Elaborating the cry of pain model of suicidality: Testing a psychological model in a sample of first-time and repeat self-harm patients.

OBJECTIVES: Few studies have specifically tested the Cry of Pain model (CoP model; Williams, 2001). This model conceptualizes suicidal behaviour as a behavioural response to a stressful situation which has three components: defeat, no escape potential, and no rescue. In addition, the model specifies a mediating role for entrapment on the defeat-suicidal ideation relationship, and a moderating role for rescue factors on the entrapment-suicidal ideation relationship. This is the first study to investigate the utility of this psychological model in a sample of first-time and repeat self-harm (SH) patients. METHOD: One hundred and thirteen patients who had been admitted to hospital following an episode of SH (36 first-time, 67 repeat) and 37 hospital controls completed measures of defeat, entrapment/escape potential, rescue (social support and positive future thinking), as well as depression, anxiety, and suicidal ideation. RESULTS: Analyses highlighted differences between the three participant groups on all of the CoP variables. Hierarchical regression analysis confirmed that total entrapment and internal entrapment mediated the relationship between defeat and suicidal ideation, whilst impaired ability to think positively about the future (but not social support) moderated the relationship between total and internal entrapment and suicidal ideation. CONCLUSIONS: The findings provide further empirical support for the CoP Model. The findings are discussed in relation to theory and practice and we recommend that the findings are replicated within a prospective design.

Mental health nurses' attitudes towards severe perinatal mental illness.

AIM: This paper reports on a study exploring the experiences and attitudes of generic mental health nurses towards care of women with severe mental illness during the perinatal period. BACKGROUND: Severe mental disorder in the perinatal period is a global public health concern. However, there are concerns that mental health nurses other than dedicated perinatal mental health teams may lack knowledge, skills and experience in caring for such disorders, because of their low prevalence. METHODS: Sixteen generic Registered Mental Nurses working in public adult mental health services participated in three focus groups during 2007. FINDINGS: Participants did not perceive any difference between symptoms during perinatal and non-perinatal periods. There were mixed attitudes towards caring for women with severe mental illness in the perinatal period. Fear and anxiety was expressed by the nurses when caring or feeling responsible for the babies of clients. Lack of communication between professional groups and decreased clinical decision-making following the introduction of the Edinburgh Post Natal Depression Scale caused frustration. Confidence was displayed when working with known and trusted colleagues. CONCLUSION: Generic mental health nurses would benefit from more education on perinatal mental health and there may be a need for them to be supported by specialist perinatal mental health practitioners.