Foreknowledge, caring, and the side-effect effect in young children.

Children and adults often judge that the side effects of the actions of an uncaring story agent have been intentional if the effects are harmful but not if these are beneficial, creating an asymmetrical "side-effect" effect. The authors report 3 experiments involving 4- and 5-year-olds (N = 188) designed to clarify the role of foreknowledge and caring in judgments of intentionality. Many children showed the side-effect effect even if agents were explicitly described as lacking foreknowledge of the outcome. Similarly, when agents were described as possessing foreknowledge but their caring state was unspecified, children more often judged that the negative, compared with the positive, effects of agents' actions were brought about intentionally. Regardless of foreknowledge, children infrequently judged positive outcomes as intentional when agent caring was unspecified, and they gave few attributions of intentionality when agents were described as having a false belief about the outcome. These results testify to the robustness of the side-effect effect and highlight the extent to which children's intentionality judgments are asymmetrical. The findings suggest developmental continuity in the link between reasoning about morality and intentionality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prediction of suicidal intent in depressed patients

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in-patients. A total of 338 adult depressed psychiatric in-patients were examined and classified according to DSM-III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self-Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self-rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self-esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.     

Problem Solving Deteriorates Following Mood Challenge in Formerly Depressed Patients With a History of Suicidal Ideation.

The authors divided 34 participants who had a history of depression into 2 groups, those having previous suicidal ideation or behavior (n = 19) and those having no such symptoms (n = 15), then compared the 2 groups with a group of participants who had no history of depression (n = 22). Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of suicidal ideation shifted in MEPS performance, producing significantly less effective problem solutions following mood challenge, consistent with a differential activation account of vulnerability for recurrence of suicidal ideation and behavior. The deterioration in effectiveness following mood challenge was moderated by lack of specificity in autobiographical memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor intentionality: An emerging view of process and performance.

Contends that intentionality, viewed as a trait related to counselor functioning and performance, is an emerging perceptual construct that is important for counseling research. Differing definitions of intentionality focus on bipolarity, unintentional functions, and being trapped in one intentionality. Empirical studies have shown that counselor behavior is perceived as counselor intention and that counselor ratings of counselor response helpfulness were not predictive of client perceptions; client ratings were not predictive of counselor perceptions of response helpfulness either, but trained observers significantly predicted both client and counselor ratings. It is suggested that a more clearly defined and measured construct of intentionality could be used to distinguish levels of professional functioning in counselors. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's motivational perception as related to the instrumentality and effect of action.

On the basis of F. Heider's (1958) balance conceptions, a model was developed for specifying relations between the perceived properties of an act (its instrumentality and its consequentiality) and the intentionality attributed to the act. 129 1st-, 4th-, and 6th-graders made intentionality judgments of actions described in 10 pairs of stories, each pair made up of contrasting actions varying in instrumentality and/or consequentiality. The older Ss adhered more closely to the naive psychological model both in intentionality choice and in the reasons for their choice. The 1st-graders had more difficulty judging intentionality on the basis of an act's instrumentality as compared to its consequentiality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acetaminophen toxicity in an urban county hospital

BACKGROUND: The prevalence and characteristics of acetaminophen-associated liver injury in hospitalized patients are not well defined. METHODS: We identified patients hospitalized for excessive acetaminophen ingestion at an urban county hospital over a 40-month period (1992 to 1995) and reviewed their medical records to determine the incidence and clinical features of the ingestions and their outcomes. RESULTS: Of the 71 patients studied, 50 were classified as having taken acetaminophen during suicide attempts and 21 as having accidentally poisoned themselves while attempting to relieve pain. The suicidal patients had ingested almost twice as much acetaminophen as those in the accidental-overdose group (median, 20 vs. 12 g; P=0.009). Among the patients for whom data were available, 63 percent of those in the accidental-overdose group and 25 percent of those in the suicidal group had chronic alcohol abuse (P=0.009). The patients in the accidental-overdose group more often had severe liver necrosis (aminotransferase levels, >3500 IU per liter; 52 percent vs. 14 percent; P=0.002), and were more likely to have hepatic coma (33 percent vs. 6 percent, P=0.006). There were four deaths (19 percent) in the accidental-overdose group and one (2 percent) in the suicidal group (P=0.04). Five patients -- three in the accidental-overdose group and two in the suicidal group -- had ingested 4 g of acetaminophen or less. Acetaminophen ingestion accounted for 12 percent of all patients hospitalized with overdoses (71 of 589) and 40 percent of patients with acute liver failure (10 of 25) during the study period. CONCLUSIONS: In an urban county hospital, patients hospitalized with acetaminophen toxicity related to accidental misuse had higher rates of morbidity and mortality than those who attempted suicide, even though the latter had taken more acetaminophen. A higher frequency of chronic alcohol abuse among the patients with accidental overdoses may be one explanation.     

