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Risk factors, theoretical explanations, and treatment suggestions for suicidal behaviors have historically focused largely on cognitions, but a more comprehensive picture may be provided by examining the role of affect in suicidal thoughts and behaviors. In the current study the link between affect and suicide within the theoretical framework of the circumplex model was examined empirically. Data from 104 participants demonstrated that both positive and negative affect are related to suicidal thoughts and behaviors, and that affect provided additional information about suicidality over and above the cognitive variable of hopelessness. The findings support that suicidal risk assessment may be enhanced by evaluating both hopelessness and affect, and that negative affect, in particular, is important to address in the treatment of suicidal individuals.

Prior research has identified a negative association between suicidal ideation and help-seeking, a phenomenon called "help-negation." Help-negation has been documented to occur for both professional and nonprofessional sources of help. In this study help-seeking attitudes, stigma concerns, and perceptions of social support were examined as possible mediators of help-negation. Data were collected from a nonclinical sample of college undergraduates at a midwestern university (N = 321). Findings provided partial support for the mediation hypotheses. Help-seeking attitudes and stigma were significant predictors of help-seeking intentions ([beta] = 0.34 and [beta] = -0.17, p less than 0.05, respectively), but did not mediate help-negation for professional sources. Perceptions of social support, on the other hand, fully mediated help-negation for nonprofessional sources ([beta] = 0.27, p less than 0.05).

Scholars have based their understanding of college-student suicide in the United States largely on the study of European Americans, and therefore, its relevance to making culturally informed decisions with suicidal Asian American college students is unclear. This article explores aspects of suicide assessment potentially unique to Asian American college students and discusses possible ways to handle the process of breaking confidentiality that are more sensitive to Asian American needs. First, the authors briefly review issues of confidentiality, informed consent, and standards of care. Second, they examine several aspects of Asian American college students' experiences in the United States and of Asian cultural values. Specifically, the authors review acculturation and the experience of immigration, intergenerational relationships, collectivistic cultural values, the myth of the "model minority," and perfectionism. Third, they offer culturally informed considerations for assessing suicidal risk and ways to manage breaking confidentiality. Finally, they suggest the Collaborative Assessment and Management of Suicidality model and the Suicide Intervention Response Inventory-2 as potentially useful tools for culturally sensitive work with Asian American college students.

The factor structure of the Suicide Opinion Questionnaire (SOQ) was investigated in 2 studies. In the first study, the SOQ was administered to 568 participants to investigate the relative strength of 3 competing latent structure models previously identified in the literature. Confirmatory factor analyses provided no support for any of the prior models. An exploratory factor analysis of these data resulted in a weak 2-factor structure accounting for only 15.33% of the common variance. In the second study, this 2-factor structure was evaluated using SOQ data from 288 college students. Confirmatory factor analysis results failed to support the 2-factor model. Based on these results, the authors recommend that future research efforts should focus on developing a more contemporary and psychometrically sound measure of attitudes toward suicide. (Contains 3 tables.)

A sample of 40 suicide notes were analyzed for motivational content in relation to an existential-constructivist theory of suicide. Results generally supported the 4 theoretical categories of somatic, relational, spiritual, and psychological motivations, with 39 notes having content that could be classified according to the aforementioned categories. Psychological motivations were found to be the most prevalent, followed by relational, spiritual, and somatic concerns. Notes of completed suicides included more relational motivations than did those of suicide attempters, and older writers of notes showed more psychological and fewer spiritual motivations than did younger writers. Recommendations are offered for revising the theory to provide a stronger meaning-based understanding of suicidal behavior.

The Perceived Wellness Survey (PWS; T. Adams, 1995; T. Adams, J. Bezner, & M. Steinhardt, 1997) is a recently developed instrument intended to operationalize the comprehensive Perceived Wellness Model (T. Adams, J. Bezner, & M. Steinhardt, 1997), an innovative model that attempts to include the balance of multiple life activities in its evaluation of well-being. Two university samples (N = 317) were used to (a) examine the psychometric properties of the PWS, (b) determine how well the PWS represents the Perceived Wellness Model, and (c) ascertain how well the PWS relates to psychological functioning. Results suggest that the PWS may have potential as a psychometrically sound instrument that does relate in hypothesized ways to standardized measures of mental health. Specifically, a revised 33-item PWS accounted for 29.3% of the variance in Beck Depression Inventory-Second Edition (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) scores, 11.4% of the variance in Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1993) scores, and 18.2% of the variance in scores on the Hopkins Symptom Checklist-21 (D. E. Green, F. H. Walkey, I. A. McCormick, & A. J. W. Taylor, 1988) when controlling for impression management. Despite this support for the overall PWS, the authors' examination found no psychometric evidence for the existence of separate subscale dimensions, as suggested by the Perceived Wellness Model, the theory upon which the PWS was designed. Implications for these findings are presented.

