Anthony Fulginiti

Talking about suicide may not be enough: family reaction as a mediator between disclosure and interpersonal needs

Abstract Background: Although most people who make an attempt do not die, attempt survivors remain at particularly elevated risk for suicide in the short- and long-term. Moreover, the research on suicide-related disclosure and subsequent family reactions on risk factors for the development of suicidal desire is limited. Aims: This study examined the relationships between disclosure, family reaction and two interpersonal needs connected to the development of suicidal desire. Methods: Data from 74 attempt survivors who participated in a larger study were analyzed to assess the relationships between degree of suicide-related disclosure, quality of family reaction and thwarted belongingness and perceived burdensomeness. Results: Results indicated that higher rates of disclosure predicted more positive family reactions, which in turn predicted lower levels of thwarted belongingness and perceived burdensomeness. Although there was no direct relationship between disclosure and the outcome variables, bootstrapping analyses indicated that family reaction mediated the relationship between disclosure and both belongingness and burdensomeness. Conclusions: These findings suggest the need for more family interventions that promote healthy reactions following suicide-related disclosure in order to facilitate the recovery and treatment process.

The perceived effectiveness of online social work education: insights from a national survey of social work educators

ABSTRACT Despite rapid growth in online learning in social work and a growing body of research showing comparable levels of effectiveness and student satisfaction, concerns about online social work education remain among faculty. This is important given that faculty acceptance can play a pivotal role in the success and failure of online education. The current study aimed to compare levels of perceived effectiveness of online and on-the-ground education across nine social work competencies, as well as examine the association between experience with online education and perceived effectiveness of online education. The sample included 376 faculty recruited from schools of social work in the United States. Results suggest that online education is consistently perceived as being less effective than on-the ground education in helping students to meet Council on Social Work Education competencies. Furthermore, perceptions of effectiveness of online education are lowest for practice-oriented competencies. Regression analyses showed that tenure status, years of full-time teaching, technological preparedness, and level of exposure to online education were significantly associated with perceived effectiveness of online education. It is critical that schools develop more opportunities for faculty to engage in direct teaching experience online as well as enhance their levels of comfort and proficiency with technology.

Testing the psychometric properties of the self-harm and suicide disclosure scale

Suicide-related disclosure is an important component of identifying individuals at risk for suicide. However, no standardized measures exist to assess the degree to which individuals have disclosed suicide-related experiences. Therefore, the present study tested the psychometric properties of the Self-Harm and Suicide Disclosure Scale. A sample of 142 individuals, predominantly female and Caucasian, with ages ranging from 18-77 who had experienced suicidal ideation or behavior in their lifetime completed online surveys. A Rasch model analysis was used to test the item and individual separation and reliability and model fit of the instruments use for disclosure to both family and nonfamily members. Analyses indicated strong item separation and reliability. Items were removed to improve model fit, resulting in two revised instruments. Findings indicate the Revised Suicide and Self-Harm Disclosure Scales are appropriate measures for assessing the depth of suicide-related disclosure. Future studies should attempt to replicate these findings with a more diverse sample.

Suicide Attempt Survivorship and Designation as a Concealable Stigmatized Identity

Despite literature on unique challenges faced by people living with concealable stigmatized identities (CSIs), no research has explored this concept among suicide attempt survivors. Social network interviews with 26 attempt survivors about their family relationships were used to assess whether attempt-survivor status is consistent with CSI criteria. Participants concealed their attempt from 51% of family members and perceived that 46% of them held stigmatizing attitudes toward attempt survivors. Additionally, 42% agreed that being a survivor is central to who they are, and 46% indicated they commonly thought about being an attempt survivor. Applying the CSI concept to attempt survivors establishes conceptual linkages to resources and interventions developed for other CSIs, which could increase the field’s ability to respond to attempt-survivor needs.

