An experimental investigation of the influence of loneliness on changes in belongingness and desire to escape.

OBJECTIVE: Loneliness is a well-established risk factor for suicide in young adults, but the mechanisms involved are still unclear. Drawing on the Interpersonal Theory of Suicide, the Evolutionary Model of Loneliness, and Prospect Theory, we examined if high and low levels of loneliness are associated with different patterns of response to losses or gains of belongingness. METHODS: A sample of 188 students completed the UCLA-Loneliness scale (version 3) and measures of suicide risk. Participants in the top and bottom tertiles of loneliness scores completed a computerized task designed to induce changes (gains, losses) or consistency in risk factors for suicide (belongingness, burdensomeness) over time, and examined the effect on desire to quit the task. RESULTS: The results showed that the high loneliness group exhibited a larger magnitude of effect on desire to quit from gaining belongingness than for losing belongingness. In contrast, the low loneliness group showed a larger change in desire to quit from losing belongingness than gaining belongingness. CONCLUSION: The findings provide preliminary experimental support for distinct profiles of suicide risk based on prevailing levels of loneliness. The findings are discussed in relation to a need for increased precision in theoretical models of suicide and loneliness.

The Parents' Self-Stigma Scale: Development, Factor Analysis, Reliability, and Validity.

For parents of children with a mental health disorder, self-stigma can negatively impact their self-esteem and empowerment. Although measures of self-stigma exist, these have not been created in consultation with parents of children with a mental health disorder. Thus, the aim of this study was to construct a new scale based on parents' experiences and developed in partnership with parents through participatory action research (PAR). Draft items that reflect parents' self-stigmas were drawn from qualitative research. A PAR group further developed these items for conceptual and experiential representativeness, and wording suitability and interpretability. With data from 424 parents of children with a mental health disorder, factor analyses indicated three factors: self-blame, self-shame, and bad-parent self-beliefs. These factors were negatively correlated with self-esteem and empowerment. Internal consistencies were acceptable. In sum, parent self-stigma is best operationalised as including self-blame, self-shame, and bad-parent self-beliefs. A valid, PAR-informed measure is provided to promote consistent, authentic, and sensitive measurement of these components.

Neuroticism confers vulnerability in response to experimentally induced feelings of thwarted belongingness and perceived burdensomeness: Implications for suicide risk.

OBJECTIVE: This study investigated the role of individual differences in neuroticism in conferring increased reactivity to the interpersonal antecedents for suicide proposed by the interpersonal theory of suicide. METHOD: Undergraduate students (N = 113) were screened and selected to form high (n = 58) and low (n = 55) neuroticism groups, and an experimental computer task was used to manipulate participants' experience of thwarted belongingness and perceived burdensomeness. Participants' self-reported desire to persist in the face of this induced interpersonal adversity was measured. RESULTS: Results indicate that high neuroticism confers increased reactivity to the experimental induction of the interpersonal antecedents of suicidal ideation: Thwarted belongingness and perceived burdensomeness. Furthermore, this vulnerability corresponds to a diminished desire to persist with the task in the face of interpersonal adversity. CONCLUSIONS: Neuroticism confers vulnerability for suicidal desire via an increased reactivity to the proximal, causal risk factors proposed by the interpersonal theory of suicide. This has implications for considering how personality risk factors such as neuroticism may interact with proximal interpersonal risk factors to increase suicidal ideation.

Experimentally-enhanced perceptions of meaning confer resilience to the interpersonal adversity implicated in suicide risk.

