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1.
J Psychiatr Res ; 124: 42-49, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32114031

RESUMO

Modern theories of suicide, such as the Interpersonal Theory of Suicide, have overcome past conceptual limitations within suicide research by examining factors that help differentiate suicide attempters from those who experience suicidal ideation, but never attempt suicide. One such factor that has been studied extensively is fearlessness about death. Given the varying levels of lethality for different methods used in suicide attempts, an important question is if different levels of fearlessness about death are needed for specific methods. The central aim of this study was to test whether various methods for suicide are associated with different levels of fearlessness about death in a large sample of suicide attempt survivors. Participants were 620 suicide attempt survivors from active military, veteran, and civilian populations. Suicide attempt status was confirmed by two independent raters coding qualitative accounts and participants indicating at least one past attempt with intent to die on other survey items. Results indicated that fearlessness about death does not differ by attempt method and that nearly all methods are statistically equivalent to one another. Despite several methods requiring significantly more time facing mortal fear and severe physical anguish (e.g., cutting, hanging/asphyxiation), as well as certain means being much more lethal (e.g., firearm), differences in ability to enact a suicide attempt with a particular method was not associated with fearlessness about death. This may further indicate the importance of clinicians focusing on practical capability aspects (e.g., means safety, access, comfort with method) with patients at an increased risk for suicide.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32026518

RESUMO

OBJECTIVE: Suicide is consistently within the top ten leading causes of death in the United States. The suicide rate of National Guard personnel is elevated relative to the general population; however, research suggests that many of the suicide risk factors for military personnel are similar to the suicide risk factors for civilians. We examined whether negative urgency moderated the relationships between anger/hostility and perceived burdensomeness/thwarted belongingness in both a military and civilian samples. METHOD: There were two samples in the current study: (1) military personnel (majority national guard) and (2) community members oversampled for suicide attempt history. RESULTS: Our hypotheses were partially supported with the interaction of hostility and negative urgency predicting perceived burdensomeness in the military sample. Within civilians, anger interacted with negative urgency to predict perceived burdensomeness. There were nonsignificant findings for analyses predicting thwarted belongingness. Exploratory analyses indicated that in both samples, anger and hostility interacted with negative urgency to predict suicidal ideation. CONCLUSIONS: Results suggest that aggressive attributes may contribute to individuals feeling as though they are a burden on others when moderate to high levels of negative urgency are present. Additionally, this study provides foundational support for the differences between suicidal desire and ideation.

3.
Psychol Serv ; 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32068415

RESUMO

Research indicates that connection to mental health care services and treatment engagement remain challenges among suicide attempt survivors. One way to improve suicide attempt survivors' experiences with mental health care services is to elicit suggestions directly from attempt survivors regarding how to do so. This study aimed to identify and synthesize suicide attempt survivors' recommendations for how to enhance mental health treatment experiences for attempt survivors. A sample of 329 suicide attempt survivors (81.5% female, 86.0% White/Caucasian, mean age = 35.07 ± 12.18 years) provided responses to an open-ended self-report survey question probing how treatment might be improved for suicide attempt survivors. Responses were analyzed utilizing both qualitative and quantitative techniques. Analyses identified four broad areas in which mental health treatment experiences might be improved for attempt survivors: (a) provider interactions (e.g., by reducing stigma of suicidality, expressing empathy, and using active listening), (b) intake and treatment planning (e.g., by providing a range of treatment options, including nonmedication treatments, and conducting a thorough assessment), (c) treatment delivery (e.g., by addressing root problems, bolstering coping skills, and using trauma-informed care), and (d) structural issues (e.g., by improving access to care and continuity of care). Findings highlight numerous avenues by which health providers might be able to facilitate more positive mental health treatment experiences for suicide attempt survivors. Research is needed to test whether implementing the recommendations offered by attempt survivors in this study might lead to enhanced treatment engagement, retention, and outcomes among suicide attempt survivors at large. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

