Kirk D. Strosahl

Interpersonal problem solving and parasuicide

This study examined the relationship between interpersonal problem solving and suicidal behavior among psychiatric patients. Subjects were 123 psychiatric inpatients, admitted for current parasuicide, serious suicide ideation, or non-suicide-related complaints. A group of 16 orthopedic surgery patients was included to control for hospitalization trauma and current stress. All subjects completed a revised version of the Means-End Problem Solving Procedure, the Rathus Assertiveness Schedule, and a suicide expectancy measure. Psychiatric patients scored lower than the medical control group on the assertive schedule, but no differences were noted as a function of suicidal behavior status. Psychiatric patients expected suicide to solve problems more than did controls. Suicidal patients had higher expectancies than did nonsuicidal patients. Active interpersonal problem solving did not distinguish suicidal and nonsuicidal psychiatric patients but did separate parasuicides from suicide ideators. Among patients without a parasuicide history, less active and greater passive problem solving discriminated first-time parasuicides from suicide ideators and nonsuicidals. Results suggest that assertion deficits may characterize the psychiatric population in general, but suicidal behavior within psychiatric patients may be related to lower active problem solving.

Prediction of suicide intent in hospitalized parasuicides: reasons for living, hopelessness, and depression.

This study examined the risk prediction efficiency of the Reasons for Living Inventory Survival and Coping Beliefs Scale, Beck Hopelessness Scale, Beck Depression Inventory, and the Life Experiences Survey with a sample of 51 newly hospitalized parasuicides. The index of suicidal potential chosen for this study was suicide intent as measured by Becks Suicide Intent Scale. Regression analyses indicated that the Survival and Coping Beliefs Scale emerged as the single most important predictor of suicide intent. Hopelessness and depression made secondary and nonsignificant contributions. Hopelessness was a significant predictor of suicide intent when analyzed apart from Survival and Coping Beliefs, but not among a subsample of 43 repeat parasuicides. Classification analyses showed that neither hopelessness nor survival and coping beliefs were accurate at classifying low- or high-intent parasuicides. Factors contributing to the efficacy of survival and coping beliefs as a risk prediction index are discussed, as is the false-negative dilemma in suicide risk assessment and prediction.

A Structured Interview Version of the Hamilton Rating Scale for Depression: Reliability and Validity

Reliability and validity data are provided for pre- and posttreatment administrations of a structured interview version of the Hamilton Rating Scale for Depression (HRSD) integrated with the National Institute of Mental Health Diagnostic Interview Schedule (DIS). Ss were 70 adult patients requesting therapy for depression

Modeling effects on suicidal behavior.

Knowledge of suicidal behavior, i.e., psychiatric patients indicating that they have an acquaintance or relative who has attempted or committed suicide, has been cited as a risk factor in the assessment of suicide potential. The authors evaluated psychiatric patients hospitalized for a suicide attempt (N = 30), serious suicidal ideation (N = 26), or other non-suicide-related reasons (N = 20) and also a control group of 18 patients admitted for orthopaedic surgery. Information derived from a structured clinical interview revealed that suicide attempters have fewer suicidal models than individuals in the other patient groups, and they are more interpersonally distant from the models they do know. Depression level was not positively related to the recall and reporting of suicidal models. Measures assessing suicide-related beliefs revealed that suicide attempters rated suicide as an effective solution for problems to a greater extent that did patients in the remaining three groups. The implications of these results for social learning models of suicidal behavior are discussed.

Imagery assessment by self report: A multidimensional analysis of clinical imagery

Two studies examined the theory that emotive-abstract, sensory modality, and control imagery are functionally distinct abilities and that emotive-abstract imagery and image control are directly related to the quality of intherapy imagery. In Study One, 199 subjects completed self-report measures of sensory modality, molar imagery, and image control and completed an analogue clinical visualization task. In Study Two, 53 test-anxious covert behavior therapy participants completed the self-report battery and provided ratings of in-therapy image clarity. Results indicated that emotive/abstract imagery, sensory modality imagery, and image control are factorially distinguishable abilities; a cross-sample factor analysis revealed some instability but a theoretically consistent pattern of results. Regression analyses demonstrated that emotive-abstract imagery abilities were the best predictors of performance on the analogue task, whereas both image control and emotive imagery were related to the clarity of in-therapy imagery. Results illustrate the qualitative difference between low- and high-order image processes and the possible interaction between emotive imagery and image control. Implications for imagery assessment and individual differences research are discussed.