Employment status influences the weekly patterns of suicide among alcohol misusers

As part of the National Suicide Prevention Project in Finland, a nationwide psychological autopsy study, all suicide victims (n = 1397) over a 12-month period were investigated concerning factors associated with any variation in suicide frequency between weekdays and weekends. In particular, employment status was expected to have influenced the weekly pattern of alcohol misuse, and thereby to have caused clustering of suicides at weekends among the employed. Among suicide victims who had misused alcohol, those in employment were significantly more likely to have committed suicide during the weekend that those without work (52% vs. 34%, p < 0.001). In logistic regression analysis, employment was the only independent variable significantly associated with suicide at the weekend. According to forensic chemical analysis, those classified as misusers had frequently used alcohol at the time of suicide, regardless of the weekday, and slightly more often if employed. The clustering of suicides at weekends among employed alcohol misusers is probably explained by a weekly pattern in the use of alcohol, which suggests that besides the established risk factors for suicide among alcohol misusers, the act of using alcohol per se also contributes to the suicidal act.     

The Ubiquitous Clinical Problem of Adult Intimate Partner Violence: The Need for Routine Assessment.

Mental health providers need to know that the problem of intimate partner violence (IPV) is ubiquitous--that is, seemingly everywhere at once--within populations that access health care services. Because IPV is a gendered phenomenon where women predominantly tend to be victimized and because women tend to access psychological services at higher rates than men, there is an increased probability that victims of IPV will access services. Without this awareness, diagnostic procedures may be inaccurate, and providers may not intervene to reduce lethality if IPV is not evaluated as part of routine assessment procedures. This article provides concrete procedures for IPV screening and assessment in order to adequately address the problem and also presents initial safety-planning strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interventions for intimate partner violence: Review and implications for evidence-based practice.

The objective of this article was to survey available intimate partner violence (IPV) treatment studies with (a) randomized case assignment, and (b) at least 20 participants per group. Studies were classified into 4 categories according to primary treatment focus: perpetrator, victim, couples, or child-witness interventions. The results suggest that extant interventions have limited effect on repeat violence, with most treatments reporting minimal benefit above arrest alone. There is a lack of research evidence for the effectiveness of the most common treatments provided for victims and perpetrators of IPV, including the Duluth model for perpetrators and shelter–advocacy approaches for victims. Rates of recidivism in most perpetrator- and partner-focused treatments are approximately 30% within 6 months, regardless of intervention strategy used. Couples treatment approaches that simultaneously address problems with substance abuse and aggression yield the lowest recidivism rates, and manualized child trauma treatments are effective in reducing child symptoms secondary to IPV. This review shows the benefit of integrating empirically validated substance abuse and trauma treatments into IPV interventions and highlights the need for more work in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A perspective on the journal review process.

Comments on S. Epstein's (see record 1996-12802-001) suggestions for improving the journal review process. Rabinovich disagrees with Epstein's recommendation to provide the identity of the reviewers. The author discusses providing positive feedback to authors, providing suggestions for alternative methods of conducting research, and viewing the review process as mentoring as ways to improve the review process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological help for victims of crime.

In interventions to help victims, service providers should be guided by theory and research and anticipate that multiple actors will influence the way in which victims cope with their experience. Careful and deliberate intervention initiated early by persons first in contact with a victim, followed in some cases by later professional corrective intervention, are parts of an overall system of potential interventions. As service providers, educators, and researchers, psychologists can demonstrate leadership in developing theory, creating new knowledge, and designing and evaluating interventions. To be effective, psychologists must collaborate with practitioners in the health, mental health, and criminal justice systems to demonstrate the value of research and evaluation for improving services to victims. Theory-based field trials of victim services should supplement other forms of research to develop better ways of helping victims of crime. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy of severe depression.

Presents 3 case illustrations of severely depressed women (aged 17, 43, and 50 yrs), showing the collaborative efforts of patients and staff in group psychotherapy within the ward milieu. In these cases, many assumptions about "untreatable" patients were critically examined and rejected. Psychological approaches were designed which successfully reached the bases of conflict by reinstituting traumatic situations and providing ways of developing corrective emotional experiences. Psychological theories helpful in such basic psychotherapeutic work are discussed. The authors do not identify their approach with one particular theoretical school or type of psychotherapy, suggesting that the problem with most approaches to treatment of severe depression is that the understanding of the psychodynamics of depression is not really put to use in designing treatment programs. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation and intimate partner violence in newlyweds.

Is the inability to regulate negative emotions a risk factor for intimate partner violence (IPV)? To address this question, the authors asked 72 newlywed couples to report their levels of negative affect every day for 7 days and examined whether variability in those reports was associated with the IPV self-reported to have been perpetrated over the previous year. Although main effects of variability in both husbands' and wives' negative affect did not reach statistical significance, variability in husbands' negative affect significantly interacted with wives' reports of IPV to account for husbands' IPV, even after overall levels of husbands' negative affect, marital satisfaction, and chronic stress were controlled. Specifically, whereas variability in negative affect was unrelated to IPV among husbands with wives who reported no IPV, such variability was positively associated with the IPV perpetrated by husbands with wives who also reported having perpetrated IPV during the previous year. Although preliminary, these results support theories suggesting that the ability to regulate negative emotions may help intimates avoid perpetrating IPV, particularly when faced with a partner's IPV perpetration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multicomponent intervention to prevent partner violence within an existing service intervention.