4.
Perspect Psychol Sci ; 15(1): 44-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697611

RESUMO

People regularly make decisions that are not aligned with their own self-interests. These irrational decisions often stem from humans having bounded rationality (e.g., limited computational power), which produces reliable cognitive biases that occur outside of people's awareness and influences the decisions people make. There are many important decisions leading up to a suicide attempt, and it is likely that these same biases exist within suicide-related decisions. This article presents an argument for the likely existence of cognitive biases within suicide-related decision making and how they may influence people to make irrational decisions. In addition, this article provides new evidence for using a behavioral economic intervention-nudges-as a potential way to combat rising suicide rates. We explore how nudges can help increase means safety, disseminate suicide prevention skills/materials, diminish well-known biases (e.g., confirmation bias), and uncover biases that may be occurring when making suicide-related decisions.

5.
Arch Suicide Res ; : 1-20, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31749417

RESUMO

Suicide is a public health concern and has been the tenth leading cause of death in the United States since 2008. The Interpersonal-Psychological Theory of Suicidal Behavior is an empirically supported model of suicide. The theory posits that thwarted belongingness and perceived burdensomeness examine the individual's perceived connectedness to others around them and together create suicidal desire. Anxiety is another widespread public health concern, associated with suicidal ideation and suicide attempts above and beyond the effects of socio-demographic factors and other mental disorders. A key factor in anxiety disorders is intolerance of uncertainty, or the individual's tendency to perceive ambiguous situations and events as being aversive to emotional and behavioral well-being. Additionally, different facets of aggression have been associated with both intolerance of uncertainty and suicidal desire. The current study sought to examine how facets of aggression moderated the associations between intolerance of uncertainty (both prospective and inhibitory) and thwarted belongingness/perceived burdensomeness. Participants were 440 adults recruited online. The hypotheses of aggression facets moderating the association between intolerance of uncertainty and perceived burdensomeness were largely supported with statistical significance for six out of eight models. Similarly, the hypotheses of aggression facets moderating thwarted belongingness were largely supported with significant moderations for seven out of eight models. The results were upheld when using Benjamini-Hochberg test of significance to account for Type I error. Overall, results indicate that aggressive facets can amplify the associations between intolerance of uncertainty and thwarted belongingness/perceived burdensomeness; however, results differed based on the intolerance of uncertainty dimensions.

6.
Behav Ther ; 50(6): 1173-1184, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31735251

RESUMO

BACKGROUND: Anxiety sensitivity cognitive concerns (ASCC), or fear of cognitive dyscontrol sensations, confers risk for anxiety and mood psychopathology. Recent work demonstrated that novel perceptual challenges generated by a head mounted display can elicit fear among those with elevated ASCC. This suggests that interoceptive exposure to perceptual challenges may offer a means to mitigate ASCC. This study was designed to evaluate whether repeated exposure to novel perceptual challenges can reduce ASCC, and if these effects are stronger among those experiencing greater negative emotionality as a proxy for individuals likely to present for treatment. METHODS: Participants with elevated ASCC (N = 57) were randomized to one of three experimental conditions utilizing a head-mounted display. In the rotations condition (n = 20), participants viewed themselves spinning in a circle. In the opposite directions condition (n = 20), participants turned their head while the camera moved in the opposite direction creating dissonance in their visual field. In the control condition (n = 17), participants completed a series of simple arithmetic problems. RESULTS: Participants in the rotation condition, relative to control, reported significant reductions in ASCC from pre- to post-exposure and these effects were strongest for those with elevated negative affect. The main effect of the opposite directions exposure on post-treatment ASCC was non-significant, but follow-up analyses revealed that reductions in ASCC were observed among those with elevated negative affectivity. DISCUSSION: Perceptual illusion challenges appear to have utility for reducing ASCC through repeated exposure. There was evidence for the perceptual illusion exercises, particularly the rotations condition, specifically reducing ASCC, making this challenge the first we are aware of that specifically targets ASCC-related concerns. LIMITATIONS: As a proof-of-concept study, the present sample was not recruited for clinically-significant psychopathology, and only a brief follow-up was utilized. Future research should utilize a longer follow-up and test if these exposures mitigate ASCC-relevant psychopathology among clinical samples.


