Problem-solving skills in suicidal psychiatric patients.

We examined a diathesis-stress-hopelessness model of suicidal behavior, the diathesis in question being a cognitive deficit in problem solving. We further expanded an analysis of the problem-solving skills and deficits of suicidal persons. This we accomplished by comparing a sample of 50 hospitalized patients on suicidal precautions with a control sample of 50 nonsuicidal hospitalized patients. The suicidal group differed from the control group on a number of dependent measures in accordance with the hypothesis that suicidal individuals are deficient in impersonal and interpersonal problem solving, experience more stress, and are more hopeless. Interpersonal problem-solving deficits were confined to tasks requiring subjects to generate alternative solutions to problems, as well as to anticipate negative consequences for proposed solutions. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment organization and history of suicidal behavior in clinical adolescents.

133 adolescents in psychiatric treatment participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. The comparison group comprised 64 adolescents who had never experienced suicidal ideation or behaviors; the case group included 69 adolescents with histories of suicidal behavior (n?=?53 ) and severe suicidal ideation (n?=?16 ). Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison adolescents in psychiatric treatment had experienced attachment-related trauma. Lapses in the monitoring of reasoning or discourse occurred during the attempted discussion of these events in 73% of adolescents in the case group but in only 44% of adolescents in the clinical comparison group (p?=?.002 ), suggesting that cognitive disorganization may be an important variable mediating between traumatic experience and suicidal behavior. Female adolescents and older adolescents were significantly more likely than other adolescents to be in the case group. Preoccupied attachment, in interaction with unresolved-disorganized attachment, was associated with the case group, whereas dismissing attachment was associated with the comparison group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social problem solving in suicidal adolescents.

Whether adolescent suicide attempters would have deficits in interpersonal problem solving and the relation between social problem solving, suicide intent, and medical lethality were evaluated. Compared with psychiatric and normal controls, adolescents who attempted suicide exhibited poorer social problem-solving abilities, particularly in terms of problem orientation. Specifically, suicide attempters brought more maladaptive cognitive-emotional-behavioral response sets to problematic situations than did psychiatric and normal controls. Both suicide attempters and psychiatric controls had similar deficits in problem-solving skills (e.g., generation of alternatives, decision making, and solution implementation) compared with nonhospitalized peers. Social problem solving was not found to be correlated with suicide lethality or intent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An integrative conceptual framework for assessing and treating suicidal behavior in adolescents

Suicidal adolescents represent a uniquely demanding clinical population. Regardless of psychotherapeutic orientation, the existing standards of care demand a relatively broad and integrative approach with multiple and specific treatment targets, as well as ongoing and repeated risk assessment. The current article provides an integrative conceptual framework for these tasks in day to day clinical practice with essentially two goals: (1) to provide a summary of therapeutic and assessment tasks (i.e. the content of therapy and assessment) consistent with existing standards of care and supported by empirical findings, and (2) to emphasize the varied roles, tasks, demands and limitations of psychotherapy with suicidal adolescents.     

Role of dread in suicidal behavior.

The proposition that inhibition of the experience of dread ordinarily evoked by suicidal intention is a necessary condition for suicidal action was evaluated by comparison of genuine and faked suicide notes. 3 judges, unaware that some notes were simulated, independently rated 33 matched pairs of genuine and faked notes in terms of 5 variables. On the basis of a combined X2 analysis, confirmation was achieved for 4 of 5 hypotheses (p     

Self-representation of suicidal adolescents

This study focused on the self-representations of suicidal adolescent. Twenty-six Israeli suicidal inpatients, 24 nonsuicidal inpatients, and 24 control participants completed scales on suicidal tendencies, the hedonic value of self-representations, the complexity (differentiation, integration) of these self-representations, and the discrepancies among self domains (actual, ideal, ought). Suicidal adolescents showed more negative self-representations, a less differentiated and less integrated organization of self-attributes, and more discrepancies between the 3 assessed domains of the self than did control participants. In addition, compared with psychiatric nonsuicidal participants, suicidal adolescents showed a less complex organization of self-attributes and a higher discrepancy between ideal self and ought self. Results were discussed in terms of the vulnerable self of suicidal adolescents, characterized by uneven processing of positive and negative information, confusion, and simplicity.     

Fears of death in suicidal and nonsuicidal adolescents.

