Robert J. Cramer

Protection Motivation Theory and Stages of Change in Sun Protective Behavior

This study examined the usefulness of the stage of change model and protection motivation theory (PMT) in creating brief persuasive appeals to promote healthy sun-behavior. College women (N = 254) read one of four essays that manipulated the level of threat and coping appraisal. The transition from the precontemplation to contemplation stage was promoted by threat appraisal information, but transition from contemplation to the preparation stage occurred only when individuals were provided with both high threat and high coping information. Thus, brief communications based on PMT may create attitudes leading to behavior change when later, more intensive, interventions are introduced.

Pathways to suicidal behaviors in childhood.

Path analyses were applied to test a model that includes internalizing and externalizing behavior problems as predictors of suicidal behaviors in children. Parents of an inpatient sample of boys (N=87; M age=9.81 years) rated the frequency of suicidal ideation and completed standardized measures of behavior problems. Blind raters rated the severity of the childrens suicidal behaviors. Results revealed a significant direct effect for suicidal ideation on suicide attempt and for depressive symptoms on suicidal ideation. There was also a significant indirect path from impulsivity to suicidal ideation through aggressive and depressive symptoms. Clinical implications are discussed.

SPIRITUALITY, LIFE STRESS, AND AFFECTIVE WELL-BEING

Recent research has explored many aspects of affective well-being, including depressive symptoms, positive and negative affect. The present study sought to contribute to this line of inquiry by investigating the role of life stress, spiritual life integration (SLI), and social justice commitment (SJC) in predicting affective well-being. Participants were 136 undergraduate students with a mean age of 18.82 (SD = 1.07), and age range of 17–22. Participants completed a questionnaire packet including the Undergraduate Stress Questionnaire (USQ), Beck Depression Inventory (BDI), Positive and Negative Affect Scale (PANAS), and Spiritual Involvement Scale which includes SLI and SJC subscales. In line with previous findings, life stress significantly predicted negative affect and depressive symptoms in hierarchical regression analyses. Contrary to previous research, SLI did not predict any aspect of affective well-being. Finally, SJC significantly predicted positive affect, negative affect, and depressive symptoms. Interpretations, implications, limitations, and future research are discussed.

A Trait-Interpersonal Perspective on Suicide Risk in Criminal Offenders

Despite elevated rates of suicide among offenders, research has yet to adequately address theoretically driven risk models in this population. The present study addresses such a gap by investigating a synthesized framework using 2 well-developed theoretical models, the Five-Factor Model (FFM) of personality and the interpersonal-psychological theory of suicide (IPTS). Archival data from mitigation evaluations for pre-sentenced criminal offenders (n = 307) were analyzed using structural equation modeling (SEM). Results supported a hypothesized personality-IPTS-suicide framework in which neuroticism and extraversion predict IPTS components, namely perceived burdensomeness, thwarted belongingness, and acquired capability. IPTS constructs subsequently directly and indirectly (via suicidal ideation) predicted suicide potential. Findings have important implications for suicide theory, research, and risk assessment with offenders.

A Method for Evaluating Competency in Assessment and Management of Suicide Risk

ObjectiveAlthough health professionals increasingly are expected to be able to assess and manage patients’ risk for suicide, few methods are available to evaluate this competency. This report describes development of a competency-assessment instrument for suicide risk-assessment (CAI—S), and evaluates its use in an objective structured clinical examination (OSCE).MethodsThe authors developed the CAI—S on the basis of the literature on suicide risk-assessment and management, and consultation with faculty focus groups from three sites in a large academic psychiatry department. The CAI—S structures faculty ratings regarding interviewing and data collection, case formulation and presentation, treatment-planning, and documentation. To evaluate the CAI—S, 31 faculty members used it to rate the performance of 31 learners (26 psychiatric residents and 5 clinical psychology interns) who participated in an OSCE. After interviewing a standardized patient, learners presented their risk-assessment findings and treatment plans. Faculty used the CAI—S to structure feedback to the learners. In a subsidiary study of interrater reliability, six faculty members rated video-recorded suicide risk-assessments.ResultsThe CAI—S showed good internal consistency, reliability, and interrater reliability. Concurrent validity was supported by the finding that CAI—S ratings were higher for senior learners than junior learners, and were higher for learners with more clinical experience with suicidal patients than learners with less clinical experience. Faculty and learners rated the method as helpful for structuring feedback and supervision.ConclusionThe findings support the usefulness of the CAI—S for evaluating competency in suicide risk-assessment and management.

