A Review of: “Responding to Loss: A Resource for Caregivers by Adolf Hansen”

This study evaluated gender differences on the Reasons for Living Inventory (RFL) specifically among older adults, a population known to have the highest suicide rate among all age groups, with older men being disproportionately at risk. Community-dwelling women (n = 175; M age = 69.0 years; 81% Caucasian) and men (n = 145; M age = 69.5 years; 76% Caucasian) completed the RFL. Results showed no significant gender differences on the RFL subscales and the total score. The rank order of the subscales was also the same for older men and women. An implication of these findings is that the robust gender differences on the RFL found among younger individuals appear to diminish with advancing age, although it is unclear to what extent older men improve in the reasons for staying alive or older women decline in their reasons for staying alive.     

An exploration of gender differences on the reasons for living inventory among older adults

This study evaluated gender differences on the Reasons for Living Inventory (RFL) specifically among older adults, a population known to have the highest suicide rate among all age groups, with older men being disproportionately at risk. Community-dwelling women (n = 175; M age = 69.0 years; 81% Caucasian) and men (n = 145; M age = 69.5 years; 76% Caucasian) completed the RFL. Results showed no significant gender differences on the RFL subscales and the total score. The rank order of the subscales was also the same for older men and women. An implication of these findings is that the robust gender differences on the RFL found among younger individuals appear to diminish with advancing age, although it is unclear to what extent older men improve in the reasons for staying alive or older women decline in their reasons for staying alive.     

Additive interactions between sex and forced sexual intercourse victimization on depressive symptoms and suicidality: Youth risk behavior survey 2001–2017

BackgroundAdolescents who have been forced to have sexual intercourse have higher rates of depressive symptoms and suicidality.PurposeThis research investigated whether the association between adolescent forced sexual intercourse victimization and depressive symptoms or suicidality varies significantly by sex.MethodThis secondary analysis pooled cross-sectional data from the Youth Risk Behavior Survey 2001 through 2017 (N = 132,580) using R to estimate adjusted risk differences and additive interactions.FindingsResults show an extremely high prevalence of depressive symptoms and suicidality among adolescents who experience forced sexual victimization. This association is significantly higher among females for depressive symptoms, but significantly higher among males for suicide attempt or suicide attempt requiring treatment.Resultsalso showed that approximately 40% of both males and females who attempted suicide requiring treatment also had a history of forced sexual intercourse victimization.DiscussionThese findings highlight the importance of screening for sexual victimization, depression and suicidality among adolescents.     

NEWS AND NOTES

An online questionnaire (n = 301) was conducted to analyze the cross-cultural influence of the use of suicide bulletin board systems. Factor analysis demonstrated that participants had two types of motives: the constructive motive of mutual help and the destructive motive of suicide preparation. The results showed that suicidal thoughts did not worsen with suicide bulletin board systems usage, and there is no difference in the demographic data, motives of the participants, and the effects of the suicide message boards between Japan and Germany.     

Rumination and Hopelessness as Mediators of the Relation Between Perceived Emotion Dysregulation and Suicidal Ideation

The present study examined whether particular emotion dysregulation dimensions were associated with suicidal ideation through their effects on ruminative thinking and hopelessness. Emerging adults (ages 18–25) with (n = 32) and without (n = 111) a suicide attempt history completed an emotion dysregulation measure at baseline and measures of rumination, hopelessness, depressive symptoms, and suicidal ideation 2–3 years later. Multiple suicide attempters (n = 15) were distinguished by elevated scores on emotion dysregulation dimensions involving impulse control difficulties and inability to access effective emotion regulation strategies. The Strategies dimension, assessed at baseline, was significantly associated with both rumination and hopelessness at follow-up, and with higher ideation at follow-up. Rumination and hopelessness mediated the relation between Strategies and ideation, even when adjusting for depressive symptoms. Perceived inability to access emotion regulation strategies may increase vulnerability to suicidal ideation through its effects on rumination and hopelessness.     