Suicidal, psychiatric, and normal adolescent girls and boys, ages 15–17 yrs, participated in a study on five types of death fears. A mixed within-between multivariate analysis of variance (5 factors?×?3 groups) yielded significant interactive effects indicating that there were different profiles of fears among the three groups: Relative to the other groups, suicidal adolescents displayed little differentiation between facets of fear, with differences in the magnitude of fear limited to the intrapersonal facets. Correlates of fear varied between groups: Fear was positively correlated with suicidality in normal Ss, negatively correlated with suicidality among suicidal ones, and unrelated to suicidality in the psychiatric group. It is suggested that fear of death is processed and experienced differently by suicidal and nonsuicidal adolescents to serve as a facilitator or inhibitor of suicidal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family characteristics and behavior problems of suicidal and non-suicidal children and adolescents

Development of methods for gene transfer into specific cell types or tissues is important for experimental research as well as clinical therapeutical approaches. We report here the cloning and characterization of the envelope (env) gene and the U3 region of a retrovirus from an infected human Small Cell Lung Cancer (SCLC) cell line. The replication of this murine retrovirus is also fully supported by other lung cancer cell lines of different histological origin. We present evidence that a long terminal repeat (LTR)-beta-galactosidase (beta-Gal) reporter construct performed as well as an analogous cytomegalovirus (CMV) promoter beta-Gal construct in the human lung epithelial cell line A549 and in the human larynx carcinoma cell line HEp2.     

Interactional analysis of suicidal behavior.

Analyzes the limitations inherent in 5 empirical research models (pure environmental, pure individual differences, discrete parallel, nonparallel typological, and parallel typological models) that have been used to study suicidal behavior. These extant models are shown to have specific limitations in terms of their ability to reflect an interactional perspective on suicidal behavior. A more adequate research model was then developed and used to test 2 hypotheses derived from a general interactional thesis; approximately 510,400 Ss were studied. Findings support both hypotheses, thus providing considerable support for the general thesis, i.e., that such real-life behaviors cannot adequately be understood by recourse to either individual difference variables alone or environmental variables alone. The implications of these findings and the empirical research model that revealed them are discussed in terms of heuristic value and relevance to students of other forms of human behavior. (76 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving deficits in suicidal patients: Trait vulnerability or state phenomenon?

A diathesis-stress model had been proposed (D. E. Schotte and G. H. Clum; see PA, Vols 69:1287 and 74:15906), in which deficits in interpersonal problem-solving skills are said to predispose individuals under chronic stress to depression, hopelessness, and suicide ideation. The present study examined the stability of interpersonal problem-solving skills in a short-term, longitudinal study of hospitalized suicide ideators (N?=?36). The Ss displayed marked changes in depressive symptoms, state anxiety, hopelessness, and suicide intent over time, and these improvements were associated with improvements in interpersonal problem-solving skills. It is concluded that interpersonal problem-solving deficits may be a concomitant, rather than a cause, of depression, hopelessness, and suicide intent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive and personality factors in suicidal behavior.

Studied the role of aggression in suicidal behavior. The personality functioning of 20 suicide attempters, 20 nonsuicidal psychiatric controls, and 20 suicide completers was assessed using the Rorschach. There were 11 female and 9 male 21–63 yr old Ss in each group. M. Feffer's role-taking task (see record 1960-04380-001) provided a test of the cognitive functioning of the 1st 2 groups. All 3 groups experienced the breakthrough of more aggressive than libidinal drive derivatives, but no significant differences between the groups were found. Only the suicide attempters' aggressive responses were more primitive than their libidinal responses. On the role-taking task, the suicidal group's cognitive functioning in the neutral situation was superior to their functioning in the aggressive one. The control group yielded no such difference. The suicidal group's performance in the aggressive situation was also significantly inferior to the control group. Results are interpreted as underscoring the role of cognition in symptom choice. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A cross-cultural comparison of behavior disturbance and suicidal behavior among psychiatrically hospitalized adolescents in Israel and the United States

This study examines sexual behavior, serotonin turnover in the central nervous system, and testosterone in free-ranging non-human primates. Study subjects were 33 young adult male rhesus macaques (Macaca mulatta) living in naturalistic social groups on a 475-acre South Carolina barrier island. Blood and cerebrospinal fluid (CSF) samples were obtained during random trappings, and the subjects were located for observation by radio telemetry. Quantitative behavioral samples totaling 203 observation hours were taken during two mating seasons (September through January) in 1994 and 1995. Control observations (65 h) on 13 subjects were also taken during the non-mating seasons in 1994 and 1995. The results indicate that CSF 5-hydroxyindoleacetic acid (5-HIAA), CSF testosterone, and plasma testosterone concentrations increase significantly during the mating season. During the mating season, there were significant increases in high intensity aggression, low intensity aggression, grooming behavior, and heterosexual mounting. In the mating season, CSF 5-HIAA was significantly correlated with several sociosexual behaviors: consorts per hour, heterosexual mounts per hour, and inseminations per hour. In contrast to previous findings from the non-mating season, CSF 5-HIAA was not correlated with any measures of aggression or sociality, although during consorting, CSF 5-HIAA was positively correlated with grooming. From these findings, we conclude that the lack of correlation between intense and severe aggression and CSF 5-HIAA in the mating season may reflect the use of high intensity aggression in 'normative' male-male competition over access to reproductively active females. We also conclude that CNS serotonin turnover is positively correlated with sexual competence, i.e. males with low CSF 5-HIAA concentrations are less sexually competent than males with higher concentrations.     

