A Multidimensional Theory of Suicide.

BACKGROUND: Theory is the foundation of science; this is true in suicidology. Over decades of studies of suicide notes, Leenaars developed a multidimensional model of suicide, with international (crosscultural) studies and independent verification. AIM: To corroborate Leenaars's theory with a psychological autopsy (PA) study, examining age and sex of the decedent, and survivor's relationship to deceased. METHOD: A PA study in Norway, with 120 survivors/informants was undertaken. Leenaars' theoretical-conceptual (protocol) analysis was undertaken of the survivors' narratives and in-depth interviews combined. RESULTS: Substantial interjudge reliability was noted (κ = .632). Overall, there was considerable confirmatory evidence of Leenaars's intrapsychic and interpersonal factors in suicide survivors' narratives. Differences were found in the age of the decedent, but not in sex, nor in the survivor's closeness of the relationship. Older deceased people were perceived to exhibit more heightened unbearable intrapsychic pain, associated with the suicide. CONCLUSION: Leenaars's theory has corroborative verification, through the decedents' suicide notes and the survivors' narratives. However, the multidimensional model needs further testing to develop a better evidence-based way of understanding suicide.

Trait gratitude and suicidal ideation and behavior: an exploratory study.

BACKGROUND: Despite the progress of positive psychology, current knowledge regarding suicide protective factors is limited. Trait gratitude (a tendency to experience gratitude in daily life) may protect against suicidal ideation and behavior. AIMS: The study tested a model of causal effects among gratitude, religiosity, reasons for living, coping, and social support as predictors of suicidal ideation, suicide threats, and suicide attempts after controlling for depression and stressful life events. METHOD: A sample of 165 college students were administered measures of gratitude, religiosity, reasons for living, social support, coping skills, stress, and depression. The study assessed lifetime and current suicidal ideation as well as lifetime suicide threat and attempt. RESULTS: Both gratitude and religiosity, along with social support, coping skills, and reasons for living, correlated negatively with prior suicidal ideation, but not with prior attempted suicide. After controlling for risk factor (depression and stress), the impact of gratitude and religiosity was no longer statistically significant. CONCLUSION: Further research could help understand the role of positive emotions and human strengths, such as gratitude, in preventing and alleviating suicidal ideation and behavior.

IS THE SUICIDE RATE A RANDOM WALK?

The yearly suicide rates for the period 1933-2010 and the daily suicide numbers for 1990 and 1991 were examined for whether the distribution of difference scores (from year to year and from day to day) fitted a normal distribution, a characteristic of stochastic processes that follow a random walk. If the suicide rate were a random walk, then any disturbance to the suicide rate would have a permanent effect and national suicide prevention efforts would likely fail. The distribution of difference scores from day to day (but not the difference scores from year to year) fitted a normal distribution and, therefore, were consistent with a random walk.

Comparison of hospice use by European Americans, African Americans, and Latinos: a follow-up study.

This study investigated the rate of hospice use by Latinos and African Americans relative to their prevalence in the general population between 2004 and 2010 as a follow-up to a previous investigation. Archival data (N = 2625) were collected on patients' race/ethnicity, gender, marital status, length of stay in hospice, and reason for discharge. In contrast to previous findings, African Americans were more likely to utilize hospice services, but Latinos were less likely to use hospice services compared to the other groups. There were no differences among the racial/ethnic groups in terms of length of stay or disposition at termination. Strengthening efforts to reach a larger racial/ethnic representation in hospice programs may increase the rate of hospice use by some racial/ethnic groups but not others.

Family functioning and risk factors for disordered eating.

This study investigated whether any of seven factors of family dysfunction predicted five risk factors for developing eating disorders in young adult women. Participants completed demographic questions, the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) and the Setting Conditions for Anorexia Nervosa Scale (Slade & Dewey, 1986) online. Five stepwise multiple regressions evaluated whether FAD scores predicted any of the eating disorder risk factors. Unhealthy affective responsiveness predicted general dissatisfaction and social and personal anxiety, and unhealthy general functioning predicted adolescent problems. No FAD factors predicted perfectionism or weight control. These results confirm the importance of families' affective responsiveness and general functioning to the risk of developing eating disorders. However, the lack of relationship among problem-solving, communication, roles, affective involvement, or behavior control with any of the risk factors for eating disorders warrants further investigation.

Peak experiences of psilocybin users and non-users.