Blame Attribution as a Moderator of Perceptions of Sexual Orientation–Based Hate Crimes

Blame attribution is a valuable mechanism explaining decision making. However, present literature mainly employs blame attribution as a dependent variable. The shortcoming of this fact is that blame attribution offers a potentially valuable explanatory mechanism for decision making. The authors designed two studies to investigate blame attribution as a moderator of sentencing decisions in sexual orientation—based hate crimes. Study 1 showed that mock jurors punished perpetrators of hate crimes more severely than a control condition. Also, degree of victim blame influenced punitive decision making. In Study 2, mock jurors extended findings that perpetrators of hate crimes are more harshly punished than those of other types of crimes. Victim and perpetrator blame failed to moderate decision making in this more complex scenario. Results are discussed in relation to hate crimes definitions and attribution theory.

Borderline Personality Symptomatology as a Mediator of the Link Between Child Maltreatment and Adult Suicide Potential

The present study tests borderline personality symptoms as meditational pathways between child maltreatment and suicide potential among college students. A sample of 268 participants completed a questionnaire battery including demographic data, the Comprehensive Child Maltreatment Scale, Inventory of Altered Self-Capacities, and Personality Assessment Inventory. Results: Three multiple mediation models (1 for each type of child maltreatment) were conducted. Results demonstrated that the same set of borderline personality characteristics mediated the relations between each type of child maltreatment (i.e., physical abuse, emotional abuse, and neglect) and suicide potential. The mediating borderline symptoms were affective dysregulation, identity problems, and paranoia. The meditation model is discussed with regard to attachment, trauma, and suicide theories, as well as suicide risk assessment.

Jury selection in child sex abuse trials: a case analysis.

Child sex abuse cases have been the target of considerable psycho-legal research. The present paper offers an analysis of psychological constructs for jury selection in child sex abuse cases from the defense perspective. The authors specifically delineate general and case-specific jury selection variables. General variables include authoritarianism, dogmatism, need for cognition, pretrial knowledge, and race/socioeconomic status. Case-specific variables include sexual attitudes, homonegativity, juror abuse history, and beliefs about children. The paper also provides a factual background of a representative case, incorporates relevant case law, identifies sources for voir dire and juror questionnaire items, and discusses lessons from the primary authors first experience as a trial consultant for the defense.

Hate Crimes on Trial: Judgments about Violent Crime against Gay Men

This study investigated the degree to which judgments regarding a murder case were influenced by victim sexual orientation and hate crime evidence. Results indicated that victim blame was lower when the victim was gay than when the victim was of unspecified or heterosexual orientations, regardless of whether evidence of a hate crime was provided. Additionally, the severity of sentencing increased when evidence of a hate crime was provided. Mock juror authoritarianism and homonegativity moderated the effect of crime condition on sentencing, such that being low in either characteristic enhanced the likelihood of assigning the death penalty to perpetrators of hate crimes. Implications for theory, legal policy, and trial consultation practice are discussed.

Coping With A Patient’s Suicide: A Curriculum for Psychiatry Residency Training Programs

ObjectiveThe suicide of a patient is often experienced as a traumatic event by the clinician involved. Many articles have identified the need for education to guide clinicians through the aftermath of patient suicide; however, little has been published on development of such a curriculum, particularly for residents. This article describes one residency training program’s development of an organized curriculum on coping with patient suicide and evaluates the impact of a core aspect of the training on clinicians’ knowledge about and confidence with coping with patient suicide.MethodsThe training includes a biennial half-day workshop for all trainees plus an “as-needed curriculum” used after a completed suicide. A total of 42 clinicians (39 psychiatry residents and 3 psychiatry faculty) participated in a workshop on coping with patient suicide. Their attitudes and knowledge about the topic were assessed before and after the training.ResultsParticipation in the workshop was associated with large and statistically significant increases in knowledge and self-perceptions of competence in coping with patient suicide.ConclusionThe addition of a curriculum on coping with patient suicide has the potential to significantly enhance psychiatric residency training.