Emotion Dysregulation and Vulnerability to Suicidal Ideation and Attempts

This study investigated the predictive utility of a six-dimensional conceptualization of emotion dysregulation for suicidal ideation, as well as its ability to distinguish among individuals with differing histories of suicidality. Young adults (N = 96) with current suicidal ideation but no suicide attempt history (n = 17), a history of a single (n = 20) or multiple attempts (n = 17), or no current ideation/no past attempts (n = 42) completed measures of emotion dysregulation, suicidal ideation, depression, hopelessness, and a diagnostic interview. Multiple suicide attempters differed from participants with no suicidal ideation/no past attempts on two emotion dysregulation dimensions—nonacceptance of emotional responses and perceived limited access to emotion regulation strategies. After adjusting for depression symptoms and the presence of a mood or anxiety diagnosis, limited access to emotion regulation strategies significantly predicted current suicidal ideation, a relation that was found to be statistically mediated by hopelessness.     

Deliberate self-harm among younger and older adults

This study examined self-harming behaviors among younger and older adults who completed the Self-Harm Inventory (SHI). A 2 (age group) × 2 (gender) analysis of variance showed a significant main effect for age such that younger adult students (M = 3.42, SD = 3.86) had higher SHI total scores than community-dwelling older adults (M = 1.58, SD = 2.35). Younger adults endorsed “Yes” responses significantly more frequently than older adults on 13 of 22 items. Future research should examine specific behaviors of older adults who self-harm more frequently and explore relationships between self-harming behaviors and other risk and resiliency factors for elder suicide.     

Effectiveness of an interprofessional education model based on the transtheoretical model of behaviour change to improve interprofessional collaboration

This study aimed to assess the effectiveness of an interprofessional education model (IPE) based on the transtheoretical model to improve the participants’ interprofessional collaborative practice. The study was conducted in Iran using a controlled before-and-after study design. The participants (n = 91) were the residents of emergency medicine and nurses of the emergency units from two teaching hospitals affiliated to Iran University of Medical Sciences. The participants in the intervention group (n = 40) were 22 residents and 18 nurses. The control group (n = 51) consisted of 20 residents and 31 nurses. The participants were classified based on their stage of readiness to change. The interventions were two-day workshops for each stage (i.e., attitude and intention). We used the Interprofessional Collaborator Assessment Rubric (ICAR) to assess the effectiveness of the developed model. The interprofessional collaboration of the participants in the intervention and control groups was assessed at four time points before and after the intervention in the real emergency unit environment. Student’s t-test and repeated measures analysis of variance (RM-ANOVA) were used to analyse the data. We used partial eta-squared (η²) for effect size calculations. The mean values of ICAR scores in the intervention and control groups were 95.63 ± 19.14 and 89.19 ± 16.11 before the intervention. The mean values of ICAR scores at 3 months after the intervention were 99.82 ± 22.32 and 88.29 ± 16.87 in the intervention and control groups, respectively. After 6 months, the mean values of ICAR scores of the intervention and control groups were 98.6 ± 23.40 and 87.98 ± 16.01, respectively. The results showed that the intervention had a medium educational effect size (partial η² = 0.06) on performance of the participants. Our results showed that an IPE model that is tailored to the learners’ stage of readiness to change improves interprofessional collaboration in the participants. The developed model could be applied for improving interprofessional collaborative performance in other IPE programmes.     

Rape: The roles of outcome expectancies and hypermasculinity

Outcome expectancies regarding coercive sexual behavior of male undergraduates were investigated to understand their possible association with self-reported past and future coercive sexual behavior and hypermasculine personality styles. Subjects indicating lower negative outcome expectancies regarding rape reported a greater history of coercive sexual behavior and higher future likelihood of raping, and were more likely to fit a hypermasculine personality pattern. Regression analysis revealed that a hypermasculine personality style, self-reported likelihood of raping, and the interaction between rape outcome expectancies and hypermasculine personality best predicted a history of sexual coercion. Implications for future research and primary prevention are discussed.     

GENDER,AIDS, AND BEREAVEMENT: A COMPARISON OF WOMEN AND MEN LIVING WITH HIV

The purpose of this study was to examine the bereavement experience, psychiatric morbidity, and suicidality in bereaved men and women living with HIV. HIV + women (n = 31) who reported a loss in the recent 12 months were case matched to bereaved HIV + men (n = 62) on the basis of lifetime histories of major depression. Study participants were examined for grief reactions, psychiatric morbidity, mood symptomatology, and suicidality using the Texas Revised Inventory of Grief Revised, Structured Clinical Interview for DSM-III–R, the Hamilton Depression and Anxiety Rating, and the Diagnostic Interview Schedule for Suicide. Bereaved HIV + women presented with intensified bereavement responses, a higher prevalence of current generalized anxiety disorder, and elevated thoughts and gestures of suicide and when compared to HIV + men. In conclusion, bereaved women living with HIV may be at increased risk for bereavement complicated with psychiatric morbidity and thoughts of suicide. It is critical that adequate mental health support services be available to this growing risk group of bereaved individuals.     