Cancer pain management in developing countries: a mosaic of complex issues resulting in inadequate analgesia

OBJECTIVE: To determine the prevalence of suicidal ideation and the symptomatic profile as well as to identify the sociodemographic characteristics highlighting female adolescents with the highest scores on suicidal ideation in adolescents living in Mexico City: students and suicidal patients. MATERIAL AND METHODS: A cross-sectional and ex-post-facto study was carried out in order to analyze information from two samples: 1,712 junior and junior high school women students (representative student sample in Mexico City), and 30 adolescents inpatient hospitalized for her suicide attempts (clinical sample). RESULTS: Prevalence of presence as well as persistence of suicidal ideation were higher in the clinical sample, nevertheless 11.8% of the school sample had everyone of the symptoms in a range of 1 to 7 days. The most persistent of the ideation symptoms was: "My family would be better if I were dead"; and in the clinical sample it was "I thought about killing myself". Finally, the sociodemographic characteristics that best matched the student girls having the highest scores in suicidal ideation were: to be on junior high school, to get low grades, to acknowledge school performance as bad and to have interrupted her studies. The characteristics that highlight the girls with a first attempt were analyzed in the clinic sample in comparison with those ones with two or more attempts. It was significant that girls in the second group were living only with one parent and they thought in the last attempt that their dead would be possible or certain. CONCLUSIONS: The prevalence of suicidal ideation was important in the school sample. If it is considered that this psychological construct has a strong association with suicidal attempt, and multiple suicide conduct, then is a priority to detect adolescents in risk and to make preventive efforts, considering the sociodemographic characteristics that configurate in risk for suicidal ideation.     

A sequential culture approach to study osteoclast differentiation from nonadherent porcine bone marrow cells

BACKGROUND: This study reports relationships between suicidal behavior and its risk factors in prepubertal children and whole blood and platelet serotonin-related measures. METHODS: Seventy-five prepubertal psychiatric inpatients including 23 (30.7%) nonsuicidal, 32 (42.7%) with suicidal ideation, and 20 (26.6%) with a suicide attempt were compared to 35 normal prepubertal controls with regard to platelet serotonin content, serotonin-amplified platelet aggregation, and whole blood tryptophan. RESULTS: Mean whole blood tryptophan content was significantly lower among inpatient children with a recent suicide attempt than among normal controls or inpatients with suicidal ideation (F = 3.94, df = 3.54, p < or = .01). Inpatient children with a mood disorder had significantly higher platelet serotonin content than inpatients without a mood disorder (F = 3.86, df = 2.80, p < or = .03). Racial/ethnic differences were also observed for inpatients and normal controls, with whites having significantly lower levels of platelet serotonin (expressed as ng/mL blood or ng/10(9) platelets) than blacks or Latinos. Blacks had significantly higher levels of whole blood tryptophan than other racial/ethnic groups. CONCLUSIONS: The results suggest that whole blood tryptophan and platelet serotonin content should be studied for their predictive validity as risk factors for suicidal behavior in youth while controlling for racial/ethnic differences.     