BACKGROUND AND OBJECTIVES: The interpersonal theory of suicide proposes that perceived burdensomeness and thwarted belongingness (PB-TB) are proximal causes of suicidal desire. Here we test whether experimentally induced perceptions of meaningfulness can confer resilience against interpersonal adversity and enhance persistence, the erosion of which is a potential antecedent to suicide risk. METHODS: Undergraduate university students (N = 93) were randomly allocated to complete a team task under conditions of high or low task-extrinsic meaning and high or low PB-TB. Participants in the high task-extrinsic meaning condition were given the opportunity to donate to a charity as part of their experimental participation, whereas those in the low task-extrinsic meaning condition were not. RESULTS: Consistent with the buffering hypothesis that suicide resilience is active only when adversity is heightened, participants in the high task-extrinsic meaning condition who reported higher levels of perceived meaningfulness displayed greater willingness to persist in the face of experimentally-induced high PB and TB compared to those in the low task-extrinsic meaning condition and those in conditions where the interpersonal adversity was not induced (low PB and TB). LIMITATIONS: The meaning induction was effective only in a subset of participants. The dual induction of PB and TB also precludes inferences about their independent causal effects on willingness to persist. CONCLUSIONS: Meaning-making interventions may attenuate the impact of proximal interpersonal antecedents of suicidal desire. Enhancing resilience in this manner can potentially improve the efficacy of prevention efforts beyond the direct amelioration of suicide risk factors.

The benefits and risks of asking research participants about suicide: A meta-analysis of the impact of exposure to suicide-related content.

One obstacle potentially hindering research on suicide is the assumption that assessing suicide may make individuals more likely to engage in suicidal thoughts or behaviours; a concern expressed by ethics committees, researchers, and clinicians. However, decisions which are overly cautious and restrictive when approving research proposals will hinder important research in this area. The present aim was to conduct a meta-analysis to examine whether asking about suicide or exposure to suicide-related content in research studies led to changes in participants' levels of distress, suicidal ideation, or suicide attempts. A systematic search of peer-reviewed and unpublished literature from 2000 to 2017 identified 18 studies. Exposure to suicide-related content led to significant, albeit small, reductions in suicidal ideation (g = -0.13, p < .001) and a lower likelihood of engaging in suicidal behaviour (OR = 0.714, p < .05). The reduction in suicidal ideation was moderated by age such that adolescents showed nearly twice as large a reduction in suicidal ideation from pre- to post-exposure as adults did. Thus, evidence to date suggests that asking research participants about suicide does not increase risk, and may be associated with small benefits. Ethics review boards should calibrate their consideration of the risks associated with participation based on the available evidence and relative to the cost of depriving potential participants of any benefits that participation may offer.

Suicide risk assessment: Trust an implicit probe or listen to the patient?

Previous research suggests implicit cognition can predict suicidal behavior. This study examined the utility of the death/suicide implicit association test (d/s-IAT) in acute and prospective assessment of suicide risk and protective factors, relative to clinician and patient estimates of future suicide risk. Patients (N = 128; 79 female; 111 Caucasian) presenting to an emergency department were recruited if they reported current suicidal ideation or had been admitted because of an acute suicide attempt. Patients completed the d/s-IAT and self-report measures assessing three death-promoting (e.g., suicide ideation) and two life-sustaining (e.g., zest for life) factors, with self-report measures completed again at 3- and 6-month follow-ups. The clinician and patient provided risk estimates of that patient making a suicide attempt within the next 6 months. Results showed that among current attempters, the d/s-IAT differentiated between first time and multiple attempters; with multiple attempters having significantly weaker self-associations with life relative to death. The d/s-IAT was associated with concurrent suicidal ideation and zest for life, but only predicted the desire to die prospectively at 3 months. By contrast, clinician and patient estimates predicted suicide risk at 3- and 6-month follow-up, with clinician estimates predicting death-promoting factors, and only patient estimates predicting life-sustaining factors. The utility of the d/s-IAT was more pronounced in the assessment of concurrent risk. Prospectively, clinician and patient predictions complemented each other in predicting suicide risk and resilience, respectively. Our findings indicate collaborative rather than implicit approaches add greater value to the management of risk and recovery in suicidal patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mind full of life: Does mindfulness confer resilience to suicide by increasing zest for life?