Assuntos
Ansiedade/psicologia , Ilusões/psicologia , Adulto , Afeto , Transtornos de Ansiedade/terapia , Medo/psicologia , Feminino , Humanos , Masculino , Adulto Jovem
7.
J Affect Disord ; 257: 536-550, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323595

RESUMO

BACKGROUND: Theories of suicide posit distinct etiological pathways for suicide attempts (SA) and suicidal ideation (SI) that are marked, in part, by disruptions in the ability to regulate reactions to threat/mutilation and interpersonally-relevant emotional stimuli. However, little research has specifically tested these associations. To address this gap, the present study extracted the Late Positive Potential (LPP) during an emotion regulation task to evaluate the independent associations that SA history and SI share with initial responsivity to, and regulation of, these distinct emotional contents. METHODS: A clinical sample (N = 257) were recruited based on elevations in suicide risk factors. Participants completed a picture viewing and regulation task that included threat/mutilation, reward, and neutral images from the International Affective Picture System. Immediately prior to picture onset, participants were instructed to passively view the image, increase their emotional reaction to the image, or decrease their emotional reaction to the image. RESULTS: Differential patterns of LPP amplitudes only emerged in the context of attempts to regulate emotional responses such that SA history predicted a superior ability to volitionally mitigate responses to threat/mutilation while SI was related to a worse ability to increase responses to reward. Effect sizes were in the small and small-to-medium range. LIMITATIONS: The present data were cross-sectional and included low trial counts. CONCLUSIONS: Taken together, these findings support existing theories of suicide suggesting that distinct mechanisms underlie suicidal thoughts and behaviors. Future research should seek to determine if these mechanisms may serve as a viable intervention targets.

8.
Psychiatry Res ; 276: 262-268, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31125903

RESUMO

Suicide remains a public health concern with suicide rates showing a consistent increase over the last 20 years. Recent studies have found a relationship between anxiety sensitivity (i.e., the fear of anxiety related symptoms) and suicidality. Specifically, a relationship has been found between anxiety sensitivity cognitive concerns (ASCC) and suicidality. The knowledge around this relationship, however, has relied mostly on self-report measures. This study seeks to expand on the current literature by exploring the association between ASCC and suicidality, through the use of head-mounted display perceptual illusion challenges (e.g., using tactile sensations and mannequins to create illusions that the participant has switched bodies). A head-mounted display was used to elicit symptoms (e.g., depersonalization, derealization) related to ASCC in a sample of undergraduate students (N = 54). Suicidality and depression were measured by the Inventory of Depression and Anxiety Symptoms-2 (IDAS-II), anxiety sensitivity cognitive concerns by the Anxiety Sensitivity Index-3 (ASI-3), and distress by the Subjective Units of Distress Scale (SUDS). Findings indicated that suicidality was associated with self-reported ASCC as well as the fear generated from the challenges. Furthermore, our results found that challenge-induced fear predicted suicidality scores above and beyond the traditional self-report measures of ASCC. The small sample size and low suicide risk of the current sample limits generalizations to more severe populations.


Assuntos
Ansiedade/psicologia , Medo/psicologia , Ilusões/psicologia , Suicídio/psicologia , Adolescente , Adulto , Despersonalização/psicologia , Depressão/psicologia , Feminino , Humanos , Masculino , Fatores de Risco , Estudantes/psicologia , Adulto Jovem
9.
Psychiatry Res ; 273: 82-88, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30640055

