently than distressed controls. Distressed controls used wishful thinking and resignation more than did suicide atempters. Results are discussed in terms of the similarities between suicide attempters and nonsuicidal distressed adolescents and the need to more closely investigate specific subgroups of suicide attempters.     

Accurate diagnosis of personality disorders: Some critical factors

Issues pertaining to the accurate diagnosis of personality disorders are discussed from a scientist-practitioner perspective. An attempt is made to distinguish state (Axis I) from trait (Axis II) disorders, and personality (“normal”) from personality disorders (“abnormal”). The reliability and validity of personality disorder diagnoses are explored, and the four criteria for all personality disorder diagnoses are clarified: These criteria are: 1) presence of psychological symptomology, 2) stability over time, 3) consistency across situations, and 4) under-responsiveness to currently available treatments. Also, a distinction is made between categorical and dimensional diagnostic criteria, similar to the distinction between personality type and trait approaches. Recommendations are provided for improving the clinical and empirical work in this area, and implications for treatment are discussed.     

Facilitating autonomy in passive-dependent persons: An integrative model

Passive and dependent qualities are commonly found in psychiatric patients suffering from a variety of disorders. While such tendencies are often secondary to an Axis I clinical syndrome, they are occasionally more persistent and refractory. The present article attempts to provide therapeutic guidelines useful when working with clients displaying stable personality traits of passivity and dependency. An attempt is made to adapt and combine several therapeutic techniques to be applicable to passive-dependent clients. More specifically, problem-solving approaches and self-control strategies can be used to facilitate autonomy if precautions are taken to reduce the dogmatic and didactic styles commonly employed with these techniques. The Socratic method of interviewing is posited as a useful means of developing problem-solving skills without creating unnecessary dependence on the therapist. Self-control strategies can help reduce the reliance on others as the primary source of satisfaction for dependent clients. In this way, passive-dependent clients may become more self- reliant and autonomous in their daily functioning.The author would like to thank Patti Watson, Katie Brooks, and Estyn Williams for comments made on an earlier draft of this article.     

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.