Exploring suicide-related disclosure motivation and the impact on mechanisms linked to suicide

Abstract Suicide-related disclosure enables improved risk management but disclosure motivations are understudied. This study identified reasons for and against disclosing suicidal thoughts and examined their link to future disclosure and interpersonal needs among 44 people receiving psychiatric care. The most endorsed reasons for disclosure (approach-motivations) included help-seeking, shared background, and catharsis. The most endorsed reasons against disclosure (avoidance-motivations) included fear of rejection, shame, and hospitalization. Higher mean approach motivation was associated with more disclosure intent and less burdensomeness. No associations with avoidance motivation were observed. Programming that seeks to orient people toward approach motivation holds promise for attenuating suicide risk.

Is There a Need for LGBT-Specific Suicide Crisis Services?

Background: Lesbian, gay, bisexual, and transgender (LGBT) youth are more than twice as likely to attempt suicide than their peers. Although LGBT-specific crisis services have been developed, little is known about the need for these services beyond that of general lifeline services. Aims: The present study sought to (a) describe the primary reasons for calling a specialized provider as opposed to another and (b) examine sociodemographic differences in the primary reason by race, ethnicity, gender, age, and sexual orientation. Method: Data from 657 youth who sought crisis services from an LGBT-specific national service provider in the United States were assessed. Logistic regression models assessed demographic differences. Thematic analysis of open-ended responses regarding reasons for choosing this LGBT-specific crisis service provider followed a consensus model. Results: Most respondents indicated they either would not have contacted another helpline (26%) or were not sure (48%). Nearly half (42%) indicated they called specifically because of LGBT-affirming counselors, a reason more commonly reported by gender minority (transgender and gender nonbinary) and queer or pansexual youth than cisgender, gay, or lesbian youth. Conclusion: LGBT-specific crisis services appear to play an important role in suicide prevention. Further research is needed to understand the use of culturally tailored suicide prevention approaches.

Homelessness, Mental Health and Suicidality Among LGBTQ Youth Accessing Crisis Services

LGBTQ youth experience increased risks of homelessness, mental health disorder symptoms, and suicidality. Utilizing data from LGBTQ youth contacting a suicide crisis services organization, this study examined: (a) rates of homelessness among crisis services users, (b) the relationship between disclosure of LGBTQ identity to parents and parental rejection and homelessness, and (c) the relationship between homelessness and mental health disorder outcomes and suicidality. A nationwide sample of LGBTQ youth was recruited for a confidential online survey from an LGBTQ-focused crisis services hotline. Overall, nearly one-third of youth contacting the crisis services hotline had experienced lifetime homelessness, and those who had disclosed their LGBTQ identity to parents or experienced parental rejection because of LGBTQ status experienced higher rates of homelessness. Youth with homelessness experiences reported more symptoms of several mental health disorders and higher rates of suicidality. Suggestions for service providers are discussed.

But Everyone is Doing It (Sort of)! Perceived Sexual Risks in the Social Environment and the Impact on Homeless Youth Engagement in Concurrent Sexual Relationships

Although homeless youth are likely to engage in concurrent sexual relationships and doing so can accelerate HIV transmission, the issue of sexual concurrency (i.e., having sexual partnerships that overlap in time) has received scarce attention in this vulnerable population. The literature that exists tends to focus on individuals’ characteristics that may be associated with concurrency and overlooks the influence of their social environment. Informed by the risk amplification and abatement model (RAAM), this study explored the association between pro-social and problematic social network connections, and sexual concurrency among homeless youth using drop-in center services (Nu2009=u2009841). Nearly 37% of youth engaged in concurrency. Partially consistent with the RAAM, regression analyses showed that affiliation with more problematic ties (i.e., having more network members who practice concurrency and unprotected sex) was associated with greater sexual concurrency. Programs addressing HIV risk among homeless youth in drop-in centers should consider the role youths’ network composition may play in concurrency.

Teaching Note—Developing an Online Blended Learning Course on Psychiatric Diagnosis

ABSTRACT It has been suggested that the task of teaching and learning social work practice in an online environment can greatly be facilitated if thoughtful attention is paid to course design. This article details the design of a blended-learning online course to teach MSW students the process of psychiatric diagnosis. First, the development of the course philosophy is discussed. Second, the choice of the VARK (visual, aural, read/write, kinesthetic) learning model is explained. Finally, the design of the course consistent with the philosophy and learning model is presented.