RESUMO

Nocturnal panic involves waking suddenly from sleep in a state of panic, with no apparent cause, and affects more than half of patients with panic disorder. The Fear of Loss of Vigilance theory is the only proposed model for nocturnal panic, suggesting nocturnal panickers fear states in which they are unable to react to danger or protect themselves from threats. Prior work using a self-report questionnaire designed to test the theory (i.e., Fear of Loss of Vigilance Questionnaire; FLOVQ) was unsuccessful at differentiating nocturnal from daytime panickers. This study tested the theory using alternative measures to the FLOVQ. We predicted nocturnal panickers would show elevated responses to measures assessing fears of being unable to respond to or protect themselves from threats. A diverse community sample (N = 218) completed self-report measures related to panic attacks, intolerance of uncertainty, responsibility for harm, and anxiety sensitivity dimensions. Nocturnal panickers endorsed greater inhibitory intolerance of uncertainty and responsibility for harm, but not prospective intolerance of uncertainty, or anxiety sensitivity physical or cognitive concerns. This study provides support for the fear of loss of vigilance theory and suggests intolerance of uncertainty and responsibility for harm reduction be targeted in treatment for nocturnal panic attacks.


Assuntos
Medo/psicologia , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Inquéritos e Questionários , Incerteza , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/psicologia
10.
Suicide Life Threat Behav ; 49(4): 1105-1118, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30091246

RESUMO

OBJECTIVE: The acquired capability for suicide (ACS) is one of the most important breakthroughs in suicide research. ACS refers to an individual's increased fearlessness about death over time from experiencing painful and provocative events (PPE) and is based on opponent-process theory-a habituation model. Few studies have investigated how ACS develops and found that ACS remained relatively stagnant. METHOD: This study sought to expand these findings by observing how ACS develops in two cross-sectional data sets involving high-risk nonclinical samples of physicians (n = 419) and veterinary students (n = 124). Participants completed online questionnaires assessing both general PPEs (e.g., witnessing abuse) and job-specific PPEs (e.g., exposure to euthanasia), as well as ACS. RESULTS: Our results partially replicated prior findings indicating that more PPEs do not significantly affect ACS. CONCLUSIONS: Limitations of this study include the use of cross-sectional data and self-report measures. These results, in combination with existing models of habituation, suggest ACS may not progress linearly.


Assuntos
Médicos/psicologia , Estudantes/psicologia , Ideação Suicida , Suicídio/psicologia , Adulto , Estudos Transversais , Morte , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
11.
Suicide Life Threat Behav ; 49(4): 1044-1057, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30117194

RESUMO

OBJECTIVE: Means safety interventions are effective at reducing suicide rates. This study examined beliefs about firearm ownership or storage and suicide risk, lifetime suicidal thoughts, and openness to means safety. METHOD: A community sample of 107 American adult firearm owners (51.4% male; 82.2% White; m age = 37.46) completed a series of self-report questionnaires via Amazon's Mechanical Turk. RESULTS: Hierarchical linear regressions indicated that beliefs regarding firearm ownership or storage were associated with openness to means safety measures to prevent a suicide attempt by someone else, but not to prevent one's own suicide attempt. Additionally, results from analyses of covariance indicated that firearm owners with lifetime ideation had stronger beliefs regarding the association between firearm ownership or storage and suicide risk. CONCLUSIONS: Findings indicate firearm owners' willingness to engage in means safety may be influenced by the degree to which they believe firearm storage is associated with suicide. Furthermore, firearm owners with prior suicide ideation are more open to the idea that firearm ownership and storage are related to suicide risk. Viewing suicide as salient to one's own life may serve as a focal point in efforts to increase openness to means safety among firearm owners.


Assuntos
Armas de Fogo , Propriedade , Suicídio/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Ideação Suicida , Tentativa de Suicídio , Inquéritos e Questionários , Estados Unidos , Violência , Adulto Jovem
12.
Suicide Life Threat Behav ; 49(5): 1318-1331, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30368865