Developmental Accounts of Intentionality: Toward Integration

A variety of developmental accounts of intentionality, arising from disparate theoretical perspectives, can now be found in the literature. This paper argues that this diversity is undermining the ability of developmental psychologists to construct a coherent developmental account of the capacity and that it would be more productive to pursue an integrated approach. To this end, the dominant theoretical positions on the development of intentionality are reviewed and evaluated: intentionality as goal-directedness, a result of parental scaffolding, an innate capacity for intersubjectivity, and behavioral object-directedness. Particular attention is given to comparing three key features of each position: the definition of intentionality adopted, the types of behaviors considered to be evidence of intentionality, and the proposed developmental sequence. The possibility of constructing an integrated approach based on these components is explored.     

A study of self-injurious and suicidal behavior in a veteran population.

This patient safety improvement study was conducted (1) to establish a database of intentional patient self-injuries and suicidal behavior among veterans in a large urban VA health care system, and (2) to investigate whether there were demographic and/or clinical characteristics of veterans who self-injure that might predict seriousness of suicidal intent and aid in future efforts at prevention. A total of 175 clinician-administered, post self-injury interviews were completed between 2006 and 2008 in a VA health care system in the Northeast. Findings suggest that self-injuries with high suicidal intent were characterized by male gender, older age, planning of self-injury, no wish to be saved, and a negative feeling about having survived. Additional results indicated that staff ratings of patient intent to die were significantly lower than patient self-rated intent to die, a finding that gives rise to questions of whether staff may tend to underestimate patient suicidal intent. Also, although more than 80% of the veterans in this sample considered their self-injurious actions impulsive, planning of self-injury was significantly associated with higher intent to die. Veterans who completed suicide during the study time period were significantly more likely than those who had nonfatal self-injuries to have experienced combat. The implications of these findings are discussed, including whether combat exposure may lead to an acquired capacity for lethal behaviors such as suicide (Joiner, 2005). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relationship between fluoxetine use and suicidal behavior in 654 subjects with anxiety disorders

BACKGROUND: In the past few years, there has been controversy over the relationship between suicidal behavior and fluoxetine use. This report examines the relationship between fluoxetine use and suicidal behavior in the Harvard/Brown Anxiety Disorders Research Program (HARP). METHOD: HARP is a naturalistic, prospective, longitudinal anxiety disorders study. Probabilities of suicidal behavior for 654 subjects were examined using life table analysis for the study group as a whole and stratified by depression status at intake. RESULTS: Subjects not using fluoxetine during follow-up had almost twice the probability of making a suicide attempt or gesture during the follow-up than subjects who were using fluoxetine, although this difference was not statistically significant. Subjects having episodes of major depressive disorder (MDD) at intake were more likely than those not having an episode to receive fluoxetine during follow-up (74/166 [45%] vs. 118/488 [24%], chi squared= 24.85, df= 1, p < .0001). Among those subjects having episodes of MDD at intake, there was a statistically significantly lower probability of suicide attempts/gestures for those taking fluoxetine than for those not using fluoxetine during follow-up (log-rank chi squared= 5.10, df= 1, p= .02). CONCLUSION: We found no evidence that fluoxetine use is associated with increased risk of suicide attempts or gestures. However, we did find that subjects with more suicide risk factors at intake were more likely to use fluoxetine than those without these risk factors.     

The facilitating effects of money and moral set on the moral judgment of adolescent delinquents.

Previous research with normal elementary school children and adolescent delinquents had demonstrated the effectiveness of modeling procedures in promoting their level of intentionality (i.e., the developmentally more mature judgment of a misdeed in terms of intent rather than consequent material damages). The present study with 20 male juvenile delinquents (mean age = 12 yrs) investigated the extent to which such increases in intentionality reflect the appearance of previously acquired responses, rather than the learning of new behaviors as a consequence of modeling. Following establishment of a baseline, Ss were exposed to a manipulation in which money and adult moral set maximized the operation of old moral response styles but precluded the learning of new ones. Posttest evaluation revealed significant increases of 20% in level of intentionality in experimental Ss in comparison with controls. Alternative interpretations of these effects are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social influence on children's standards for judging criminal culpability.