Think Yourself Thin: Concern for Appropriateness Mediates the Link Between Hypnotizability and Disordered Eating

There has been no research examining why people with disordered eating tend to be highly hypnotizable. The authors examine the hypothesis that concern for appropriateness mediates the association between hypnotizability and disordered eating. Fifty participants aged 15 to 30 completed the Eating Attitudes Test–26 (EAT–26) and the Concern for Appropriateness Scale (CAS) and were administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C). EAT–26 scores predicted CAS scores (β = 0.24, p < .001), CAS scores predicted SHSS:C scores (β = 0.38, p < .001), and the mediation model was significant (Sobel Test; R² = .24, z = 2.54, p < .01). Individuals with problematic eating attitudes may tend to be more hypnotizable than those with normal eating attitudes at least in part because they are highly influenced by interpersonal messages.     

Clinical decision making regarding suicide risk: Effect of patient and clinician age

To ascertain how patient age influences suicide risk assessment, clinicians (N = 262) read an ambiguous vignette about Bill (aged either 39 or 79 years old) and subsequently rated Bill’s suicide risk and hospitalization needs. Suicide-risk ratings varied greatly and young clinicians rated Bill’s suicide risk and hospitalization needs higher when he was elderly (79 years old); whereas, older clinicians rated Bill’s suicide risk and need for hospitalization higher when he was younger (39 years old). The interaction between patient and clinician age may reflect a “similarity” bias, such that clinicians perceive those who are different (i.e., younger or older) to be at elevated risk.     

A two-year review of suicide ideation assessments among medical,nursing, and pharmacy students

Suicide is the 10th leading cause of death in the U.S. and has increased in prevalence during the past 15 years. Patients who attempt suicide are more likely to have contact with their primary care provider than a mental health provider in the month before attempting suicide, highlighting the need for competency in suicide ideation (SI) assessment. The Communications Skills for Health Professionals is an interprofessional course involving first-year medical, nursing, and pharmacy students. Specific instruction regarding assessment of SI was delivered through an online module and later practiced by students with standardized patients (SP). A final Objective Structured Clinical Examination featured an SP with depression, but without SI, though an assessment of SI was indicated. Three hundred fifty six interviews were reviewed and 55.1% (196/356) of students assessed for SI. Across professions, 65.5% (93/142) of medical students, 52.5% (32/61) of nursing students, and 46.4% (71/153) of pharmacy students performed an assessment. Medical students’ SI assessment was highest across the groups (p = 0.001), while pharmacy students’ SI assessment was lowest (p = 0.004). Results suggest that additional educational strategies should be developed and implemented to increase SI assessment performance in all professions, but especially in pharmacy students.     

A novel determination of energy expenditure efficiency during a balance task using accelerometers. A pilot study

The objectives of this study are to determine the displacement of the center of pressure (CoP) and its association with the spectral energy density of the acceleration required for the maintenance of postural balance in different standing positions in healthy participants using design observational and setting laboratorial studies. Participants were 30 healthy university students aged between 18 and 32 years old (mean [M] ± standard deviation [SD] = 21,57 ± 3,31 years). Triaxial accelerometer and a pressure platform were used in order to obtain energy spectral density and CoP sway measurements during four balance tasks. Statistically significant differences were found for anteroposterior (p = 0.002) and mediolateral (p = 0.009) CoP displacement between the conditions eyes closed and stable surface and the conditions eyes closed and unstable surface. A statistically significant correlation was also observed between Z-axis (anterior-posterior) of the accelerometer and mediolateral axis of the CoP (r = 0.465; p = 0.01) and between Y-axis accelerometer (mediolateral) and displacement of the CoP in the anteroposterior axis (r = 0.413; p = 0.023). Spectral energy density appears to be associated with the displacement of CoP in healthy participants.     

