Meghan A. Marty

Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults

Older adults have a disproportionally high rate of completed suicide as compared to the general population. Whereas a large literature has focused on risk factors related to elder suicide, limited research exists on relationships between coping strategies with protective factors against suicide and suicidal ideation in this population. Community-dwelling older adults (N = 108, mean age = 71.5 years, age range = 60–95 years) completed the Coping Orientations to Problems Experienced scale, Reasons for Living inventory, and Geriatric Suicide Ideation Scale (GSIS). Problem- and emotion-focused coping were associated positively with reasons for living and negatively with suicide ideation. Dysfunctional coping was associated positively with suicide ideation, but results did not support the hypothesized negative relationship with reasons for living. Thus, problem- and emotion-focused coping appear to be adaptive, whereas dysfunctional coping appears to be somewhat less related to resilience to suicidal ideation among community-dwelling older adults. Implications of the study are that some coping strategies may serve as protective factors against suicide and that coping strategies should be evaluated as part of a thorough assessment of suicidal risk among older adults. The results also provide some evidence of convergent validity for the recently developed GSIS.

Personality, suicidal ideation, and reasons for living among older adults.

OBJECTIVES This study examined associations between diverse types of personality disorder (PD) features, personality traits, suicidal ideation, and protective factors against suicide among community-dwelling older adults. METHODS Participants (N = 109, M age = 71.4 years, 61% female) completed the Coolidge Axis II Inventory, NEO Five-Factor Inventory, Geriatric Suicide Ideation Scale, and Reasons for Living Inventory. RESULTS PD features had positive correlations with suicidal ideation and mixed relationships with aspects of reasons for living. Personality traits had negative correlations with suicidal ideation, with the exception of neuroticism, which had a positive relationship, and were mostly unrelated to reasons for living. In regression analyses, borderline and histrionic were the only PD features that contributed significant variance in suicidal ideation, whereas neuroticism was the only personality trait that contributed significant variance in suicidal ideation. No individual PD features or personality traits contributed significant variance in reasons for living. DISCUSSION The findings highlight the complexity of risk and protective factors for suicide and suggest that a thorough assessment of suicidal potential among older adults should include attention to their underlying personality traits.

Analysis of the Psychometric Properties of the Interpersonal Needs Questionnaire (INQ) Among Community-Dwelling Older Adults

OBJECTIVES This study evaluated the structure and validity of the use of the 18-item Interpersonal Needs Questionnaire (INQ-18), a measure of thwarted belongingness (TB) and perceived burdensomeness (PB), among older adults. METHOD Community-dwelling older adults (N = 284; mean age = 73 years; age range = 64-96 years; 56% women) anonymously completed a questionnaire packet. RESULTS Principal axis factor analysis indicated that two factors should be retained. Items in the first factor reflected the concept of TB, whereas items in the second factor were consistent with the concept of PB. Both factors had medium-to-large positive correlations with hopelessness, depression, suicide ideation, and low meaning in life, providing evidence for convergent validity. CONCLUSIONS Findings from this study support the use of the INQ-18 among community-dwelling older adults.

Geriatric Depression Scale

Abstract The Long Form and the Short Form of the Geriatric Depression Scale (GDS) were compared in a VA nursing home population. The study had two phases. In the first phase, 86 geriatric male veterans were administered the Long Form of the GDS at intake. The Long Form was rescored on the Short Form and a scatterplot was constructed. The Short Form of the GDS consistently identified 94% of the participants using the Long Form as the standard. In the second phase of the study, 31 veterans were administered both the Long Form and the Short Form of the GDS in alternating order during their intake or annual screening assessment. A scatterplot showed the Short Form to consistently identify 100% of the participants using the Long Form as the standard.

Relationships among depressive, passive-aggressive, sadistic and self-defeating personality disorder features with suicidal ideation and reasons for living among older adults.

Objectives: Suicide among older adults is a major public health problem in the USA. In our recent study, we examined relationships between the 10 standard DSM-5 personality disorders (PDs) and suicidal ideation, and found that the PD dimensions explained a majority (55%) of the variance in suicidal ideation. To extend this line of research, the purpose of the present follow-up study was to explore relationships between the four PDs that previously were included in prior versions of the DSM (depressive, passive-aggressive, sadistic, and self-defeating) with suicidal ideation and reasons for living. Method: Community-dwelling older adults (N = 109; age range = 60–95 years; 61% women; 88% European-American) completed anonymously the Coolidge Axis II Inventory, the Reasons for Living Inventory (RFL), and the Geriatric Suicide Ideation Scale (GSIS). Results: Correlational analyses revealed that simple relationships between PD scales with GSIS subscales were generally stronger than with RFL subscales. Regarding GSIS subscales, all four PD scales had medium-to-large positive relationships, with the exception of sadistic PD traits, which was unrelated to the death ideation subscale. Multiple regression analyses showed that the amount of explained variance for the GSIS (48%) was higher than for the RFL (11%), and this finding was attributable to the high predictive power of depressive PD. Conclusion: These findings suggest that depressive PD features are strongly related to increased suicidal thinking and lowered resilience to suicide among older adults. Assessment of depressive PD features should also be especially included in the assessment of later-life suicidal risk.

Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10)

BACKGROUND The Geriatric Anxiety Scale (GAS; Segal et al. (Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Journal of Anxiety Disorders, 24, 709-714. doi:10.1016/j.janxdis.2010.05.002) is a self-report measure of anxiety that was designed to address unique issues associated with anxiety assessment in older adults. This study is the first to use item response theory (IRT) to examine the psychometric properties of a measure of anxiety in older adults. METHOD A large sample of older adults (n = 581; mean age = 72.32 years, SD = 7.64 years, range = 60 to 96 years; 64% women; 88% European American) completed the GAS. IRT properties were examined. The presence of differential item functioning (DIF) or measurement bias by age and sex was assessed, and a ten-item short form of the GAS (called the GAS-10) was created. RESULTS All GAS items had discrimination parameters of 1.07 or greater. Items from the somatic subscale tended to have lower discrimination parameters than items on the cognitive or affective subscales. Two items were flagged for DIF, but the impact of the DIF was negligible. Women scored significantly higher than men on the GAS and its subscales. Participants in the young-old group (60 to 79 years old) scored significantly higher on the cognitive subscale than participants in the old-old group (80 years old and older). CONCLUSIONS Results from the IRT analyses indicated that the GAS and GAS-10 have strong psychometric properties among older adults. We conclude by discussing implications and future research directions.

Basic Issues in Interviewing and the Interview Process

The ability to conduct an efficient and effective clinical and diagnostic interview is arguably one of the most valued skills among mental health professionals. It is during the interview that the clinician learns about the difficulties and challenges experienced by the client and begins to form the foundations of a healing professional relationship. Although the metaphor is not a novel one, the job of the interviewer may be likened to that of a detective trying to collect enough data and organize the clues to “solve the mystery,” in this example, the presenting problem of the client. The most important aspect of this detective metaphor is that effective interviewers (detectives) are served well by their natural curiosity (truly wanting to understand all aspects of the client’s experiences, no mater how painful or uncomfortable) and the thoughtfulness of their approach (being guided by strategies and principles for gathering data while also forming an emotional connection with the client).