The transfer of social influence on criminal sentencing to new cases by 142 children in Grades 4, 5, 7, and 8 was assumed to reflect a modification of judgmental standards. The Ss imposed sentence in 4 hypothetical criminal cases varying in intentionality and in amount of material damage done. Ss in the experimental conditions simply heard that the judge had imposed a harsh sentence in 1 or 2 of the cases, which was intentional and resulted in material damage. Compared to a nontreatment control, the Ss in the experimental conditions became harsher in their sentences for the case(s), and the increased harshness carried over to subsequent cases. Initial transfer did not depend on whether the Ss anticipated hearing the judge's sentence in the subsequent case. Further, in Grades 4 and 5 the transfer as relatively greater to the high intentionality/low damage case than to the low intentionality/high damage case, indicating a shift toward a standard based on intentionality. Results of a 2nd experiment with 79 3rd–5th graders show that the Ss inferred that the judge's harsh sentence was because of the intentions behind the act. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of highlighting intention on intentionality and restitutive justice.

Used 4 moral judgment stories to assess intentionality and restitutive justice in 115 children in nursery school and Grades 1 and 3. A treatment designed to highlight intention improved performance on intentionality for 1st- and 3rd-grade Ss but had no effect on restitutive justice responses at any age. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In charge but not in control: The management of teaching relationships by adults with low perceived power.

The paradoxical use of punitive force by adults with low perceived power was explored in teaching interactions. Punitive force was measured by the intensity of physical effort used in operating controls that displayed negative feedback to child trainees. Women who differed in perceived power were assigned to (a) situations in which they had high, low, or ambiguous control and (b) responsive, unresponsive, or ambiguously responsive children. women with low perceived power—when given ambiguous control— were more likely than other women to (a) use high levels of punitive force and (b) show elevated levels of autonomic arousal. Arousal, in turn, partially mediated the relationship between perceived power and use of force. Women with low perceived power were also more likely to attribute intentionality to children whose behavior was ambiguous. Results were interpreted as having implications for violence within adult–child relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization.

Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intentionality and Moral Judgments in Commonsense Thought About Action.

The concept of intentional action occupies a central place in commonsense or folk psychological thought. This paper describes two psychological experiments designed by the author and Joshua Knobe. The experiments investigate further some questions that arose from Knobe's work on responsibility and intentionality beliefs in folk psychology. They show that there is reason to doubt that subjects' beliefs about the intentionality of side effects are simply a product of their beliefs about the agent's responsibility for these effects. The author also considers how the experimental results bear on Knobe's most recent views about the relation of subjects' value judgments about side effects and their intentionality judgments. What the experimental results suggest is that subjects do not simply use either their belief that a side effect is bad, or that the agent is responsible for it, to determine their view about the intentionality of its production. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deceived and distorted: Game outcome retrospectively determines the reported time of action.

Previous work suggested the association between intentionality and the reported time of action was exclusive, with intentionality as the primary facilitator to the mental time compression between the reported time of action and its effect (Haggard, Clark, & Kalogeras, 2002). In three experiments, we examined whether mental time compression could also be observed in an unintended action. Participants performed an externally cued key press task that elicited one of two possible tones. The reported time of action shifted closer to the tone when the tone was used to indicate the winner of a race (Exp.2) compared to when the tone was meaningless and did not indicate winning (Exp.1). This suggests that reported time of an unintended action could shift toward the effect in some contexts. Furthermore, the results from Exp.2 and Exp.3 (tones were substituted with verbal feedback) showed that a presumed winning action was judged to occur earlier whereas a presumed losing action was judged to be later. These findings therefore support the view that the reported time of action is reconstructed from known temporal information rather than determined by intentionality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The influence of live and symbolic modeling on promoting moral judgment of adolescent delinquents.

Compared the influence of live, symbolic, or no modeling on the promotion of intentionality in 3 groups of 12 13-yr-old delinquent males. Generalizability of effect was assessed through performance on a 2nd related but nonmanipulated aspect of moral judgment, moral relativism. Both live and symbolic modeling produced very significant increases in intentionality compared to controls. No significant differences were obtained between groups on moral relativism, although all 3 groups decreased slightly on this dimension on posttest. A 9-mo follow-up revealed no differences between groups in number or severity of intervening delinquent offenses. Treatment effects are discussed in terms of their depth and generalizability as well as their relationships to moral behavior in delinquency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)