RESUMO

OBJECTIVES: Despite the general suicide rate within the military being comparable to the general population when comparing peers, there are certain branches of the military that have elevated risk. Specifically, the U.S. National Guard has suicide rates that are constantly higher than other military branches and civilian peers. The National Guard are a unique military population in which they frequently transition between military and civilian life. With these unique experiences and heightened risk, military suicide prevention efforts may benefit from further research within this population. Posttraumatic stress disorder (PTSD) is another concern amongst military personnel and has been linked to suicidal behavior. METHODS: The current study examined the indirect effects that distress tolerance, a protective factor against suicide, has on the relationship between PTSD and constructs within a well-validated theory for suicide (the Interpersonal-Psychological Theory for suicidal behaviors) in a sample of U.S. Army National Guard personnel. RESULTS: Results indicated that distress tolerance had a significant indirect effect on the relationship between PTSD and thwarted belongingness, perceived burdensomeness, and capability for suicide. CONCLUSIONS: These findings are consistent with previous literature examining the relationship between distress tolerance and our outcome variables. These results could have important clinical implications, mainly that intervention strategies targeting distress tolerance could have significant impacts on suicide-relate thoughts.

13.
Arch Suicide Res ; : 1-18, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30300101

RESUMO

Suicide rates within the military are elevated relative to the general population; however, research suggests that many of the suicide risk factors for military personnel are similar to the suicide risk factors for civilians. Given that many military specific experiences (e.g., number of deployments) are not considered robust predictors of either suicidal ideation or behavior, it has been posited that deployment specific experiences (e.g., post-battle experiences) may be better able to explain the increased rates of suicide among military personnel. Therefore, the current study aimed to examine the relationship between post-battle experiences and perceived burdensomeness (PB), thwarted belongingness (TB), and suicidal ideation within 3 different military samples: a non-clinical sample of Army National Guard personnel, a non-clinical sample of active duty U.S. Air Force Security Forces personnel, and a clinical sample of U.S. Army personnel receiving outpatient treatment. Post-battle experiences were found to be significantly associated with TB in both non-clinical samples; however, the association between post-battle experiences and TB was non-significant within the clinical sample. Furthermore, results indicated that post-battle experiences were not significantly associated with either PB or suicidal ideation in any of the samples. These findings suggest that in non-clinical samples, post-battle experiences impact a soldier's ability to feel connected to others. Within clinical samples, results indicate that post-battle experiences may not be a direct contributor to either PB or TB. These results indicate a need for universal intervention promoting interpersonal support of military personnel and their families prior to development of further need for psychological interventions. This upstream approach may decrease further development of TB and potentially prevent suicidal desire.

14.
J Consult Clin Psychol ; 86(11): 946-960, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30335426

RESUMO

OBJECTIVE: Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized. METHOD: This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk. RESULTS: Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32). CONCLUSIONS: AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/psicologia , Risco , Ideação Suicida , Suicídio/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicopatologia , Comportamento de Redução do Risco , Autoimagem , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Adulto Jovem
15.
Suicide Life Threat Behav ; 48(6): 699-708, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-28869802

RESUMO

Firearms account for half of all U.S. suicide deaths, but research on mechanisms through which firearms confer risk is limited. Although research has indicated firearm ownership and the unsafe storage of firearms are associated with an elevated risk of suicide, such research cannot provide insight into the extent to which a history of using a gun plays a role. We recruited a community sample (N = 100; 76% female; 44% Black) oversampled for prior suicidal behavior in a high gun ownership state (Mississippi). Consistent with hypotheses, a greater number of lifetime experiences of firing a gun were associated with elements of the capability for suicide (fearlessness about death, pain tolerance, pain persistence) and lifetime suicide attempts, but not with suicide ideation or simple pain detection. These findings indicate that guns may confer risk of suicide in part through increased comfort and aptitude with the weapon, a notion consistent with the construct of practical capability. Furthermore, these findings are consistent with research indicating that guns do not cause healthy individuals to become suicidal, but rather increase risk among already suicidal individuals. Overall, our findings highlight the importance of considering practical experience with guns as well as simple ownership and storage methods.


