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)     

Toward a cognitive therapy for suicidal individuals.

Explores whether studies of cognitive characteristics of the suicidal individual differentiated the suicidal patient from other patients sufficiently enough to warrant a distinct treatment strategy. The cognitive characteristics of suicidal patients are reviewed, and it is argued that a wide assortment of studies has consistently revealed cognitive differences between suicidal and nonsuicidal individuals that are not attributable to depth of depression or degree of psychopathology. Some of the specific observed tendencies of suicidal patients are discussed, including cognitive rigidity, dichotomous thinking, ineffective problem solving, a view of suicide as a desirable solution, hopelessness, and cognitive distortions. Possible interventions for use with suicidal patients are suggested. (63 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)     

Correlates of suicidal behavior in a juvenile detention population

The present study identifies the correlates of current suicidal ideation and past suicide attempt among 555 adolescents in a county juvenile detention center. Suicidal behavior in delinquent boys was generally associated with depression and decreased social connection, whereas suicidal behavior in delinquent girls was associated with impulsivity and instability. Current ideation was most significantly associated with current depression. In multivariate analyses, past attempts were associated with suicidal ideation and ineffective coping for males, with major life events and impulsivity for females, and with not residing with at least one biological parent prior to detention for both males and females.     

Self-reported suicidal ideation in adolescent psychiatric inpatients.

In an investigation of the psychosocial correlates of suicidal ideation in adolescent inpatients, the Beck Scale for Suicide Ideation (BSI) was administered to 108 inpatients between 12 and 17 yrs of age who were diagnosed with mixed psychiatric disorders. A series of multiple regression analyses that controlled for gender, ethnicity, age, diagnosis of a mood disorder, and a history of a past suicide attempt were then used to examine the relationships of the Beck Depression Inventory, Anxiety Inventory, and Hopelessness Scale (BHS) with the BSI. Regardless of the series, the BHS contributed unique variance to the explanation of the BSI scores. The results are discussed as supporting the use of the BSI with adolescent inpatients and indicating that hopelessness is related to suicidal ideation when depression is controlled for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cluster analysis of MCMI scores of suicidal psychiatric patients: four personality profiles

Millon Clinical Multiaxial Inventory (MCMI) scores from 299 suicidal psychiatric outpatients were cluster analyzed in hopes of identifying clinical subgroups and deriving specific treatment indications. The analysis revealed four personality profiles: Negativistic/Avoidant/Schizoid, Avoidant/Dependent/ Negativistic, Antisocial, and Histrionic/Narcissistic. This grouping was validated by examining demographics, diagnoses, and scores on several psychometric scales. Results showed few differences in demographics, diagnosis, or intelligence, but significant differences in depression severity, hopelessness, anxiety, problem-solving self-appraisal, and alcohol abuse. Implications for tailoring interventions for subtypes of suicidal patients are discussed.     

Toward an animal model of Type A behavior.

Attempted to differentiate behaviors of Mongolian gerbils analogous to Type A (coronary-prone) and Type B (non-coronary-prone) human behavior. Preliminary classification of 20 Ss was based on performance on differential reinforcement of low rates 20-sec and 60-sec schedules. To retain their preliminary classification, Type A and Type B Ss were required to be dominant and subordinate, respectively, in matches with Ss of opposite behavioral classification. Ss that exhibited Type A timing won significantly more dominance matches than did Type B Ss. Incidence rates of Type A and Type B behavior in the 2 selectively bred generations were significantly greater than frequencies in the original stock. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Possible association of a polymorphism of the tryptophan hydroxylase gene with suicidal behavior in depressed patients

OBJECTIVE: This study was designed to test the hypothesis that serotonin-system-related genes may be correlated with suicide risk. METHOD: Fifty-one unrelated Caucasian inpatients with major depression, with or without a history of suicidal acts, were genotyped for a biallelic polymorphism at the tryptophan hydroxylase locus. RESULTS: The less common tryptophan hydroxylase U allele occurred with greater frequency in the patients who had attempted suicide. A logistic regression analysis confirmed an association between tryptophan hydroxylase genotype and lifetime history of suicide attempts. CONCLUSIONS: Serotonergic-system-related genes may influence the risk of suicide in persons with major depression.     

