An empirical study of the psychodynamics of suicide: A preliminary report

Preliminary results from a study of psychodynamic constructs are presented based on data from inpatients following a suicide attempt. The study examines the association between four psychodynamic constructs, severity of suicidal intent, and severity of depressive symptomatology in a sample of hospitalized suicide attempters. Higher levels of suicidal intent were associated with less differentiated self and object representations and less emotional investment in relationships. More severe depressive symptoms in suicide attempters were correlated with more self‐targeted anger; less eternally directed anger, higher levels of shame and guilt, more affectively negative views of relationships, greater use of maladaptive and self‐sacrificing defenses, and more impaired reality testing. These findings offer some preliminary empirical support for the validity of psychodynamic theories of suicidal behavior. Depression 4:89–91 (1996). © 1997 Wiley‐Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106104/1/9_ftp.pd

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Abstract The current study aims to further our understanding of the applicability of the transtheoretical model (TM) to intimate partner violence (IPV), with particular focus on mental health symptoms (depression, posttraumatic stress disorder symptomatology, suicidal ideation) in a sample of lowincome African American women seeking medical services at an inner city emergency department. Results revealed that of the 121 abused African American women, the majority (95%) were in the precontempla-tion and contemplation stages of the change process. Further, contrary to predictions, bivariate analyses revealed those at further stages of change endorsed more severe mental health symptoms. However, a multivariate analysis of variance examining differences in level of mental health symptoms between women high and low on stages of change was inconclusive due to the small number of women at the higher stages of the TM model. These findings contribute to the growing body of literature supporting the TM as applied to IPV. Results are discussed in terms of applicability to intervention design. Keywords intimate partner violence; African American women; transtheoretical model The transtheoretical model (TM), also known as the stages of change model, describes an individual's readiness to change behavior. The TM suggests that to make a successful behavior change, individuals must go through a process of evaluating and increasing their readiness to change, ultimately making the change and maintaining the behavior. The TM conceptualize

Suicide Prevention

36th Annual Grimes Lectur

Utilization of Services by Abused, Low-income African-American Women

BACKGROUND: Little is known about health care and service utilization patterns among low-income African-American women, particularly those who report intimate partner violence (IPV). OBJECTIVES: (1) Identify utilization patterns among low-income African-American women. (2) Demonstrate utilization differences by IPV status. PARTICIPANTS: One hundred and fifty-three African-American women from medical care clinics at a large inner-city public hospital. DESIGN: Case–control study. Predictor variable IPV assessed by the Index of Spouse Abuse. Outcome variables, health care, and service utilization, determined using the Adult Service Utilization Form. RESULTS: Of the 153 participants, 68 reported high IPV levels. The mean age was 32 years, majority were poor and unemployed, and 15.7% were homeless. The overall utilization rates were low. When controlled for homelessness and relationship status, high IPV levels were associated with greater psychiatric outpatient utilization. We found differences in the use of other medical or community services by IPV group. CONCLUSIONS: Women reporting high IPV levels are more likely to receive mental health services than women reporting low IPV levels, but may not have access to other needed services. Primary care providers should assess the mental health, legal, and social service needs of abused women, which will facilitate receipt of services

Daily Hassles and Suicide Ideation in African-American Female Suicide Attempters: Moderating Effect of Spiritual Well-Being

Suicide risk is increased for previous suicide attempters, who may be vulnerable to exacerbating factors such as daily hassles; yet, individual-level, adaptive characteristics may ameliorate risk. We examined the influence of daily hassles on suicidal ideation and the moderating role of spiritual well-being and its subscales of religious and existential well-being. In our cross-sectional study, 148 African-American female suicide attempters were recruited from a large, urban hospital and completed the Survey of Recent Life Events, Spiritual Well-Being Scale, and Beck Scale for Suicide Ideation. Religious and existential well-being moderated the association between hassles and suicidal thoughts; this relationship was weaker for individuals with greater levels of spiritual well-being. Historically, spiritual beliefs have been important to the African-American community and their promotion may effectively prevent additional thoughts of suicide by attempters experiencing hassles of daily life

Spiritual Well-Being and Depressive Symptoms in Female African American Suicide Attempters: Mediating Effects of Optimism and Pessimism

Spiritual well-being is a well-established predictor of mental health, yet the potential mechanisms of this association are relatively unexplored. We examined the influence of spirituality, including religious and existential well-being, on depressive symptoms, and the potential mediating effect of optimism and pessimism, in a sample of 66 African American female suicide attempters. Participants were recruited from a large, urban hospital and completed the Spiritual Well-Being Scale, Life Orientation Test-Revised, and the Beck Depression Inventory-II. The association between spiritual well-being and depressive symptoms was mediated indirectly through both optimism and pessimism; greater religious and existential well-being was related to more optimism, and less pessimism and, in turn, to fewer depressive symptoms. Historically, spiritual well-being has been important to the African American community, and its beneficial effects on mental health might be explained, in part, by their effect on cognitive-emotional functioning