Social connections and suicidal thoughts and behavior.

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness—(a) living alone, (b) perceived social support, (c) interpersonal conflict, and (d) belongingness. Participants (n = 814) were recruited from 4 residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and that belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Development of a semistructured clinical interview for suicidal behaviors in adolescents.

Describes the development of the Suicidal Behaviors Interview (SBI) developed by W. M. Reynolds (in press), a semistructured clinical interview measure of suicidal behaviors designed for use with adolescents. Ss were 352 adolescents, ages 12–19 yrs. Results indicate high internal consistency (rα?=?.92) and interrater reliability (rrr?=?.97, ricc?=?.99) and significant correlations with self-report measures of depression (r?=?.47) and suicidal ideation (r?=?.62 and .68). Factor analysis of SBI items resulted in a 3-factor solution that was parsimonious with the general formulation of suicidal behavior represented by the SBI. Examination of SBI factors indicated relatively high levels of reliability (rα?=?.83 to .90) and moderate intercorrelations (r?=?.49 to .66) among the factors. The results of this investigation suggest that the SBI is a psychometrically sound clinical interview for the evaluation of suicidal behaviors of adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents.

It was hypothesized that suicidal inpatient adolescents (n?=?38) will exhibit a higher tolerance for physical pain than nonsuicidal inpatients (n?=?29) and control participants (n?=?34). Participants provided self-reports of hopelessness, dissociation, suicidal tendencies, depression, and anxiety and were administered a series of thermal pain stimuli by means of a Thermal Sensory Analyzer (TSA). The suicidal participants significantly differed from the 2 controls in pain thresholds and tolerance and in most self-report measures, even after controlling for motivation, medication, diagnosis, and length of hospitalization. Significant correlations were found between pain measures and self-report measures. The results were discussed in terms of the role that body experiences play in suicidal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From abandonment to symbiosis: A developmental reversal in suicidal adolescents.

This article presents the abandonment-symbiosis hypothesis. This hypothesis pertains to the dynamics of suicide in youngsters who experience difficulties in separation from their symbiotic families. It is suggested that such youngsters have experienced various types of rejection and abandonment in early childhood and have developed insecure attachment styles and insufficient ego functions in order to cope with difficulties. It is also suggested that these youngsters have become scapegoats by their dysfunctional families and that they are held in a symbiotic grip in order to continue to bear the negative projections of their families. As such, they are prevented from developing a proper sense of individuation and autonomy. The sequence that begins with abandonment and continues with symbiosis is a reversal of normal development is critical for the emergence of suicidal behavior. The various aspects of the abandonment-symbiosis hypothesis are demonstrated by case studies and empirical data. A combination of individual and family treatment is recommended as the best approach for the treatment of such youngsters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gesture behavior in unmedicated schizotypal adolescents.

Schizotypal personality disorder is characterized by interpersonal and verbal communication deficits. Despite the important role of gesture in social communication, no published reports examine the use of gesture by individuals with SPD. In this study, raters code gesture from videotaped interviews of unmedicated adolescents with SPD, other personality disorders, or no Axis II disorder. Results indicate that SPD adolescents show significantly fewer gestures but do not differ from the other groups in overall rate of movement. The findings are discussed in light of brain regions involved in dysfunction, parallels to schizophrenia, and treatment implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving skills training and relationship therapy in the treatment of antisocial child behavior.

The present investigation evaluated the effects of cognitive-behavioral problem-solving skills training (PSST) and nondirective relationship therapy (RT) for the treatment of antisocial child behavior. Psychiatric inpatient children (N?=?56, ages 7–13) were assigned randomly either to PSST, RT, or to a treatment-contact control condition (in which children met individually with a therapist but did not engage in specific activities designed to alter antisocial behavior). Children were hospitalized during the period in which treatment was administered and discharged thereafter. The PSST condition led to significantly greater decreases in externalizing and aggressive behaviors and in overall behavioral problems at home and at school and to increases in prosocial behaviors and in overall adjustment than the RT and contact-control conditions. These effects were evident immediately after treatment and at a 1-year follow-up. The RT and control children did not consistently improve over the treatment and follow-up periods. Comparisons with nonclinical (normative) levels of functioning revealed that a significantly higher proportion of PSST children, compared with those in other conditions, fell within the normative range for prosocial behavior at posttreatment and at follow-up. Even so, the majority of PSST children and almost all RT and control children remained outside the normative range of deviant behavior. The implications of the results for further research for antisocial youth are highlighted. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)