BACKGROUND: Mindfulness is a trainable skill that may enhance resilience to suicidality among vulnerable groups such as young people. The current study examined whether mindfulness protects against suicidal desire in the face of heightened risk and adversity by increasing zest for life in a sample of university students. METHODS: In a prospective design, participants (N = 233) were assessed at two time points over eight weeks. Online surveys included the Mindful Attention and Awareness Scale, Zest for Life Scale, Interpersonal Needs Questionnaire, Kessler Psychological Distress Scale, and items assessing suicidal ideation and suicidal intent. RESULTS: Baseline mindfulness was associated with lower suicidal ideation and intent at follow-up. Moderated mediation analyses confirmed the effects of mindfulness on ideation and intent were mediated by zest for life and these indirect effects were stronger at higher versus lower levels of general (psychological distress) and suicide-specific (perceived burdensomeness and thwarted belongingness) risk. LIMITATIONS: Single item assessments of suicidal desire. CONCLUSIONS: Findings suggest that mindfulness protects against suicidal desire in conditions of heightened risk and adversity by enhancing one's orientation towards a life worth living. Theories of suicide should consider the dynamic interplay between risk and life-sustaining resilience, while clinicians treating suicidality could use mindfulness strategies to strengthen the desire to (re)engage with life, thereby complementing direct amelioration of suicide risk factors.

Mothers' Decisions to Disclose or Conceal Their Child's Mental Health Disorder.

Parents of children with mental health disorders are often faced with the dilemma of disclosing or concealing their child's disorder. These decisions have important implications for both child and parent. Our aim is to describe mothers' experiences with the disclosure dilemma; specifically, we describe what is disclosed (or concealed), how, and why, as well as the consequences of these decisions. Data from interviews with 11 mothers of children (aged 5-13 years) with mental health disorders, and a participatory action research group (four mothers) were thematically analyzed. Mothers selectively disclosed (and concealed) to protect and advocate for their child. Their decisions were often influenced by, or were a reactance to, others' opinions, with mothers not only avoiding, but also defending against stigma, and exercising their right to privacy. Despite anticipating negative feedback, mothers more often experienced empathy and support following disclosure. Recommendations are made for developing mothers' confidence in disclosing.

Changes in the Relative Balance of Approach and Avoidance Inclinations to Use Alcohol Following Cue Exposure Vary in Low and High Risk Drinkers.

According to the ambivalence model of craving, alcohol craving involves the dynamic interplay of separate approach and avoidance inclinations. Cue-elicited increases in approach inclinations are posited to be more likely to result in alcohol consumption and risky drinking behaviors only if unimpeded by restraint inclinations. Current study aims were (1) to test if changes in the net balance between approach and avoidance inclinations following alcohol cue exposure differentiate between low and high risk drinkers, and (2) if this balance is associated with alcohol consumption on a subsequent taste test. In two experiments (N = 60; N = 79), low and high risk social drinkers were exposed to alcohol cues, and pre- and post- approach and avoidance inclinations measured. An ad libitum alcohol consumption paradigm and a non-alcohol exposure condition were also included in Study 2. Cue-elicited craving was characterized by a predominant approach inclination only in the high risk drinkers. Conversely, approach inclinations were adaptively balanced by equally strong avoidance inclinations when cue-elicited craving was induced in low risk drinkers. For these low risk drinkers with the balanced craving profile, neither approach or avoidance inclinations predicted subsequent alcohol consumption levels during the taste test. Conversely, for high risk drinkers, where the approach inclination predominated, each inclination synergistically predicted subsequent drinking levels during the taste test. In conclusion, results support the importance of assessing both approach and avoidance inclinations, and their relative balance following alcohol cue exposure. Specifically, this more comprehensive assessment reveals changes in craving profiles that are not apparent from examining changes in approach inclinations alone, and it is this shift in the net balance that distinguishes high from low risk drinkers.

Mindfulness and zest for life buffer the negative effects of experimentally-induced perceived burdensomeness and thwarted belongingness: Implications for theories of suicide.

Suicide research can be enhanced by an ability to safely manipulate putative causal variables. The present studies developed an experimental task to modify risk factors identified by the interpersonal theory of suicide (perceived burdensomeness and thwarted belongingness) and examine their hypothesized suppressive effect on persistence in adversity in undergraduate university students. Variables that may moderate the impact of these risk factors on persistence (zest for life and mindful awareness) were incorporated as potential resilience factors. Study 1 (N = 92) found elevated burdensomeness and diminished belongingness significantly impaired persistence. Additionally, these predicted effects were moderated by individual differences in zest for life. In Study 2 (N = 52), individuals trained in mindfulness prior to the experimental task displayed greater persistence relative to controls. Findings provide experimental support for the role of perceived burdensomeness and thwarted belongingness in the manner predicted by the interpersonal theory, and demonstrate a way to experimentally test the effects of resilience factors that reduce the impact of these interpersonal factors. (PsycINFO Database Record

Multifacet assessment of capability for suicide: Development and prospective validation of the Acquired Capability With Rehearsal for Suicide Scale.

