Predicting Suicidal Behavior: Are We Really that Far Along? Comment on “Discovery and Validation of Blood Biomarkers for Suicidality”

A recent publication focused on biomarkers of future suicidal behaviors identifies several genes expressed in high-risk states among four samples. We discuss the implications of this study as well as the current state of research regarding biomarkers of suicidal behavior

The body grid as an assessment tool for body image

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Constructivist Psychology on 19 May 2017 available online: http://www.tandfonline.com/10.1080/10720537.2017.1320244The aim of this study was to analyze the body grid (BG) as an assessment tool for body image in a sample of patients with breast cancer, after surgery. We explored two measures of cognitive structure, percentage of variance accounted for by the first factor (PVAFF) and polarization, and we compared measures of body image and body self-esteem obtained by means of the BG with those obtained via a validated body image questionnaire. Our sample was composed of 23 patients (12 subjected to radical mastectomy, 11 subjected to conserving surgery) and 24 healthy controls. Participants were administered the BG and the Multidimensional Body Self Relations Questionnaire (MBSRQ). We analyzed the similarities between instruments using correlations and nonparametric tests. We have also provided two case studies to exemplify the use of the BG.  We found statistical differences in cognitive structure between patients and healthy controls. There were no differences between women subjected to mastectomy and women with breast conserving surgery in the level of PVAFF, but there were significant differences between them in the level of polarization. We found significant correlations between body image indices of both instruments, especially self-evaluated attractiveness (MBSRQ) and distance between real and ideal body (BG). We found similar distributions of these indices in all of the samples. We concluded that the BG provides useful information about body image. The results show that both instruments assess similar constructs. This suggests that the BG is a valid instrument for body image assessmen

Content categories system for body constructs applied to patients with mastectomy

Body image is a predictor of psychological adjustment to cancer and a risk factor for depression. Questionnaires to assess body image in cancer patients assume a preconceived concept of body image and do not reflect the patient's subjective experience. This study aims to develop a content categories system for analyzing body constructs in breast cancer patients from their own experience. Methods The sample comprised 542 constructs, from 23 patients subjected to surgery (12 mastectomy/11 breast-conserving surgery) and 24 controls. Participants were assessed with the Body Grid. Three independent judges coded the constructs elicited following a tentative categories system. Result Six categories appeared: Objective Appearance, Esthetics, Function, Strength, Energy and Emotions, with similar distribution in the samples. Objective Appearance, Esthetics and Emotions were the most used. The inter-rater agreement was very good. Conclusions These findings highlight the importance of knowing which thematic areas concern the most to each patient and the absent ones in their constructions, in order to focus psychotherapy on the developing of new meanings that allow a more integrated body imag

eHealth tools for assessing psychomotor activity in schizophrenia: A systematic review

Objective: Psychomotor abnormalities are relevant symptoms in the clinical presentation of schizophrenia, and assessing them could facilitate monitoring. New technologies can measure psychomotor activity objectively and continuously, but evidence on the topic is scarce. Our aim is to systematically review the existing evidence about eHealth tools for assessing psychomotor activity in patients diagnosed with schizophrenia. Method: We performed a systematic search of the PubMed and Embase databases and identified 15 relevant articles on eHealth tools for assessing psychomotor activity in schizophrenia. Results: eHealth devices accurately assessed psychomotor activity and were well accepted. Abnormalities in psychomotor activity helped differentiate between different subtypes of schizophrenia. Abnormal increases in psychomotor activity were correlated with acute presentations, while lower activity was associated with relapses, deterioration, and negative symptoms. Conclusion: Actigraphy is still the preferred eHealth device in research settings, but mobile applications have great potential. Further studies are needed to explore the possibilities of psychomotor monitoring and mobile health applications for preventing relapses in schizophrenia. eHealth could be useful for monitoring psychomotor activity, which might help prevent relapses.This study received grant support from the Instituto de Salud Carlos III (Grant/Award Number: ISCIII CM19/ 00026)

Life cycle and suicidal behavior among women

It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicideJ. Lopez-Castroman was supported by a Fundamental Foundation research grant for this stud

