Tennessee Lives Count: Statewide gatekeeper training for youth suicide prevention.

Youth suicide remains a significant public health problem in the United States. In 2004, the Garrett Lee Smith Memorial Act provided states and tribes with funding to implement and evaluate youth suicide prevention programs. The Tennessee Lives Count project was developed through a collaborative model at the state level and delivers an enhanced version of the Question, Persuade, Refer gatekeeper training program to individuals working with youth across the state. This article describes the development of the project and preliminary outcomes of 416 participants in child welfare, juvenile justice, health, and education systems at pretest, posttest, and 6-month follow-up. The findings suggest the training has an immediate and long-term impact on perceived knowledge of suicide prevention, self-efficacy, and attitudes about the inevitability of suicide. Policy and practice implications are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of familism in the relation between parent–child discord and psychological distress among emerging adults of Mexican descent.

Although parent–child discord is a predictor of distress among emerging adults, little is known about this important link among Mexican-descent populations. This is an important gap, given Mexican Americans’ high risk for psychological distress and their expected high value placed on close family ties. This topic was studied in a sample of 392 college students from El Paso, TX (n = 193) and from Ciudad Juárez, México (n = 199). The authors tested a stress-appraisal model with self-report measures of familism, parent–child discord, threat appraisals of parent–child discord, and psychological distress. As predicted, threat appraisals partially mediated the relation between parent–child discord and psychological distress. Moreover, the relation between parent–child discord and threat appraisals was stronger at higher than at lower levels of familism. Study findings highlight the need to consider that, under certain conditions, familism may increase risk of distress among emerging adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A college suicide prevention model for American Indian students.

College student suicide prevention efforts are important to campus administrators and mental health professionals due to increasing concerns about managing suicidal students. This article describes the development and preliminary effectiveness of a campus suicide prevention program designed for American Indian (AI) students who are at higher risk for suicide compared with the general population. Using the medicine wheel as a guiding framework, the current prevention model integrates communication links between AI tribes and prevention program staff, educational and cultural programming, and spiritual ceremonies with the larger campus mental health resources available to students. A discussion of the barriers faced and solutions generated for implementing the program is offered, along with suggestions for disseminating this AI-specific prevention program to other universities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent suicide prevention: Current research and social policy implications.

The rate of adolescent suicide has increased dramatically in the past few decades, prompting several interventions to curb the increase. Unfortunately, many of the intervention efforts have not benefited from current research findings because the communication between researchers and those who develop the interventions is inadequate. Of specific concern are the increasingly popular curriculum-based suicide prevention programs, which have not demonstrated effectiveness and may contain potentially deleterious components. This article reviews the current epidemiological research in adolescent suicide and suggests how this knowledge could be used more effectively to reduce the rate of adolescent suicide. Recommendations include support for integrated primary prevention efforts; suicide prevention education for professionals; education and policies on firearm management; education for the media about adolescent suicide; more efficient identification and treatment of at-risk youth, including those exposed to suicidal behavior; crisis intervention; and treatment for suicide attempters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The 18-month impact of an emergency room intervention for adolescent female suicide attempters.

Following a suicide attempt by female adolescents, the impact of a specialized emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 female adolescent suicide attempters (SA), ages 12–18 years, and their mothers (88% Hispanic) to receive during their ER visit either: (a) specialized ER care aimed at enhancing adherence to outpatient therapy by providing a soap opera video regarding suicidality, a family therapy session, and staff training; or (b) standard ER care. The adjustment of the SA and their mothers was evaluated over 18 months (follow-up, 92%) using linear mixed model regression analyses. SA's adjustment improved over time on most mental health indices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The specialized ER care condition was associated with significantly lower depression scores by the SA and lower maternal ratings on family cohesion. Significant interactions of intervention condition with the SA's initial level of psychiatric symptomatology indicated that the intervention's impact was greatest on maternal emotional distress and family cohesion among SA who were highly symptomatic.… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parentline: A demonstration program for graduate practicum training and community service in clinical child psychology.

Describes a telephone consultation service for parents with questions about their children's developmental, behavioral, and learning problems. First-year graduate students participate as staff after having completed an intensive 10-wk training program that provides a knowledge and skill base in assessment, empathic responding, child development, parenting techniques, and change theory. Staff members learn to propose interventions that include providing information, developing individualized management programs, or offering referral assistance. Community utilization of the program as well as the impact of this practicum training experience on graduate students' professional development are discussed. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Fights of Spring: Separation, individuation, and grief in training centers.