The interpersonal theory of suicide proposes that acquired capability facilitates transformation of suicidal desire into lethal self-destructive behavior (Joiner, 2005). A new measure, the Acquired Capability With Rehearsal for Suicide Scale (ACWRSS), was devised to capture the key facets of acquired capability-pain tolerance and fearlessness of death-while also incorporating deliberate and active means to increase preparedness for suicide. The factor structure of the ACWRSS was tested using confirmatory factor analysis (n = 611). The 7-item ACWRSS conformed to the hypothesized 3-factor structure, demonstrating excellent fit and good internal consistency (α = .83). Measurement invariance across gender was also demonstrated on configural, metric, and scalar levels. Next, in the first longitudinal study of the association between acquired capability and suicide ideation, intention, and readiness (n = 234), the acquired capability facets prospectively predicted specific phases in the motivational-volitional pathway toward suicide readiness. Moreover, 2 of the acquired capability components mediated the relationship between baseline nonsuicidal self-injury and suicide readiness at follow-up. In an inpatient psychiatric sample (n = 108), the ACWRSS was significantly correlated with prior suicide attempts and thoughts and episodes of nonsuicidal self-injury, and its facets demonstrated differential sensitivity to change. The ACWRSS is the first measure of acquired capability that reliably and validly captures all key facets of this critical component of the interpersonal theory of suicide. Its brevity enhances its utility for both research and clinical settings. (PsycINFO Database Record

Probing the implicit suicidal mind: does the Death/Suicide Implicit Association Test reveal a desire to die, or a diminished desire to live?

Assessment of implicit self-associations with death relative to life, measured by a death/suicide implicit association test (d/s-IAT), has shown promise in the prediction of suicide risk. The current study examined whether the d/s-IAT reflects an individual's desire to die or a diminished desire to live and whether the predictive utility of implicit cognition is mediated by life-oriented beliefs. Four hundred eight undergraduate students (285 female; Mage = 20.36 years, SD = 4.72) participated. Participants completed the d/s-IAT and self-report measures assessing 6 indicators of suicide risk (suicide ideation frequency and intensity, depression, nonsuicidal self-harm thoughts frequency and intensity, and nonsuicidal self-harm attempts), as well as survival and coping beliefs and history of prior suicide attempts. The d/s-IAT significantly predicted 5 out of the 6 indicators of suicide risk above and beyond the strongest traditional indicator of risk, history of prior suicide attempts. However, the effect of the d/s-IAT on each of the risk indicators was mediated by individuals' survival and coping beliefs. Moreover, the distribution of d/s-IAT scores primarily reflected variability in self-associations with life. Implicit suicide-related cognition appears to reflect a gradual diminishing of the desire to live, rather than a desire to die. Contemporary theories of suicide and risk assessment protocols need to account for the dynamic relationship between both risk and life-oriented resilience factors, and intervention strategies aimed at enhancing engagement with life should be a routine part of suicide risk management.

The effect of approach/avoidance training on alcohol consumption is mediated by change in alcohol action tendency.

Training people to respond to alcohol images by making avoidance joystick movements can affect subsequent alcohol consumption, and has shown initial efficacy as a treatment adjunct. However, the mechanisms that underlie the training's efficacy are unknown. The present study aimed to determine 1) whether the training's effect is mediated by a change in action tendency or a change in selective attention, and 2) whether the training's effect is moderated by individual differences in working memory capacity (WMC). Three groups of social drinkers (total N = 74) completed either approach-alcohol training, avoid-alcohol training or a sham-training on the Approach-Avoidance Task (AAT). Participants' WMC was assessed prior to training, while their alcohol-related action tendency and selective attention were assessed before and after the training on the recently developed Selective-Attention/Action Tendency Task (SA/ATT), before finally completing an alcohol taste-test. There was no significant main effect of approach/avoidance training on alcohol consumption during the taste-test. However, there was a significant indirect effect of training on alcohol consumption mediated by a change in action tendency, but no indirect effect mediated by a change in selective attention. There was inconsistent evidence of WMC moderating training efficacy, with moderation found only for the effect of approach-alcohol training on the AAT but not on the SA/ATT. Thus approach/avoidance training affects alcohol consumption specifically by changing the underlying action tendency. Multiple training sessions may be required in order to observe more substantive changes in drinking behaviour.

