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Biomedical subjects

A P Haas

Publications and source records attributed to A P Haas.

11 recordsLinked to original sources
PubMed2001

Recognizing and responding to a suicide crisis.

Data from therapists who were treating 26 patients when they committed suicide were utilized to identify signs that warned of a suicide crisis. Three factors were identified as markers of the suicide crisis: a precipitating event; one or more intense affective states other than depression; and at least one of three behavioral patterns: speech or actions suggesting suicide, deterioration in social or occupational functioning, and increased substance abuse. Problems in communication between patient and therapist were identified as factors interfering with crisis recognition. Evaluation of the identified affects and behaviors may help therapists recognize a suicide crisis.

Adolescent↗
PubMed2001

Recognizing and responding to a suicide crisis.

Data from therapists who were treating 26 patients when they committed suicide were utilized to identify signs that warned of a suicide crisis. Three factors were identified as markers of the suicide crisis: a precipitating event; one or more intense affective stats other than depression; and at least one of three behavioral patterns: speech or actions suggesting suicide, deterioration in social or occupational functioning, and increased substance abuse. Problems in communication between patient and therapist, often originating in therapeutic anxiety over the patient's possible suicide, were identified as factors interfering with crisis recognition. Evaluation of the identified affects and behaviors may help therapists recognize a suicide crisis.

Adolescent↗
PubMed2000

Therapists' reactions to patients' suicides.

OBJECTIVE: The authors wished to obtain information from therapists about their reactions to the suicides of patients in their care. METHOD: Therapists for 26 patients who committed suicide completed a semistructured questionnaire about their reactions, wrote case narratives, and participated in a workshop to discuss their cases. The therapists discussed what they would do differently, the impact of the death on their treatment of suicidal patients, their interaction with patients' relatives after the suicides, and the reactions of their colleagues and supervisors. RESULTS: Shock, grief, guilt, fear of blame, self-doubt, shame, anger, and betrayal were the major emotional reactions. In 21 out of 26 cases, therapists identified at least one major change they would have made in their patients' treatments; most frequently mentioned were changes in medication, hospitalization of the patients, and consultation with the patients' previous therapists. Nineteen of the therapists saw the patients' relatives after the suicides; in almost all cases the relatives were not critical of them. Some of the therapists were reluctant to accept subsequent suicidal patients into their practices. Although colleagues were supportive, institutional responses and case reviews were rarely helpful, offering either blame or false reassurance that the suicide was inevitable. CONCLUSIONS: Clinicians felt they learned from participating in the project and that it was therapeutic for them. Review of such cases by a disinterested independent group with no institutional ties to the therapists seems desirable.

Anger↗
PubMed1991

Suicide and guilt as manifestations of PTSD in Vietnam combat veterans.

OBJECTIVE: Although studies have suggested a disproportionate rate of suicide among war veterans, particularly those with postservice psychiatric illness, there has been little systematic examination of the underlying reasons. This study aimed to identify factors predictive of suicide among Vietnam combat veterans with posttraumatic stress disorder (PTSD). METHOD: Of 187 veterans referred to the study through a Veterans Administration hospital, 100 were confirmed by means of a structured questionnaire and five clinical interviews as having had combat experience in Vietnam and as meeting the DSM-III criteria for PTSD. The analysis is based on these 100 cases. RESULTS: Nineteen of the 100 veterans had made a postservice suicide attempt, and 15 more had been preoccupied with suicide since the war. Five factors were significantly related to suicide attempts: guilt about combat actions, survivor guilt, depression, anxiety, and severe PTSD. Logistic regression analysis showed that combat guilt was the most significant predictor of both suicide attempts and preoccupation with suicide. For a significant percentage of the suicidal veterans, such disturbing combat behavior as the killing of women and children took place while they were feeling emotionally out of control because of fear or rage. CONCLUSIONS: In this study, PTSD among Vietnam combat veterans emerged as a psychiatric disorder with considerable risk for suicide, and intensive combat-related guilt was found to be the most significant explanatory factor. These findings point to the need for greater clinical attention to the role of guilt in the evaluation and treatment of suicidal veterans with PTSD.

Combat Disorders↗
PubMed1987

Long-term outcomes of heavy marijuana use among adolescents.

In order to better understand the long-term outcomes of heavy marijuana use among adolescents, 17 adolescent and 15 adult users were intensively studied over a several-year period. Among both the adolescents and the adults, heavy use of the drug was found to have similar adaptive or defensive functions, fostering a detachment from the painful or unpleasant realities of their lives. This suggests that for a large number of adolescents, both the marijuana behavior and the psychosocial patterns associated with it are brought forward into adulthood.

Achievement↗
PubMed1983

Suicide among older people: projections for the future.

Guided by recent demographic analyses of birth cohort effects, the authors demonstrate the relationship between cohort size and longitudinal suicide rates, with reference to four particular cohorts which have entered adulthood at various periods throughout the present century. Combining this perspective with a look at projected population increases among older age groups, estimates are made of the scope of the problem of suicide among older people which is likely to be encountered during the early decades of the next century.

Adolescent↗
PubMedDate not supplied

The adaptive significance of chronic marijuana use for adolescents and adults.

To the degree that the adults were aware of their difficulties, they saw marijuana as an escape from them, or as providing relief or enhancing their ability to cope with them. Neither they nor we saw marijuana as the cause of their problems. Rather, it served for most to help maintain them in a troubled adaptation, reenforcing their tendency not to look at, understand, or attempt to master their difficulties. It served to detach them from their problems, and helped them to regard even serious difficulties as unimportant. Marijuana provided a buffer zone of sensation that functioned as a barrier against self-awareness and closeness to others. Marijuana enabled the adolescents to avoid choices and challenges associated with growing up. The adults we studied appeared to have been obliged by time to make choices for which they were not prepared, and with which they were not satisfied. To the extent that their futures had caught up with them, they used marijuana in an attempt to diminish awareness of their limitations and convince themselves their problems were insignificant. If the adolescents used marijuana to detach themselves from troubled relationships with their families and to avoid planning for the future, what we have learned from the adult marijuana users provides a perspective on what these young persons' lives are likely to become.

Achievement↗