Maslow (1970) defined peak experiences as the most wonderful experiences of a person's life, which may include a sense of awe, well-being, or transcendence. Furthermore, recent research has suggested that psilocybin can produce experiences subjectively rated as uniquely meaningful and significant (Griffiths et al. 2006). It is therefore possible that psilocybin may facilitate or change the nature of peak experiences in users compared to non-users. This study was designed to compare the peak experiences of psilocybin users and non-users, to evaluate the frequency of peak experiences while under the influence of psilocybin, and to assess the perceived degree of alteration of consciousness during these experiences. Participants were recruited through convenience and snowball sampling from undergraduate classes and at a musical event. Participants were divided into three groups, those who reported a peak experience while under the influence of psilocybin (psilocybin peak experience: PPE), participants who had used psilocybin but reported their peak experiences did not occur while they were under the influence of psilocybin (non-psilocybin peak experience: NPPE), and participants who had never used psilocybin (non-user: NU). A total of 101 participants were asked to think about their peak experiences and complete a measure evaluating the degree of alteration of consciousness during that experience. Results indicated that 47% of psilocybin users reported their peak experience occurred while using psilocybin. In addition, there were significant differences among the three groups on all dimensions of alteration of consciousness. Future research is necessary to identify factors that influence the peak experiences of psilocybin users in naturalistic settings and contribute to the different characteristics of peak experiences of psilocybin users and non-users.

Associations among aspects of meaning in life and death anxiety in young adults.

This investigation explored the relationship between two aspects of meaning in life, presence of meaning in life and search for meaning in life, and the fear of death and dying in young adults. A community sample of participants (N = 168) completed measures of meaning in life and death anxiety. A multivariate analysis of variance was performed using the search for meaning and presence of meaning as independent variables and fear of death and dying as dependent variables. Results indicated that only the search for meaning in life was significantly associated with fear of dying and death in young adults.

Associations among aspects of impulsivity and eating factors in a nonclinical sample.

OBJECTIVE: Impulsivity has been well documented as a factor in the behavior of eating-disordered populations and is likely to influence normal eating patterns as well. The current study attempted to clarify the relationship between the three elements of impulsivity (nonplanning, attentional, and motor) and the three factors of eating (cognitive restraint, disinhibition, and hunger) in a nonclinical sample. METHOD: Data were collected from a sample (N = 112) of volunteer participants from the community who answered two self-report instruments related to impulsivity (the Barratt Impulsiveness Scale, Version 11) and eating (the Eating Inventory). Partial correlations were performed on the data to control for age, sex, and education. Cognitive restraint did not correlate with any element of impulsivity. Disinhibition was positively correlated with both attentional impulsivity (r = .40, p < .001) and motor impulsivity (r = .32, p < .01). Attentional impulsivity was also positively correlated with hunger (r = .24, p < .05). DISCUSSION: The lack of association between cognitive restraint and impulsivity suggests that they are functionally distinct. Disinhibition is most closely associated with impulsivity, consistent with findings from clinical samples. Further clarification of the relationship between impulsivity and eating in nonclinical populations could facilitate a better understanding of the relationship between personality variables and normal eating behavior.

Practical recommendations for ethnically and racially sensitive hospice services.

Hospice providers have long understood that hospice services are disproportionately utilized by Caucasians compared with racial and ethnic minorities. In fact, it is clear that this disparity is increasing with time despite the development of literature that recommends making services more culturally sensitive and accessible to minority groups. This suggests a need for more concrete and practical recommendations to make hospice services accessible and amenable to minority groups. For implementation in hospice service organizations, standard recommendations require enhancement to increase outreach, improve understanding of cultural issues related to death and dying, improve communication with non-English speaking populations, and implement cross-cultural training programs. In addition, the self-awareness and ethnic identity of hospice workers themselves are elements of culturally sensitive care that frequently are overlooked when discussing hospice organizations. This article outlines some specific objectives for meeting the goal of improving hospice services for ethnic and racial minorities.

Executive personality traits and eating behavior.

Eating disorders, such as anorexia, bulimia, and binge eating disorder, commonly involve a dysregulation of behavior (e.g., a lack or excess of inhibition and impulsive eating patterns) that is suggestive of prefrontal dysfunction. Functional neuro-imaging studies show that prefrontal-subcortical systems play a role in eating behavior and appetite in healthy individuals, and that people with eating disorders have altered activity in these systems. Eating behavior is often disturbed by illnesses and injuries that impinge upon prefrontal-subcortical systems. This study examined relationships between executive functioning and eating behavior in healthy individuals using validated behavioral rating scales (Frontal Systems Behavior Scale and Eating Inventory). Correlations demonstrated that increased dysexecutive traits were associated with disinhibited eating and greater food cravings. There was also a positive association with cognitive restraint of eating, suggesting that increased compensatory behaviors follow disinhibited eating. These psychometric findings reinforce those of other methodologies, supporting a role for prefrontal systems in eating.

Comparison of hospice use and demographics among European Americans, African Americans, and Latinos.

The goals of this study were to compare the rate of use of hospice services and other relevant characteristics of European American, African American, and Latino hospice patients. Information on length of stay in hospice, marital status, age, disposition at termination, living situation, caregiver, referral source, and payment method was collected on patients who used hospice care in southern New Jersey between the years 1995 and 2001 (N = 1958). African Americans and Latinos were both found to use services at significantly lower rates than European Americans. In addition, African American use of hospice declined significantly during this time period, while European American use increased. Differences were also found among the groups in marital status, living situation, caregiver, referral source, and payment method. These differences highlight the need for hospice providers to recognize issues unique to minority groups. The reasons for these disparities need to be clarified by further research.