Describes the crisis period that occurs in training programs for psychotherapists about midway through each training year, which is often referred to as "February Fight" or "Spring Madness." This crisis contains a wide variety of conflicts within the training institute, ranging from the current struggles of individual members searching for greater autonomy to institutional struggles present since the institute's beginnings. The crisis is viewed as a normal developmental stage in any training year that, when properly understood, may be used to humanize the training institution, further the professional growth of staff and students alike, and facilitate an effective termination of training for the students when the year ends. When not understood and adequately responded to, that same crisis period may prove to be unnecessarily difficult and even detrimental for both staff and students. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training professional psychologists in school-based consultation: What the syllabi suggest.

This article reports the findings from consultation syllabi from 25 American Psychological Association-approved school psychology programs (40% response rate). Most responding programs offered 1 consultation course and many programs' syllabi stated expecting students to conduct 1 consultation case. The analysis showed most syllabi listed training in multiple models of consultation, with almost all mentioning the problem-solving model. Almost all syllabi listed training in treatment, but fewer than half suggested that students would learn about the use of consultation to promote prevention. Most programs' syllabi mentioned considering others' culture in consultation, whereas fewer than half mentioned considering the impact of the consultant's culture in consultation relationships and even fewer mentioned social justice. The discussion addresses the need for a better understanding of school-based consultation preservice training, consultation training in a diverse and inequitable world, and how practitioners' cognitive appraisals of consultation services could inform school-based consultation training. Considerations for consultation syllabi design are given. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal thinking among adolescents with a history of attempted suicide

OBJECTIVE: To examine the risk of suicidal plans and ideation, depression, and other factors (low self-esteem, loneliness, fatalism, pessimism) among adolescents with a lifetime history of attempted suicide. METHOD: A self-administered questionnaire was used in a school-based survey of five middle schools (grades 6 through 8) enrolling 6,400 students. Usable questionnaires were obtained from 5,423 (85.3%). Data were obtained on a wide range of constructs including recent and lifetime suicide attempts, recent and lifetime suicide plans, recent ideation, symptoms of DSM-IV major depression, self-esteem, pessimism, loneliness, and fatalism. RESULTS: Data on crude prevalence showed thoughts about death, wishing to be dead, thoughts of suicide, and suicide plans were all significantly higher among youths with a history of attempts. Suicidal thinking was related to being more lonely, more fatalistic, and more pessimistic, and to less self-esteem, in addition to depression and a history of attempts. Multivariate analyses revealed the strongest factors associated with current suicidal thinking were history of attempts (odds ratio [OR] = 3.50), depression (OR = 5.34), and recent life stress (OR = 2.64). Compared with youths with none of the factors examined, those with six or more were at extreme risk (OR = 67.87). CONCLUSIONS: The strong association between history of suicide attempts, current ideation, and depression indicates that past suicide attempts occur in the context of other signs of psychosocial dysfunction. Given the paucity of epidemiological data on the natural history of suicidal behaviors among youths, more epidemiological studies of the antecedents and consequences of the range of suicidal behaviors among children and adolescents are needed. Given the high risk of subsequent suicidal behaviors by youths who have attempted but not completed suicide, this constitutes a high-risk population on which future research should focus.     

The influence of the concentration of volatile anesthetics on the stapedius reflex determined intraoperatively during cochlear implantation in children

STUDY OBJECTIVE: To evaluate the impact of a protocol on partner abuse (PA) at increasing identification and improving acute management of abused women by emergency department (ED) staff. METHODS: A community intervention trial compared two public hospital EDs at baseline and following implementation of a PA intervention. The intervention involved training staff at one ED in a protocol for the identification and acute management of abused women. Outcomes were assessed by reviewing a random sample of women's medical records. Identification of PA was assessed for each record on a yes/no basis. Identified cases were classified as 'confirmed' or 'suspected' PA. Acute management was assessed by ascertaining staff documentation of abuse and use of interventions. RESULTS: Approximately equal numbers of records were reviewed at each ED, pre and post implementation (total n = 8,051). Eighty-nine per cent of ED staff were trained. No difference in the overall identification of PA was found (chi 2 = 0.13, p = 0.72), but logistic regression analyses showed other significant changes. At the intervention site, there was an increase in confirmed cases of PA (chi 2 = 7.6, p = 0.006), a trend towards increased documentation (chi 2 = 3.5, p = 0.06) and a significant increase in interventions offered (chi 2 = 13.8, p = 0.002). Changes at the comparison site failed to reach significance. CONCLUSION: Implementation of this protocol resulted in a moderate increase in confirmed cases of abuse and improved the acute management offered to identified victims. The findings reinforce recommendations for widespread implementation of training and protocols to address partner abuse.     