Background To the extent that outcomes are mediated through negative perceptions of generics (the nocebo effect), observational studies comparing brand-name and generic drugs are susceptible to bias favoring the brand-name drugs. We used authorized generic (AG) products, which are identical in composition and appearance to brand-name products but are marketed as generics, as a control group to address this bias in an evaluation aiming to compare the effectiveness of generic versus brand medications. Methods and findings For commercial health insurance enrollees from the US, administrative claims data were derived from 2 databases: (1) Optum Clinformatics Data Mart (years: 2004-2013) and (2) Truven MarketScan (years: 2003-2015). For a total of 8 drug products, the following groups were compared using a cohort study design: (1) patients switching from brand-name products to AGs versus generics, and patients initiating treatment with AGs versus generics, where AG use proxied brand-name use, addressing negative perception bias, and (2) patients initiating generic versus brand-name products (bias-prone direct comparison) and patients initiating AG versus brand-name products (negative control). Using Cox proportional hazards regression after 1:1 propensity-score matching, we compared a composite cardiovascular endpoint (for amlodipine, amlodipine-benazepril, and quinapril), non-vertebral fracture (for alendronate and calcitonin), psychiatric hospitalization rate (for sertraline and escitalopram), and insulin initiation (for glipizide) between the groups. Inverse variance meta-analytic methods were used to pool adjusted hazard ratios (HRs) for each comparison between the 2 databases. Across 8 products, 2,264,774 matched pairs of patients were included in the comparisons of AGs versus generics. A majority (12 out of 16) of the clinical endpoint estimates showed similar outcomes between AGs and generics. Among the other 4 estimates that did have significantly different outcomes, 3 suggested improved outcomes with generics and 1 favored AGs (patients switching from amlodipine brand-name: HR [95% CI] 0.92 [0.88-0.97]). The comparison between generic and brand-name initiators involved 1,313,161 matched pairs, and no differences in outcomes were noted for alendronate, calcitonin, glipizide, or quinapril. We observed a lower risk of the composite cardiovascular endpoint with generics versus brand-name products for amlodipine and amlodipine-benazepril (HR [95% CI]: 0.91 [0.84-0.99] and 0.84 [0.76-0.94], respectively). For escitalopram and sertraline, we observed higher rates of psychiatric hospitalizations with generics (HR [95% CI]: 1.05 [1.01-1.10] and 1.07 [1.01-1.14], respectively). The negative control comparisons also indicated potentially higher rates of similar magnitude with AG compared to brand-name initiation for escitalopram and sertraline (HR [95% CI]: 1.06 [0.98-1.13] and 1.11 [1.05-1.18], respectively), suggesting that the differences observed between brand and generic users in these outcomes are likely explained by either residual confounding or generic perception bias. Limitations of this study include potential residual confounding due to the unavailability of certain clinical parameters in administrative claims data and the inability to evaluate surrogate outcomes, such as immediate changes in blood pressure, upon switching from brand products to generics. Conclusions In this study, we observed that use of generics was associated with comparable clinical outcomes to use of brand-name products. These results could help in promoting educational interventions aimed at increasing patient and provider confidence in the ability of generic medicines to manage chronic diseases., Author(s): Rishi J. Desai 1,*, Ameet Sarpatwari 1, Sara Dejene 1, Nazleen F. Khan 1, Joyce Lii 1, James R. Rogers 1, Sarah K. Dutcher 2, Saeid Raofi 3, Justin [...]

Proposes that in order to move beyond the simple identification of risk factors, scientific suicidology needs to give greater attention to the critical role of theory in guiding inquiry and advancing the understanding of suicidal behaviors. This article argues the importance of theoretical grounding from the perspective of psychological science and discusses implications for future research in the field. (Contains 49 references.) (GCP)

Participants categorized at trial (n=259), stabilization (n=121), and maintenance (n=140) stages of careers completed the Multidimensional Work Ethic Profile. Trial-stage members scored higher on hard work and delayed gratification, the other two groups on morality, wasted time, and leisure dimensions, with no differences on centrality or self-reliance. A life-span, multidimensional perspective of work ethic was advocated. (Contains 31 references.) (SK)

Investigates validity of the Suicide Assessment Checklist (SAC) in a sample of 1,969 admissions to a psychiatric emergency crisis center. Supporting construct related validity, total score differences were found in the expected directions as a function of referral reason. Convergent validity was based on observed correlations between selected SAC items and conceptually similar items on the Beck Depression Inventory. (Contains 24 references and 2 appendixes.) (GCP)

Surveys 162 self-identified lesbian, gay, and bisexual (LGB) individuals with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan or a past suicide attempt with significant intent to die. (Contains 33 references, 2 tables, and an appendix.) (GCP)

Investigates attitudes of mental health counselors toward rational suicide. Over 80% of respondents were moderately supportive of the idea that people can make well-reasoned decisions that death is their best option, and further, they identified a consistent set of criteria to evaluate such decisions. Discusses implications for training and practice. (Contains 34 references and 3 tables.) (GCP)

Discusses the strengths and limitations of the current pragmatic focus of research in suicidology and presents an argument for theoretical grounding as a precursor for continued advancement in this area. Presents an existential-constructivist framework of "meaning creation" as a theoretical heuristic for understanding suicide. Outlines general areas of challenge and stress that may provide pathways to suicide. (Contains 41 references.) (Author/GCP)

Although counseling psychology trainees are increasingly exposed to suicidal clients, research suggests that comprehensive, systematic training in suicidology in counseling psychology programs rarely occurs. This contribution provides counseling psychology educators and practitioners with an overview of the field of suicidology as it applies to the training and practice of counseling psychology. (Contains 284 references.) (Author/GCP)