Problem-solving behavior in suicidal adolescents.

Attempted to evaluate the assumption that suicidal behavior in adolescents is linked to diminished problem-solving capacity. The wais arithmetic subtest and rokeach's map reading problems test were administered to 13 suicidal, 13 psychiatric but nonsuicidal, and 13 normal adolescents. It was found that the suicidal group made significantly lower arithmetic subtest scores and failed the map test problems more often than the psychiatric and normal ss. It is concluded that the assumption of diminished problem-solving capacity in suicidal adolescents is correct. (24 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggressive behavior of psychiatric patients among geriatric population

The effects of protein supplements and culture dish type on in vitro fertilization (IVF) and embryo development in culture were examined in the domestic cat. In Experiment I, follicular oocytes were fertilized and cultured in either 1) modified Earle's balanced salt solution, designated MK-1, supplemented with one of the following: 10% human serum (HS), 10% FCS or 0.4% BSA, or 2) Medium 199 (M-199) supplemented with 10% FCS. Fertilization rates were lower (P < 0.01) in MK-1 + BSA (74.4%), MK-1 + FCS (56.1%), and M-199 + FCS (51.4%) than in MK-1 + HS (94.7%). A greater (P < 0.01) percentage of blastocysts was obtained in MK-1 + HS (50.0%) than in other treatment groups (range, 4.3-17.2%). In Experiment II, the effect of dish type (tissue culture dish, TCD, versus suspension culture dish, SCD) on embryo development was evaluated in MK-1 supplemented with either HS or BSA. Significantly higher proportions of IVF-derived embryos developed to blastocysts at 120 and 144 hr post-insemination, respectively, when cultured in HS/SCD (47.2 and 71.7%) than in BSA/SCD (11.4 and 27.3%) or BSA/TCD (10.4 and 25.0%). At 120 hr post-insemination, there was a lower (P < 0.01) percentage of blastocysts in HS/TCD (22.2%) than in HS/SCD. In Experiment III, six embryos per cat were transferred to the uterine horns of 17 recipients at 144 hr after hCG treatment. Five of 7 recipients which received late morulae cultured in MK-1 + BSA (SCD) for 120 hr became pregnant (71.4%). Eight of 10 recipients which received early blastocysts cultured in MK-1 + HS (SCD) for 120 hr became pregnant (80.0%). We conclude that MK-1 containing HS is highly beneficial for overcoming the in vitro developmental block of IVF-derived feline embryos and increasing the success rate of IVF/ET.     

Conforming behavior of psychiatric and medical patients.

"A group of ten non-psychotic psychiatric patients in the open ward of a general hospital was compared with seven medical patients without disabling psychiatric symptoms, with respect to the variability of their judgments of the autokinetic phenomenon… . The results indicated that neurotic Ss were consistently more variable than nonneurotic Ss in their judgments and were less affected by the group influence." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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     

Toward a cognitive process model of ethnic/racial biases in clinical judgment.

The purpose of the present article is to discuss approaches to the development of cognitive process models of misdiagnosis of African Americans, with particular emphasis on structured clinical interviews. Two basic approaches to cognitive process models are discussed. The first is cognitive bias based on prototype models of information processing. The second approach involves using the structured clinical interview to see how and when the decision-making process may be flawed, or where cognitive shifts are made in considering one diagnosis over another. Although routine training in structured clinical interviews may nullify cognitive biases associated with clinician judgment, it does not address cultural biases in the diagnostic system. It is concluded that a comprehensive approach to training in clinical decision making for mental health professionals is needed which include courses in the administration of the Structured Clinical Interview for DSM-IV, sociocultural case formulation, and cross-cultural sensitivity in making psychodiagnostic judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Toward a task analysis of assertive behavior