Comparison of neointimal hyperplasia and peri-stent vascular remodeling after implantation of everolimus-eluting versus sirolimus-eluting stents: intravascular ultrasound results from the EXCELLENT study

This study was designed to compare neointimal hyperplasia and peri-stent arterial remodeling after implantation of everolimus-eluting stent (EES) versus sirolimus-eluting stent (SES) using intravascular ultrasound (IVUS). The study population was a subgroup of 278 patients from the EXCELLENT trial, a randomized study comparing EES to SES in de novo coronary artery lesions (total n = 1,443, 3:1 randomization) who underwent post-PCI and 9-month follow-up IVUS evaluation. There were 209 patients in the EES group and 69 in the SES group. Baseline clinical and angiographic characteristics were similar between the two groups except for age and target lesion locations. At 9 months, percent neointimal volume obstruction did not differ between EES and SES (2.6 ± 4.0 % vs. 2.5 ± 4.8 %, p = 0.814). However, the relative change in the vessel (4.3 ± 13.7 % vs. 8.8 ± 18.6 %, p = 0.030) and plaque volume index (4.2 ± 17.4 % vs. 10.5 ± 22.3 %, p = 0.016) of the stented segment from post-intervention to follow-up was significantly less with EES than with SES. In addition, positive peri-stent vascular remodeling defined as an increase in vessel volume index >10 % (27.8 vs. 42.0 %, p = 0.027) and late acquired stent malapposition (LASM, 1.9 vs. 15.9 %, p < 0.001) were observed less frequently with EES than SES. EES and SES were similarly effective in reducing neointimal hyperplasia. However, positive peri-stent vascular remodeling and LASM occurred less frequently with EES than SES.     

Suicidal and Online: How Do Online Behaviors Inform Us of This High-Risk Population?

To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.     

Self-efficacy perceptions of interprofessional education and practice in undergraduate healthcare students

Self-efficacy is an individual’s perception of their ability to be successful in a given endeavour and it has been shown to have an important role in successful university education and clinical performance of healthcare workers. This article examines the self-efficacy beliefs of undergraduate healthcare students (n = 388) for the skills required for interprofessional education and interprofessional collaboration. The students were enrolled at an Australian university from the disciplines of public health, social work, and paramedic practice. The Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale, which is a valid and reliable scale, was used to determine the self-reported perceptions of self-efficacy in this cohort. The 16-item scale was developed for use with medicine and other healthcare professional undergraduate students. Student t-tests were used to compare scores between males and females, with one-way ANOVAs used to explore SEIEL scores across disciplines and year level. A significant difference was found between genders for the scores on SEIEL subscale 2 “Interprofessional evaluation and feedback” (p = 0.01) with the male mean being 2.65 units higher (Cohen’s d = 0.29). There was also a significant gender difference for the overall SEIEL scale (p = 0.029) with the male mean being 4.1 units higher (Cohen’s d = 0.238). No significant gender differences were demonstrated for the subscale “Interprofessional interaction.” Neither subscale demonstrated significant differences between healthcare disciplines or course year. Further investigation is required to explore the reasons for the outcomes of this study. With the increasing importance of interprofessional education and practice within healthcare, it would also appear reasonable to consider further research into the development and support of student self-efficacy for the skills required for interprofessional education and interprofessional collaboration within healthcare curricula.     

Experiential Avoidance Mediates the Relationship Between Sexual Victimization and Psychological Symptoms: Replicating Findings with an Ethnically Diverse Sample

Studies have found experiential avoidance mediates the relationship between sexual victimization and psychological symptoms; however, this work has been conducted primarily with Caucasian samples. The purpose of this study was to examine whether this model is applicable to a more ethnically diverse sample. Structural equation modeling was used to test a model in which avoidance mediated the relationship between sexual victimization and symptoms of post-traumatic stress disorder and depression. The model was tested simultaneously in a sample of ethnic minority women (n = 190) and in a sample of Caucasian woman (n = 473), with parameter estimates specifying the relationships among the variables fixed to be equal in both samples. The results indicated that the model was an excellent fit for the data, and support the hypothesis that sexual victimization influences depression and post-traumatic stress disorder via the same mechanisms in both Caucasian and minority samples. Findings add to the growing literature suggesting that chronic experiential avoidance may be a maladaptive process underlying the relationship between sexual victimization and negative psychological outcomes.