Intimate partner violence (IPV) is an enormous public health problem that results in injury, health problems, and substantial cost to society. Despite having a grasp of the scope of IPV, public health officials and workers know little about how to prevent it. The few empirically established primary prevention programs consist of school-based curricula targeting high school students. Additional venues for IPV prevention are needed, especially for women at elevated risk. This article describes a preventive intervention for IPV consisting of three components: (a) a structured assessment for IPV; (b) a brochure-driven intervention for women experiencing IPV, including safety planning, referrals, and advocacy; and (c) a skills-based curriculum delivered to all participants that focuses on improving relationship decisions and outcomes. While this intervention could potentially be delivered in a multitude of clinical settings, this article focuses on its delivery within a home visitation program for young, disadvantaged new mothers, a population known to be at increased risk for IPV. If found to be effective, this intervention could be incorporated into many service delivery systems, with broad-based clinical implications for IPV prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Additional adverse events among women exposed to intimate partner violence: Frequency and impact.

Objective: To assess additional adverse life events that women exposed to intimate partner violence (IPV) may have endured and to ascertain whether, and in what ways, problems in adjustment are related more to IPV or to IPV plus other adverse life events. Method: Predictors of the effects of exposure to adversities were investigated in this study of 104 women exposed to severe IPV who reported conflict tactics, adverse life events, as well as symptoms of distress. Results: The majority of participants experienced additional adversities (86%). Significant differences were found between those exposed to IPV-only and those exposed to IPV plus other adverse events in terms of IPV frequency and current symptoms of distress. Women with IPV plus other adverse events had twice as many physical assaults and 4 times as many sexual assaults from an intimate partner compared to IPV-only women. The number of adverse events contributed significantly to variance in trauma symptoms over and above that of exposure to IPV alone. Women exposed to additional events had approximately twice as many avoidance and physiological arousal symptoms as IPV-only women. Conclusions: The results of this study suggest a variety of implications for IPV treatment and interventions. Specifically, the role that additional interpersonal violence, especially sexual violence, plays in the expression of distress may relate to the type of service offered to the survivor. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Counseling victims of sexual harassment.

Describes therapeutic experiences with 10 sexual harassment victims in individual therapy and 7 sexual harassment victims in group therapy and compares them with data from sexual employment surveys and with other crime populations. Findings reveal that victims progressed through stages of feelings including confusion/self-blame, fear/anxiety, depression/anger, and disillusionment. The stress of sexual harassment was also affected by a history of prior victimization and by the victim's involvement in a formal complaint process related to the harassment. The group setting was found to be more effective than individual treatment for coping with the specific effects of sexual harassment, and Ss in group therapy used the group to understand their experience, sort through legal and employment decisions, learn new coping skills, and develop support for each other. Victims of sexual harassment differed from victims of crime: The primary effects of the harassment were on economic and career well-being; the secondary effects were on private relationships and physical well-being. The reverse is true for victims of crime. Therapeutic complications arising from the therapist's involvement in court proceedings and organizational remedies are also described. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analyses and systematic reviews of psychological treatments for chronic pain: Relevance to an evidence-based practice.

As evidence-based practitioners become more reliant on systematic reviews to inform treatment, it becomes important to systematize reporting details as well as improve the quality of the primary studies that will later be incorporated into this secondary literature. In this article, the authors consider several specific factors that can serve this function in the area of chronic pain: (a) adhering to a standardized set of reporting standards; (b) measuring a standardized set of short- and long-term outcome variables; (c) providing information about individual differences; and (d) providing detailed, easily accessible documentation of the treatment program (or progams). The article also highlights ways that practitioners and researchers can collaborate on treatment outcome research, thereby improving the ability to discover and disseminate effective treatments for patients who suffer from chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A structured stress-reduction group approach modified for victims of psychological trauma.

Victims of violence frequently experience high levels of physiological arousal and disruptions in mastery, attachment, and meaning, sometimes evolving into posttraumatic stress disorder (PTSD). Treatment in the early hours and days after the traumatic event suggest that approaches emphasizing self-care and stabilization of the victim are helpful. The authors present a structured stress-reduction group approach modified to meet the needs of victims of violence. Preliminary findings suggest the efficaciousness of this approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The complexities of domestic violence.