Conceptualized assertiveness problems in terms of a task analysis of the topography of competent responding. 47 male and 54 female undergraduates who ranged from extremely nonassertive to highly assertive (according to their scores on the Conflict Resolution Inventory) responded to 3 sets of situations requiring refusal of an unreasonable request. Content knowledge of an assertive response, delivery of the response under 2 conditions, heart rate, self-perceived tension, and the incidence of positive and negative self-statements were assessed. Differences on these variables between low-assertive (LA), moderate-assertive (MA), and high-assertive (HA) groups were analyzed to determine the nature of the response deficit in nonassertive Ss. LA Ss differed from MA and HA Ss on role-playing assessments requiring them to deliver an assertive response, but they did not differ from MA and HA Ss on their knowledge of a competent response or on hypothetical delivery situations. No significant differences in heart rate were observed between LA, MA, and HA Ss; however, higher self-perceived tension was found in LA compared to MA and HA Ss. A greater number of negative and fewer positive self-statements were reported by LA compared to MA and HA Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of clinical pharmacists on psychiatric patients

BACKGROUND: Studies of population biology are scarce in Mediterranean striped dolphins (Stenella coeruleoalba) mostly because of the lack of samples. Until now, studies of physical maturity, growth, and development of the flipper bones were not available for this species in the Mediterranean. METHODS: The osteological features and metric characters of the pectoral limbs of Mediterranean striped dolphins were analyzed with radiological techniques. Measurements were made directly on the radiographic films. RESULTS AND CONCLUSIONS: We found five carpal bones arranged in a proximal row of three and a distal row of two, although one or two additional osseous elements were occasionally observed. The phalangeal formula (excluding metacarpals) was established as 1-2:8-9-10:6-5-7:3-2:1-2. In metacarpals, epiphyseal ossification centers matured at the same time at both ends. As a general rule, the ossification of the epiphyses in the flipper bones showed a decreasing gradient in the proximodistal direction, confirming the pattern previously described in other species. Phalangeal epiphyses were not useful as indicators of skeletal maturity, and grading epiphyseal maturation of the distal radius and ulna is proposed as the more straight-forward and precise method for assessing bone maturation. In females, maturity of the flipper was achieved between 5 and 6 years of age and 160-175 cm of body length, whereas this maturation occurred between 8 and 9 years of age and 170-181 cm in length in males. Prediction of gender through examination of flipper structure was not feasible.     

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)     

Toward a model of neuropsychological activity

The main purpose of this research was to establish the intercorrelations existing among different psychological and neuropsychological test scores in a normal and homogeneous population. A second purpose was to attempt further step in the component analysis of cognitive activity measured by means of neuropsychological tests. A comprehensive neuropsychological test battery was assembled and individually administered to a 300-subject sample, aged 17-25 year-old. All of them were right-handed male university students. The battery included some basic neuropsychological tests directed to assess language, calculation abilities, spatial cognition, praxic abilities, memory, perceptual abilities, and executive functions. In addition, the Wechsler Adult Intelligence Scale was administered. Forty-one different scores were calculated. Correlations among the different test scores were analyzed. It was found that some of the tests presented a quite complex intecorrelation system, whereas other tests presented few or no significant correlations. Mathematical ability tests and orthography knowledge represented the best predictors of Full Scale IQ. A factor analysis with varimax rotation disclosed five factors (verbal, visuoperceptual, executive function, fine movements, and memory) accounting for 63.6% of the total variance. Implications of these results for a neuropsychological model about brain organization of cognition were analyzed.     

Neurobehavioral approach to classification of psychiatric patients using a competency model.

Performed Q-type factor analyses on 25 neuropsychological variables for 3 samples of right-handed adult psychiatric patients to test the hypothesis that degree and type of impairment are substantially independent of psychiatric status. Ss included an initial sample of 218 Ss, a within-laboratory replication sample of 175 Ss, and a cross-laboratory, cross-national replication sample of 102 Ss. Each S was administered a battery of tests, including the WAIS, MMPI, Halstead-Reitan Neuropsychological Test Battery, and Wechsler Memory Scale. Factor analysis classified 71% of Ss into 6 groups with strong within- and across-laboratory replications. Each group had a unique profile of competencies and deficits that was independent of psychiatric status with the exception of a group comprised primarily of young, poorly educated males with histories of learning disability and drug abuse. It is concluded that a classification system with associated treatment interventions based on patient's profile of competencies and deficits would be more useful in treatment planning than a system based on traditional nosology. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)