Suicidal behavior in African American individuals: current status and future directions.

Historically, the rates of completed suicide among African American individuals have been relatively low. However, the past 50 years have witnessed a significant rise in suicide rates among this population. In an effort to understand this trend, this article reviews relevant demographic data and empirical and clinical findings regarding the clinical presentations of suicidal behavior among African Americans across the life span. The major psychodynamic, psychosocial, and sociocultural theories offered as explanations for the incidence and nature of suicidal behavior among African Americans also are discussed. It is hoped that this systematic review will lead to more meaningful empirical investigations of the myriad factors associated with the unfortunate increase in suicidal behaviors in this population.

Erectile dysfunction in men with chronic medical illness.

This study examined interrelationships of psychosocial variables found in a psychological evaluation for erectile disorder in 75 male veterans with chronic medical illness. Patients whose partners participated in the evaluation were compared with those whose partners were not involved, and agreement on measures between patients and partners was examined. Finally, a principal components analysis was performed to assess the primary dimensions underlying the variance in mental health and sexual functioning variables. Five factors were identified, accounting for 65.5% of the variance. Results of these analyses are discussed in order to obtain an understanding of the interrelationship between behavioral, psychological, and interpersonal variables in the onset and course of sexual dysfunction.

An assessment of rates of psychiatric morbidity and functioning in HIV disease.

This study examined demography, rates of psychopathology, and functional impairment in HIV-seropositive women and men in a large, urban, public outpatient infectious disease clinic. Fifty-three percent of the women and 70% of the men met Structural Clinical Interview for DSM-III-R criteria for psychiatric disorders. Current mood disorders were the most frequent diagnoses, followed by psychoactive substance abuse/dependence disorders and psychotic disorders. Seventy-six percent of the women and 90% of the men had previous psychiatric histories, including 59% of the women and 55% of the men who had psychiatric histories prior to their knowledge of HIV seroconversion. Depressed subjects reported significant impairment in physical, social, and role functioning. Similarly, impairment in physical functioning was highly correlated with self-reported anxiety symptoms. These data suggest considerable past and current psychiatric comorbidity in HIV-infected individuals seeking medical care, and draw attention to the need for recognition and aggressive psychiatric treatment, particularly for those depressed and anxious patients with impaired functioning.

Psychopathology, family functioning, and cognitive style in urban adolescents with suicide attempts.

This study examined psychopathology, family functioning, and cognitive style in 121 African-American adolescents who attempted suicide. Group means suggested that these youths, when taken together, were not reporting significant psychological distress. However, after classifying the youths into three groups by level of depressive symptoms interesting findings emerged. Youth self-reports of depressive symptoms on the Children's Depression Inventory were associated with the presence of internalizing and externalizing disorders on the Youth Self-Report and Child Behavior Checklist, and with a maladaptive attributional style. Sixty-seven percent of participants classified their family types as maladaptive in terms of levels of cohesion and/or adaptability. In fact, the majority of adolescents and parents reported their families as disengaged. These findings are discussed from a culturally and developmentally sensitive framework which considers key demographic variables (race, socioeconomic status, age). Clinical implications are offered for individual and family interventions.

Psychopathology in urban female minority adolescents with suicide attempts.

This study examines the level of psychopathology in 53 African-American females who attempted suicide by ingestion. Parents completed a measure of adolescent psychopathology, and the youths completed measures of depression and psychopathology. Overall, the results suggested that these youths were not experiencing significant emotional distress. However, after classifying the youths into four groups by their self-reported level of depression, the incidence of parent- and youth-reported psychopathology varied. More significant levels of depression corresponded to significant internalizing difficulties, as reported by the adolescent, and myriad psychopathological difficulties, as reported by the parents. These results are discussed from a clinical perspective with a developmentally and culturally sensitive focus. Disposition decisions must consider the level of psychopathology reported by child and parent, the family's willingness to participate in outpatient treatment, and the degree to which the adolescent and her family acknowledge the significance of the suicide attempt.

A developmental analysis of the influence of body weight on the sociometry of children.

The influence of relative weight on sociometric nominations (liking and disliking) and sociometric ratings by first, third, and fifth graders was assessed. In terms of nominations, first grade overweight males, relative to other males and to overweight females, received fewer liking nominations. On the sociometric ratings, third grade overweight males were rated lower by other males. Ratings by females at each grade level, and by fifth grade males, were influenced by gender considerations and not by weight considerations. That is, boys rated boys higher than they rated girls, and girls rated girls higher than they rated boys, regardless of the child's weight status. Additional analyses demonstrated that these findings were not qualified by the weight of the child making the ratings. Thus, developmental evidence was found for less liking (but not disliking) of overweight peers among first and third grade males, while weight did not appear to influence the decisions of fifth graders. These results call into question the validity of a social stigma often assumed to be associated with overweight children.