Laser-Doppler flowmetry in neurosurgery

It is theorized that persons with strong sense of coherence are likely to define an event as less stressful and be able to manage a problem more successfully than those with weak sense of coherence. The study investigated the relationship among coherence and personal and environmental concerns, appraisal of threat, emotional distress, and high-risk behaviors in minority women at risk for human immunodeficiency (HIV) infection. As predicted, a significant negative relationship was seen between level of coherence and concerns. Moreover, women strong in coherence reported less negative appraisals of threat, less emotional distress, and fewer high-risk behaviors than those with weak coherence. Results of tests of a path model investigating the impact of coherence and appraisal on distress and risk revealed coherence to be significantly and negatively associated with appraisal, distress, and risk, both directly and indirectly through its association with appraisal. The path model accounted for 45% of the variance in distress, 10% of the variance in appraisal, and 4% of risk behavior. Continuing investigation of factors such as coherence that can lessen the seriousness of environmental stressors is imperative as it relates to women at risk for HIV infection.     

Children's emotions as organizers of their reactions to interadult anger: A functionalist perspective.

Children's emotions have been implicated as mediating their responses to interadult anger, but this proposition has not been directly tested. Sixty-four 4–8 year olds (32 boys and 32 girls) were induced to feel angry, sad, happy, or "just okay" before their exposure to interadult anger. Data were analyzed by means of (a) analyses of variance testing differences across conditions and (b) correlations between children's emotions during affect induction procedures and their reactions to interadult anger. Findings indicated that negative emotions increased children's distress and negative appraisals and expectations in reaction to interadult anger, whereas positive emotions reduced distress reactions and increased children's positive expectations about future interadult interactions. The results support a functionalist view that emotions can play a causal role in organizing and directing children's reactions to events and are consistent with research and theory highlighting the role of emotionality in children's coping with marital conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Implications of 'Psychological Injuries' for Clinical Psychology Training Programs.

This paper uses the psychological and legal concept of "psychological injury" as an illustration of the evolving market for psychological knowledge and of necessary changes in the graduate and internship training of clinical psychologists. Our current graduate and internship training fails many of our students through neglecting important areas of knowledge and experience. In this paper, I discuss the importance of exposing graduate students to: a) the economics of mental health; b) professional roles involving knowledge dissemination outside traditional academia; c) information needs of direct and indirect consumers of psychological knowledge; and, d) communication skills necessary when interacting with nonpsychologists. Suggestions are made for the improvement of our graduate training programs, including more explicit acknowledgement of the likely career paths of most of our graduates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A solution to the problem of jail suicide

In American studies in the sixties and seventies caregivers, including physicians, showed a negative attitude towards the elderly. There are indications that such a negative attitude affects the quality of care and the communication with the elderly. Based on predominantly American literature this article reviews research on medical students' knowledge about and attitudes towards older people as well as the impact of geriatric training on the image of older patients and physician-patient communication. In medical students who did not receive a geriatric training, attitudes improved in the eighties and nineties up till a slightly positive level but general gerontological knowledge displayed as many shortcomings as in former days. A few studies show that instructional modules in geriatrics do not have an impact on the attitude towards the elderly. Several studies show that contact with aged persons has a positive influence. Rather than geriatric residency or work in a nursing home, contact with healthy elderly has favourable effects. Attitude improvement based on interactions with older people is maintained during medical education. A program in gerontology as well as geriatric instructional modules can lead to knowledge improvement. Since significantly positive correlations between knowledge and attitude are sometimes demonstrated, increasing gerontological knowledge may lead to more positive attitudes.     

Advancing videotape parent training: A comparison study.

This study examines the specific effects of adding a broader based, videotape treatment component (ADVANCE) to a basic videotape parent skills training program (GDVM). ADVANCE treatment trains parents to cope with interpersonal distress through improved communication, problem solving, and self-control skills. 78 families with a child diagnosed as oppositional-defiant or conduct-disordered were randomly assigned to either GDVM alone or GDVM plus ADVANCE. Parent reports of child adjustment and parent distress, assessment of child's knowledge of social skills, as well as independent observations of mother– and father–child interactions and communication and of problem solving between parents were obtained at pre- and post-GDVM and at post-ADVANCE. Both groups significantly improved at short-term follow-up. ADVANCE produced additional significant improvements in parents' communication, problem-solving skills, and consumer satisfaction, as well as children's increased knowledge of prosocial solutions. The clinical significance of these findings is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Détresse psychologique, perfectionnisme, insatisfaction de l'image corporelle: Validation d'un modèle explicatif de la problématique suicidaire.