Approach-alcohol action tendencies can be inhibited by cognitive load.

RATIONALE: Dysregulated alcohol consumption has been attributed to an imbalance between an approach-alcohol action tendency and executive control processes. However, which specific executive control processes are involved is not known. One candidate executive process is interference suppression, which refers to the suppression of task-irrelevant information through the active maintenance of task-relevant information or a cognitive load. OBJECTIVE: The present study aimed to (1) establish whether alcohol action tendency can be inhibited by interference suppression through the use of cognitive loads and (2) to assess whether individual differences in the degree of interference suppression from cognitive loads is related to individual differences in the ability to regulate alcohol consumption. METHOD: Two groups of social drinkers (total N = 58) who differed in their ability to regulate their alcohol consumption completed a novel cognitive load variant of the approach avoidance task (AAT) and an alcohol taste test. RESULTS: Results indicated that (1) there was a relationship between alcohol bias on the AAT and alcohol consumption under low load, but not high load, consistent with the hypothesis that the action tendency would be inhibited through interference suppression, and (2) this effect of load was not modified by drinking group, with both groups demonstrating equivalent ability to inhibit the action tendency. CONCLUSIONS: The present findings suggest that alcohol action tendency can be inhibited through interference suppression, and that this is effective even for those that have difficulty regulating their alcohol consumption.

Misinformation, disinformation, and violent conflict: from Iraq and the "War on Terror" to future threats to peace.

The dissemination and control of information are indispensable ingredients of violent conflict, with all parties involved in a conflict or at war seeking to frame the discussion on their own terms. Those attempts at information control often involve the dissemination of misinformation or disinformation (i.e., information that is incorrect by accident or intent, respectively). We review the way in which misinformation can facilitate violent conflicts and, conversely, how the successful refutation of misinformation can contribute to peace. We illustrate the relevant cognitive principles by examining two case studies. The first, a retrospective case, involves the Iraq War of 2003 and the "War on Terror." The second, a prospective case, points to likely future sources of conflict arising from climate change and its likely consequences.

Alcohol-related biases in selective attention and action tendency make distinct contributions to dysregulated drinking behaviour.

AIMS: To assess whether alcohol-related biases in selective-attention and action tendency uniquely or concurrently predict the ability to regulate alcohol consumption. DESIGN AND PARTICIPANTS: Two groups of undergraduate social drinkers (total n = 55) who differed in their ability to regulate their alcohol consumption completed a novel Selective-Attention/Action-Tendency Task (SA/ATT), which assessed separately alcohol-related biases in selective attention and action tendency. SETTING: University of Western Australia, Australia. MEASUREMENT: Dysregulated drinking was operationalized as a self-reported high level of alcohol consumption on the Alcohol Consumption Questionnaire, and a high desire to reduce consumption on the Brief Readiness to Change Algorithm. Selective attention and action tendency were assessed using the SA/ATT, working memory was assessed using the operation-span task and participant characteristics were assessed using the Alcohol Use Disorders Identification Test (AUDIT) and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). FINDINGS: Results indicated that (i) there was no significant association between alcohol-related biases in selective attention and action tendency, r = 0.16, P = 0.274, and (ii) biases towards alcohol, in both selective attention, ß = 1.01, odds ratio = 2.74, P = 0.022, and action tendency, ß = 1.24, odds ratio = 3.45, P = 0.015, predicted independent variance in dysregulated-drinker status. CONCLUSION: Biases in selective attention and action tendency appear to be distinct mechanisms that contribute independently to difficulty regulating alcohol consumption. Treatment components that could be combined to target both mechanisms could enhance treatment outcomes for alcohol-use disorders.

Is sensitivity to reward associated with the malleability of implicit inclinations toward high-fat food?