Borderline personality disorder: The challenge of crisis management

El manejo del trastorno límite de personalidad puede ser un reto para el clínico, especialmente en elservicio de urgencias hospitalarias, donde se hacen necesarias decisiones rápidas que deben ser ademáslas más beneficiosas y en conjunto con el paciente, favoreciendo su autonomía y participación en laresolución de la crisis.En este artículo pretendemos revisar el manejo de la crisis de una forma práctica y, basándonos enlas guías clínicas más recientes, proporcionar una serie de pautas a los clínicos que se enfrentan a estassituaciones para manejar adecuadamente las crisis con recomendaciones basadas en la evidencia cientí-fica que tenemos hasta ahora y claves para la valoración de la conducta suicida, que es uno de los motivosmás frecuentes por lo que estos pacientes acuden a los servicios de urgencias. Finalmente revisaremos losdiferentes manejos y encuadres, repasando las indicaciones de ingreso hospitalario, así como los objetivosdel mismo.Managing patients with borderline personality disorder can pose a substantial challenge for psychia-trists. This is especially the case when patients with this disorder are seen in the emergency room, asclinicians must make rapid decisions that balance clinical benefit and the will of the patient, fosteringtheir autonomy and participation.A review is presented in this article of the strategies for practical management of crises. Based on themost recent clinical guidelines, a series of insights are provided for facing these situations, includingrecommendations based on scientific evidence, as well as the key steps for assessing suicidal behaviour,which is one of the most frequent causes behind visits to the emergency department in this patientpopulation. Finally, a review is presented on the different management approaches and frameworks,analysing the indications and aims of hospital admission.Instituto de Salud Carlos III PI16/01852Delegación del Gobierno para el Plan Nacional de Drogas 20151073American Foundation for Suicide Prevention LSRG-1-005-1

La revisión sistemática de la relación indirecta entre la pertenencia social frustrada y la sensación de ser una carga en el suicidio

Joiner's Interpersonal-Psychological Theory of Suicide (IPTS) considers the interpersonal variables of low social belonging and the perception of being a burden on others as drivers of suicidal ideation. This study has sought to review the empirical evidence on this prediction. In all, 40 studies were found. The findings report a major mediator and moderator role of perceived burdensomeness (PB) and thwarted belongingness (TB) in the relationship between the propensity toward suicide and psychological, social, and environmental factors. As the theory predicts, expecting to find that the interaction of both of these variables would be more closely linked to suicidal ideation, this does not appear to have been fully supported, generally finding a greater significance when they were integrated into separate models. It seems that attributing other forms of relationship with suicide for the variables identified by Joiner would provide IPTS with greater empirical support.La teoría interpersonal psicológica del suicidio de Joiner considera las variables interpersonales de baja pertenencia social y la percepción de ser una carga para los demás como impulsores de la ideación suicida. Este estudio revisa la evidencia empírica sobre esta predicción. En total, se han encontrado 40 estudios. Los hallazgos descubren un importante papel mediador y moderador de la carga percibida y la pertenencia frustrada en la relación entre la propensión al suicidio y los factores psicológicos, sociales y ambientales. Como predice la teoría, esperando encontrar que la interacción de ambas variables estaría más estrechamente ligada a la ideación suicida, esto no parece haber sido totalmente respaldado, encontrando generalmente una mayor significación cuando estas se integraron en modelos separados. Parece que atribuir otras formas de relación con el suicidio para las variables identificadas por Joiner proporcionaría a la teoría interpersonal psicológica del suicidio un mayor apoyo empíric

Are we studying the right populations to understand suicide?

International audienc

The strengths and difficulties questionnaire-dysregulation profile, non-suicidal selfinjury behaviors and the mediating role of stressful life events

Non-suicidal self-injury (NSSI) behaviors are self-injurious behaviors inflicted without intending death. Literature has shown the relationship between stressful life events (SLE) and NSSI behaviors. The Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) is defined as an index of self-regulatory problems, related to higher risk for suicidal ideation and attempts in adolescents. In this study the relationship between SDQ-DP and NSSI behaviors, mediated by SLE in a clinical sample of children and adolescents is analyzed. A cross-sectional study was conducted on 239 subjects (aged from 11 to 17) to test the mediation model. SDQ-DP significantly correlates with NSSI behaviors (Wald = 6.5477, p = .0105); SDQ-DP significantly correlates with SLE (T = 5.7229, p < .001); SLE significantly correlates NSSI behaviors, and the relation remains significant whilst controlling for SDQ-DP (Wald = 4.1715, p = .041); the relation between SDQ-DP and NSSI behaviors stops being significant whilst controlling for the potential mediator (SLE) (Wald = 2.9951, p = .0835). Study of indirect effect supports the mediation model (.0585 CI [.0016, .1266]). Findings are compatible with the complete mediation scenario. These results point out the importance of self-regulatory problems in coping strategies with regards to SLE and the development of NSSI behavior