This article (N=366 students), based on Baumeister's theory of suicide (1990) and taking into consideration Shneidman's multifactorial theory (1992a), studies the possibility of perfectionist attitude and body image dissatisfaction being mediated by psychological distress in the suicidal ideation and behaviors. The French l'IDPESQ-29 de Préville, Boyer, Potvin, Perrault et Légaré (1987) originating from the PSI of Ilfeld (1976), the MPS (Frost, Marten, Lahart, & Rosenblate, 1990), the BDDE-SR (Rosen & Reiter, 1996) and a short adapted questionnaire on suicidal ideation and behavior were used for this research. The frequency of occurrence of past suicidal ideation is 33% present 35%, attempts 9.6%; perfectionism 16.6%, psychological distress 15%, body image dissatisfaction 10% and Body Dysmorphic Disorder is 4.6%. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stress of patient suicidal behavior: Implications for interns and training programs in psychology.

Patient suicide and patient suicide attempts are frequently unexpected, sudden, and violent. They can have a significant emotional impact on the treating clinician, particularly if the clinician is still in a training status (cf. P. M. Kleespies et al, 1993). An estimated 40% of psychology trainees have a patient suicide (11.3%) or a patient suicide attempt (29.1%) during their training years. A concept of systematic response called psychological resynthesis (H. L. Resnick, 1969) is proposed for psychology interns and training programs that must cope with the aftermath of a patient suicide or a serious patient suicide attempt. Suggestions for suicide education and the preparation of trainees for the "occupational hazard" of patient suicidal behavior are discussed as part of a health-promotive approach to the training and clinical work environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional distress and urinary incontinence among older women.

Objective: Examined appraisals of interference and personal tolerance in the prediction of distress among women experiencing urinary incontinence (UI). Design: Interviewed women volunteering for a behavioral treatment for UI. Women were interviewed at baseline; follow-up assessments were conducted 6 weeks and 6 months later. Measures of perceived interference, tolerance, condition-specific emotional distress, symptom severity, general intelligence, and depressive symptoms were administered. Participants: 131 women (mean age = 66.6 years, SD = 8.4; range 55-90) with reported involuntary loss of urine at least once a week prior to participation. Main Outcome Measure: Emotional distress attributed to UI. Results: Path analyses indicated that greater tolerance was associated with less interference imposed by UI. Greater tolerance was also associated with less distress. Symptom severity (frequency of UI episodes, nocturia, and objectively determined fluid loss) indirectly influenced emotional distress through perceived interference. Cognitive appraisals of interference and tolerance were stable over time. Conclusions: These data indicate that appraisals of personal ability to tolerate the condition and interference of the condition on goal-directed behavior and expected activities have greater influence on emotional distress than does severity of condition-specific symptom. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologist suicide: Incidence, impact, and suggestions for prevention, intervention, and postvention.

Psychologist practitioners are not immune to certain mental health problems, including suicidality, for which they provide services. In the aftermath of two recent psychologist suicides, the American Psychological Association's Advisory Committee on Colleague Assistance (ACCA) initiated the formation of a conjoint ad hoc committee consisting of members from ACCA, the American Psychological Association (APA) Practice Directorate, and the Section on Clinical Emergencies and Crises (Section VII of APA's Division 12) to investigate the incidence of psychologist suicide and its impact on colleagues, students or interns, patients or clients, and the profession. The committee reviewed the extant empirical literature on suicide rates for psychologists, evaluated unpublished data on psychologist suicide provided by the National Institute of Occupational Safety and Health (NIOSH), interviewed colleague survivors, reviewed published case reports of the impact of therapist suicides, and linked their findings to the literature on professional distress, impairment, and self-care. The committee concluded that there is evidence suggestive of an elevated risk of suicide for psychologists in past decades. It further concluded that there is a need for further research to confirm if there is a heightened risk of suicide for psychologists in the present day and to determine factors that might contribute to such risk. Accounts from colleague-survivors suggest that the impact of a psychologist's suicide can affect many people including family, colleagues, students, and patients or clients. This article offers suggestions for possible preventive approaches, for intervention with potentially at-risk colleagues, and for postvention efforts in the wake of a colleague suicide. (PsycINFO Database Record (c) 2011 APA, all rights reserved)