Assuntos
Armas de Fogo/estatística & dados numéricos , Propriedade/estatística & dados numéricos , Suicídio , Adulto , Causas de Morte , Feminino , Utensílios Domésticos , Humanos , Masculino , Mississippi/epidemiologia , Medição de Risco/métodos , Fatores de Risco , Suicídio/etnologia , Suicídio/prevenção & controle , Suicídio/psicologia , Suicídio/estatística & dados numéricos
16.
Subst Use Misuse ; 53(6): 1041-1050, 2018 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-29172932

RESUMO

BACKGROUND: Hazardous drinking is prevalent among college students and often comorbid with mood and/or anxiety disorders; however, these disorders frequently go untreated. Prior studies have found that individuals with comorbid hazardous drinking are more likely to seek treatment than those with an hazardous drinking alone. OBJECTIVES: The current study tested possible psychological and structural explanations to understand these treatment seeking behaviors. METHODS: A sample of 222 students identified as hazardous drinkers (AUDIT ≥ 8) participated from September 2010 to April 2011. Behavioral measures designed to mimic actual treatment seeking and self-report measures were used to assess treatment seeking behaviors, and the influence of psychopathology and individual predictors on treatment interest. RESULTS: Students were more interested in treatment for emotional problems than for alcohol problems. Further, treatment seeking interest was significantly higher among individuals with comorbid hazardous drinking. When provided a telephone offer for a free on-campus clinic appointment, no students were interested in receiving treatment for alcohol use problems, but some were interested in an appointment for emotional problems (n = 13). Of those students expressing interest on the phone, seven attended the clinic appointment. Logistic regression analyses revealed that students with anxiety, anxiety sensitivity, and depression were more likely to attend the clinic appointment. Conclusions/Importance: In sum, targeting mood and anxiety disorders may be a viable way to increase treatment seeking rates in hazardous drinking college students.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Alcoolismo/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Alcoolismo/psicologia , Ansiedade/psicologia , Comorbidade , Depressão/psicologia , Acesso aos Serviços de Saúde , Humanos , Prevalência , Sudeste dos Estados Unidos/epidemiologia , Universidades
17.
Addict Behav ; 78: 160-165, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29175292

RESUMO

College students with social anxiety disorder experience more alcohol-related negative consequences, regardless of the amount of alcohol they consume. Social anxiety refers to psychological distress and physiological arousal in social situations due to an excessive fear of negative evaluation by others. The current study examined within-group differences in alcohol-related negative consequences of students who met or exceeded clinically-indicated social anxiety symptoms. In particular, we tested a sequential mediation model of the cognitive (i.e., fear of negative evaluation) and behavioral (protective behavioral strategies) mechanisms for the link between social anxiety disorder subtypes (i.e., interaction and performance-type) and alcohol-related negative consequences. Participants were 412 traditional-age college student drinkers who met or exceeded the clinically-indicated threshold for social anxiety disorder and completed measures of fear of negative evaluation, protective behavioral strategies (controlled consumption and serious harm reduction), and alcohol-related negative consequences. Fear of negative evaluation and serious harm reduction strategies sequentially accounted for the relationship between interaction social anxiety disorder and alcohol-related negative consequences, such that students with more severe interaction social anxiety symptoms reported more fear of negative evaluation, which was related to more serious harm reduction strategies, which predicted fewer alcohol-related negative consequences. Future directions and implications are discussed.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Ansiedade/etiologia , Medo/psicologia , Pensamento , Adolescente , Estudos Transversais , Feminino , Redução do Dano , Humanos , Masculino , Autoimagem , Responsabilidade Social , Estudantes/psicologia , Adulto Jovem
18.
J Affect Disord ; 222: 57-62, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28672180

RESUMO

BACKGROUND: Although the relationship between posttraumatic stress disorder (PTSD) and suicide has been firmly established, research on underlying mechanisms has been disproportionately low. The cognitive concerns subscale of anxiety sensitivity (AS), which reflects fears of cognitive dyscontrol, has been linked to both PTSD and suicide and thus may serve as an explanatory mechanism between these constructs. METHODS: The sample consisted of 60 male veterans presenting to an outpatient Veteran Affairs (VA) clinic for psychological services. Upon intake, veterans completed a diagnostic interview and brief battery of self-report questionnaires to assist with differential diagnosis and treatment planning. RESULTS: Results revealed a significant association between PTSD symptom severity and higher suicidality (i.e., ideation, plans, and impulses), even after accounting for relevant demographic and psychological constructs. Moreover, AS cognitive concerns mediated this association. LIMITATIONS: Limitations include the small sample size and cross-sectional nature of the current study. CONCLUSIONS: These findings add considerably to a growing body of literature examining underlying mechanisms that may help to explain the robust associations between PTSD and suicide. Considering the malleable nature of AS cognitive concerns, research is needed to determine the extent to which reductions in this cognitive risk factor are associated with reductions in suicide among at risk samples, such as those included in the present investigation.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos Cognitivos/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ideação Suicida , Veteranos/psicologia , Adulto , Idoso , Ansiedade/psicologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Suicídio/psicologia , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
19.
J Affect Disord ; 217: 138-143, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28410476

