A quarter century of suicide in a major urban jail: implications for community psychiatry.

OBJECTIVE: The authors' goal was to identify factors that increase the risk of suicide in urban jails. METHOD: They examined and verified all suicides as of 1992 in a representative large jail in Detroit since the beginning of record keeping in 1967 to 1992. RESULTS: There were 37 suicides over this time period. Inmates charged with murder or manslaughter were 19 times more likely to commit suicide than were inmates with other charges. Thirty-nine percent of the suicides were committed by individuals charged with murder. All 37 suicides were by hanging, and most occurred at night within 31 days of admission. Many of the inmates who committed suicide had made previous attempts while incarcerated. Thirty-nine percent of the suicides were committed by individuals charged with murder, constituting 2% of the admissions (two per day). CONCLUSIONS: An important risk factor in jail suicide not previously identified is the charge of murder or manslaughter. Treatment and prevention programs should recognize these inmates as belonging in a very high-risk category.

Relationship between climate and psychiatric inpatient length of stay in Veterans Health Administration hospitals.

OBJECTIVE: The study examined whether climate has an impact on inpatient psychiatric length of stay in Veterans Health Administration hospitals (VHA). METHOD: Data from the National Weather Service for eight climate variables for the locations of 134 VHA hospitals nationwide were factor analyzed, resulting in two climate factors representing temperature and precipitation. Factor scores were correlated with psychiatric mean lengths of stay from 1994 to 1998 for 99 VHA hospitals with inpatient psychiatric services and for the 22 VHA regional divisions (Veterans Integrated Service Networks). RESULTS: Climate factors correlated modestly but significantly with length of stay, with correlations ranging from -0. 25 to -0.37 at the hospital level and from -0.38 to -0.45 at the VHA regional level; hospitals in warmer and drier climates had shorter lengths of stay. Medical centers in colder climates had the longest lengths of stay in winter and fall. The significant correlation between climate and length of stay was not affected by recent reductions in length of stay in VHA hospitals. CONCLUSIONS: Higher clinical costs associated with longer lengths of stay in colder climates have implications for budget planning. Climate factors must also be recognized for their potential effect on performance monitoring systems focused on hospital utilization. Researchers must continue to consider broader contextual variables such as climate if they are to fully understand the determinants of health care utilization and psychiatric hospitalization costs.

Processing and recognition of facial affect in schizophrenia.

A deficit in the recognition of facial affect has been well documented in people with schizophrenia. Our 1995 research with normal subjects showed that hemispheric bias for processing facial affect is related to accuracy of recognition of facial affect. We tested whether this relationship holds in a sample of 25 people with schizophrenia who completed tasks of identification of facial affect and chimeric facial affect. Subjects with a left visual-field bias were significantly more accurate in identifying one facial emotion (sad) than were other subjects. Individual differences in hemispheric advantage for processing affect appears to be an important variable related to functional brain capacity within different populations.

Affect identification bias demonstrated with individual chimeric faces.

The current study extends previous findings of a left visual-field bias in chimeric face tasks, by using a new procedure which incorporates chimeric stimuli depicting both positive and negative target affects and requires the identification of affect in individually presented faces. This new procedure is more representative of the types of judgements made in daily social interaction. Results with this new procedure are consistent with previous findings, indicating a significant left visual-field bias for both positive and negative affects in the majority of subjects. Handedness was significantly related to lateralization scores, with dextrals showing greater left visual-field biases than sinistrals. Among sinistrals, a left visual-field bias was noted only for happy chimera.

Factor analysis of breadth and depth dimensions on Wechsler's Similarities and Vocabulary Subscales.

Previous research (Bailey, Lazar, & Edinger, 1977) has indicated the presence of Breadth and Depth factors on the Similarities subscale of the WAIS. The present study (N = 102) analyzed these two factors further, by using measures of Breadth and Depth on both the Similarities and Vocabulary subscales. Several other measures also were studied, including a Comprehension index, SAT scores, and GPA. Results of a factor analysis with oblique rotation revealed distinct Breadth and Depth factors, which strongly supported the theoretical rationale of the study. The Breadth factor seems to reflect broad-range skills of the type required on conventional IQ tests, while the Depth factor is less theoretically clear. It is suggested that Depth involves an effort component as well as ability because the S is required to provide more than a single correct answer for a given item.

A critique of "obstetrical pain-relieving drugs as predictors of infant behavior variability".

Aleksandrowicz and Aleksandrowicz (1974) concluded that "the use of obstetrical drugs is related to a considerable degree, to infantile behavior over the first month of life" (p. 944). Questions are raised about the adequacy of a number of their procedures. These questions are serious enough to disturb the foundation for any conclusions.

Clinical care of gambling disorders: training, experience, and competence among VHA psychologists.

Problem gambling is a common, highly destructive disorder which is often overlooked by clinicians. Levels of clinical training, clinical experience, and professional competence for providing clinical services for problem gambling were examined in a survey of 181 clinical psychologists working in the Veterans Healthcare Administration (VHA). The results suggest that the majority of clinical psychologists have little or no formal training and little or no past or current clinical experience in the treatment of disordered gambling, nor do they see themselves as competent to evaluate or treat patients with disordered gambling. Most have not referred patients for treatment of problem gambling and do not know of a competent provider to whom they can refer. There is an identifiable subgroup, representing 9% of respondents, who do have more training, provide services, and see themselves as competent to provide care for patients with problem gambling. The amount of formal training is positively correlated with care provided and self-ratings of competence. Despite the lack of training and experience, most respondents expressed interest in receiving additional training. These data suggest that to improve rates of diagnosis and treatment of patients with problem gambling in mental health settings, additional training needs to be made available for mental health providers as a group, with specialized training for clinicians interested in specializing in this area.