Two experiments examined the effect of positive and negative priming on implicit approach and avoidance inclinations toward high-fat food stimuli in participants high or low in reward sensitivity, using personalized unipolar variants of the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998, "Measuring individual differences in implicit cognition: The Implicit Association Test," Journal of Personality and Social Psychology, Vol. 74, pp. 1464-1480). Participants high in reward sensitivity showed an automatic processing bias that is characterized by a dual vulnerability of being particularly susceptible to priming of the rewarding aspects of high-fat foods, while being unaffected by priming of the negative aspects of those foods. In contrast, participants low in reward sensitivity generally showed no facilitation of implicit-approach inclinations following positive priming, but consistently showed facilitation of implicit-avoidance inclinations following negative priming. These results are consistent with the revised reinforcement sensitivity theory ( J. A. Gray & N. McNaughton, 2000, The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system, 2nd ed., New York, NY, Oxford University Press.) and suggest that the systems mediating reward sensitivity and punishment sensitivity are not orthogonal, as predicted by the separable subsystems hypothesis, but can be interdependent, as predicted by the joint subsystems hypothesis.

Mixed selection. Effects of body images, dietary restraint, and persuasive messages on females' orientations towards chocolate.

Many women experience ambivalent reactions to chocolate: craving it but also wary of its impact on weight and health. Chocolate advertisements often use thin ideal models and previous research indicates that this exacerbates ambivalence. This experiment compared attitudes to, and consumption of, chocolate following exposure to images containing thin or overweight models together with written messages that were either positive or negative about eating chocolate. Participants (all female) were categorised as either low- or high-restraint. Approach, avoidance and guilt motives towards chocolate were measured and the participants had an opportunity to consume chocolate. Exposure to thin ideal models led to higher approach motives and this effect was most marked among the high restraint participants. Avoidance and guilt scores did not vary as a function of model size or message, but there were clear differences between the restraint groups, with the high restraint participants scoring substantially higher than low restraint participants on both of these measures. When the participants were provided with an opportunity to eat some chocolate, those with high restraint who had been exposed to the thin models consumed the most.

The interaction of approach-alcohol action tendencies, working memory capacity, and current task goals predicts the inability to regulate drinking behavior.

The inability to regulate alcohol consumption has been attributed to an imbalance between stimulus-driven behavioral biases, or action tendencies, and the ability to exert goal-directed control, or working memory capacity (WMC). Previous research assessing the interaction between these variables has not considered the effect of whether individuals' current goals or task demands require goal-directed control. Our aim was to examine the potential interaction of appetitive action tendencies and the ability to exert control over these action tendencies as a function of whether task demands require applying control for successful task completion. Two groups of social drinkers (n = 40 per group) who differed in their ability to regulate their alcohol consumption completed a novel variant of the Approach-Avoidance Task (AAT), which separately assessed approach and avoid trials. The approach and avoidance responses differentially require goal-directed control, depending on whether the task-relevant response is incongruent with the stimulus-driven action tendency. Results indicated that (a) group differences in AAT indices were only observed on trials that required an avoidance movement, which are trials where the task-relevant response would be incongruent with an approach action tendency, and (b) the extent of the group differences for these avoidance trials was moderated by individual differences in WMC, such that problem drinkers with lower WMC showed greater behavioral bias toward alcohol than those with higher WMC. These findings suggest that difficulties in regulating alcohol consumption arise from a complex interaction of action-tendencies, WMC, and current goals or task demands.

The effect of images of thin and overweight body shapes on women's ambivalence towards chocolate.

Many women experience ambivalent orientations towards chocolate, both craving for it and having concerns about eating it. The present study investigated the effect of viewing thin and overweight images of models in chocolate advertisements on ambivalent attitudes. Participants were 84 females, aged 17-63, allocated to a thin model condition, an overweight model condition, or a control group. As predicted, following exposure to their respective images, participants in the thin condition had increased avoidance, approach and guilt scores, while participants in the overweight condition had decreased approach and guilt scores, with no change in avoidance. Control participants demonstrated ambivalence, but no changes over time. The findings show that common advertising strategies for chocolate are likely to exacerbate ambivalence in female consumers.