RESUMO

BACKGROUND: Anxiety sensitivity cognitive concerns (ASCC), refer to fears of mental catastrophe or losing control over mental processes. Recent findings show that ASCC are related to suicide risk, mood disorders and trauma-related disorders. Using controlled experimental psychopathology paradigms could be one heretofore unutilized method of increasing understanding of ASCC. Our goal was to test fear reactivity to four head-mounted display perceptual illusion challenges designed to bring on feelings of cognitive dyscontrol (i.e., derealization, depersonalization) in a group of high and low anxiety sensitivity cognitive concerns participants. METHODS: Participants (N=49) with Anxiety Sensitivity Index-3 cognitive scores at least 1.5 SD above or below the mean completed four cognitive dyscontrol challenges utilizing head-mounted display technology. RESULTS: Results showed all four challenges successfully elicited high cognitive anxiety symptoms. Consistent with other laboratory challenge studies; high versus low ASCC participants reported comparable cognitive symptoms but reported significantly greater fear. LIMITATIONS: This was an initial proof of concept study designed to examine fear reactivity to cognitive dyscontrol challenges. Therefore, no control exercises were evaluated. CONCLUSIONS: The finding that fear reactivity to the laboratory challenges can potentially serve as a viable behavioral correlate of ASCC provides a potentially useful exposure exercise for clients experiencing high levels of ASCC. Given the association between ASCC and severe psychopathology, with further investigation and refinement, such exposure exercises could be integrated into cognitive-behavioral treatments.


Assuntos
Ansiedade/psicologia , Despersonalização/psicologia , Medo/psicologia , Ilusões , Adulto , Cognição , Feminino , Humanos , Masculino
20.
J Consult Clin Psychol ; 85(6): 596-610, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28287798

RESUMO

OBJECTIVE: Anxiety sensitivity (AS) is a well-established transdiagnostic risk factor for anxiety and mood psychopathology including suicide. A variety of interventions using cognitive-behavioral skills as well as cognitive bias modification (CBM) suggest that AS can be quickly and effectively reduced in nonclinical and nontreatment seeking samples. However, it is unclear whether AS reduction protocols will have efficacy for more severe clinical samples. Moreover, the combination of cognitive-behavioral techniques with CBM focused on changing interpretation bias (CBM-I) related to AS has not been evaluated. METHOD: A patient sample with co-occurring anxiety psychopathology and active suicidal ideation (N = 74) was randomly assigned to a brief 1-session computerized treatment including: (a) psychoeducation and interoceptive exposure (i.e., cognitive anxiety sensitivity treatment [CAST]) plus CBM-I for AS; or (b) health information condition plus sham CBM for AS. Participants were assessed immediately after the 1-hr intervention as well as at 1- and 4-month follow-ups. RESULTS: Consistent with hypotheses, participants in the active treatment showed significantly greater AS reduction that was maintained through follow-up (effect sizes ranged from medium to large for the overall AS and the AS subscales). Mediation analyses suggested that changes in AS mediated suicide outcomes. CONCLUSIONS: In sum, these are the first findings to suggest that brief AS reduction protocols have efficacy both in terms of risk and symptom outcomes in patient samples showing active suicidal ideation. (PsycINFO Database Record


Assuntos
Transtornos de Ansiedade/terapia , Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Ideação Suicida , Suicídio/psicologia , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
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