Comments on the article by Robert Bornstein, "The complex relationship between dependency and domestic violence: Converging psychological factors and social forces," (see record 2006-11202-003). Although a more focused examination of the psychological factors involved in domestic violence is welcome, there are some factual errors in Bornstein's article that need attention and represent a general problem in reports of domestic violence. Bornstein wrote, "Studies indicate that more than 95% of abuse perpetrators are men" (p. 595) and then proceeded to assess dependency in male perpetrators and female victims of intimate partner violence (IPV). The study indicating that more than 95% of IPV perpetrators are men was not cited and is, in fact, fictitious. The best empirical evidence indicates an entirely different finding. Clinical predictions of dangerousness made in psychiatric emergency rooms often underestimate female dangerousness. Risk of harm to children has often been based on wife abuse-child abuse incidence co-occurrence estimates from shelter house samples of women and erroneously generalized to community samples. For these reasons, regeneration of the gender paradigm by Bornstein, or others, serves to misinform the profession. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What can be done to improve the journal review process.

Presents suggestions for improving the journal review process by providing explicit, uniform guidelines for editors and reviewers. The author also recommends providing (1) information to authors about recommending reviewers, (2) a meaningful appeals procedure, (3) identity of reviewers, and (4) forms for authors to provide feedback to reviewers. Two of these practical steps can be implemented immediately and informally. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtypes of partner violence perpetrators among male and female psychiatric patients.

The goal of this naturalistic study was to examine heterogeneity among female and male civil psychiatric patients with a history of intimate partner violence (IPV) perpetration. Participants were 567 patients drawn from the MacArthur Violence Risk Assessment Study (J. Monahan et al., 2001). The authors examined subtype composition among 138 women and 93 men with positive histories of IPV and compared these groups with 111 women and 225 men with no histories of IPV. Findings for men and women were consistent with reports from studies of male perpetrators in forensic and community settings in that generally violent/antisocial, borderline/dysphoric, and family only/low-psychopathology subtypes of perpetrators were identified in both men and women. This study provides preliminary evidence for the generalizability of typologies derived from nonpsychiatric partner violence perpetrators to psychiatric populations and suggests that typologies derived from studies of male IPV perpetrators may provide useful guidance for the investigation of female IPV perpetration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supported employment for adults with psychiatric disability: Results of an innovative demonstration project.

Describes an innovative 3-yr research and demonstration project evaluating a supported employment program on a university campus designed specifically for persons with psychiatric disability. The vocational status, job satisfaction, work integration, symptomatology, and social supports of 20 Ss were assessed during the project, and a 2-yr follow-up of employment status was conducted. While a university setting was ideal for providing supported employment services for persons with psychiatric disabilities, the university itself was not a particularly receptive or compatible employer. The 2-yr follow-up showed that 10 Ss were employed an average of 17.5 hrs per week with mean earnings of $156 per week, representing a modest increase in percentage of Ss employed, and a substantial increase in average hours worked and average wages earned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impelling and inhibiting forces in the perpetration of intimate partner violence.

The huge corpus of research identifying risk factors for intimate partner violence (IPV) has outpaced theoretical models explaining how these risk factors combine to exert their effects. This report presents a 2-stage process model investigating how a previously nonviolent interaction between intimate partners escalates to IPV. The first stage examines whether at least one partner experiences strong violence-impelling forces, which lead the individual to experience action tendencies toward IPV. The second examines whether the partner experiencing violence-impelling forces suffers from weak violence-inhibiting forces, which would otherwise serve to override such action tendencies. This model extends previous research by emphasizing the importance of inhibitory processes in IPV and by imposing a new conceptual structure on the identified IPV risk factors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Hartford Study of Supported Employment for Persons With Severe Mental Illness.

The authors compared 3 approaches to vocational rehabilitation for severe mental illness (SMI): the individual placement and support (IPS) model of supported employment, a psychosocial rehabilitation (PSR) program, and standard services. Two hundred four unemployed clients (46% African American, 30% Latino) with SMI were randomly assigned to IPS, PSR, or standard services and followed for 2 years. Clients in IPS had significantly better employment outcomes than clients in PSR and standard services, including more competitive work (73.9% vs. 18.2% vs. 27.5%, respectively) and any paid work (73.9% vs. 34.8% vs. 53.6%, respectively). There were few differences in nonvocational outcomes between programs. IPS is a more effective model than PSR or standard brokered vocational services for improving employment outcomes in clients with SMI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial comparing two vocational models for persons with severe mental illness.

The authors compared 2 approaches to vocational rehabilitation for individuals with severe mental illness: the individual placement and support (IPS) model of supported employment and the diversified placement approach (DPA), which emphasizes work readiness and offers a range of vocational options, including agency-run businesses and agency-contracted placements with community employers. In all, 187 unemployed participants with severe mental illness were randomly assigned to IPS or DPA. Over 2 years, IPS had significantly better competitive employment outcomes than DPA. Competitive employment rates over the 2-year follow-up were 75.0% for IPS and 33.7% for DPA. However, IPS and DPA did not differ on paid employment outcomes. The authors conclude that IPS is more effective than DPA in achieving competitive employment, but not paid employment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)