Biomedical subjects

D A Jobes

Publications and source records attributed to D A Jobes.

10 recordsLinked to original sources

PubMed2000

Collaborating to prevent suicide: a clinical-research perspective.

It is argued that suicidality is essentially a relational phenomenon; the presence or absence of certain key relationships paradoxically can be both suicide causing and suicide preventive. The relational aspects of suicide are especially poignant in clinical work with suicidal patients. However, when suicidality is involved, there are a number of issues that can interfere with effective clinical practice. Fortunately, a new paradigm has begun to emerge in contemporary clinical suicidology, which objectifies suicidality and emphasizes the phenomenology of suicidal states. Moreover, from an increasingly empirical perspective, this approach is creating new and better ways to effectively assess and treat suicidal conditions.

Adult↗

PubMed1999

Reasons for living versus reasons for dying: examining the internal debate of suicide.

The Reasons for Living vs. Reasons for Dying (RFL/RFD) Assessment was used to obtain suicidal outpatients' top five reasons for living and for dying, respectively. Forty-nine suicidal university counseling center patients provided 173 RFL and 145 RFD responses. These responses were organized into eight RFL coding categories and nine RFD coding categories. Two coders trained in the RFL/RFD coding system showed high levels of interrater reliability (KRFL = .81; KRFD = .80). Chi-square results for RFL and RFD coding categories showed that the coding categories were not equally salient to these suicidal patients.

Adult↗

PubMed1998

Clinicians' decision making about involuntary commitment.

OBJECTIVE: Clinicians' decision making about involuntary commitment was examined, with a focus on the effects of patient and clinician characteristics and bed availability on decisions to detain patients, the first step in involuntary commitment. METHODS: Eighteen psychologists and social workers in the emergency service of a community mental health center completed the Risk Assessment Questionnaire for 169 consecutive patients they deemed to present some degree of risk. Forty-two patients were detained. RESULTS: Three underlying constructs were significantly associated with a patient's overall risk rating, which in turn predicted the decision to detain. Two were clinician characteristics: the clinician detention ratio, which reflects the proportion of patients detained by the clinician in the past three months, and the setting in which the evaluation occurred, either an in-house emergency service or a mobile crisis unit. The availability of detention beds in the community was also a significant predictor of whether a patient would be detained. No patient characteristic, including diagnosis, sex, age, or insurance status, was significantly related to the detention decision. CONCLUSIONS: The findings suggest that the decision-making process is influenced by multiple factors, such as setting, the clinician's tendency to detain patients, and the availability of detention beds.

Adult↗

PubMed1996

The Kurt Cobain suicide crisis: perspectives from research, public health, and the news media.

The suicide of rock star Kurt Cobain in 1994 raised immediate concerns among suicidologists and the public at large about the potential for his death to spark copycat suicides, especially among vulnerable youth. The Seattle community, where Cobain lived and died, was especially affected by his sudden death. An overview of Cobain's life and death is presented and various crisis center and community-based interventions that occurred are discussed. Preliminary data collected from the Seattle Medical Examiner's Office and from the Seattle Crisis Center to assess the potential impact of Cobain's death on completed suicides and the incidence of suicide crisis calls are presented. The data obtained from the Seattle King County area suggest that the expected "Werther effect" apparently did not occur, but there was a significant increase in suicide crisis calls following his death. It is hypothesized that the lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain's suicide, and the crisis center and community outreach interventions that occurred. The Cobain suicide and the role of media influence on copycat suicides are further discussed in commentaries from public health and news media perspectives.

Adult↗

PubMed1995

Suicide prevention in adolescents (age 12-18).

The epidemiology of adolescent suicide is summarized with particular emphasis on temporal trends by age and gender. "First-generation" prevention programs, as reviewed and critiqued by the Centers for Disease Control and Prevention, are then examined. In the absence of compelling empirically based behavioral outcome data, selective targeted "second-generation" prevention efforts are then described across the primary-secondary-tertiary continuum. These efforts are focused toward targets of individual predisposition, the social milieu, or proximal agents associated with high risk for suicidal behaviors. Finally, with an eye toward the future, current obstacles and unanswered questions are explored as they relate to opportunities and hopes for change in effecting reduced rates of these behaviors.

Adolescent↗

PubMed1995

The challenge and the promise of clinical suicidology.

The existing research in clinical assessment and treatment of suicidal patients is reviewed. Data concerning the "life course" of suicidality among outpatient samples of suicidal university students are then presented. These data suggest different subtypes of suicidality, which are further considered using a conceptual model that differentiates intrapsychic versus interpsychic suicidality. The implications of these data and this model are discussed in relation to current changes in mental health care with an emphasis on differential assessment and prescriptive treatments. Future developments in clinical suicidology and ideas for additional research are discussed.

Humans↗

PubMed1994

Do you see what I see? Patient and clinician perceptions of underlying dimensions of suicidality.

The clinical suicidology literature strongly emphasizes the importance of risk assessment. However, limited empirical data are available about the assessment process. The present study investigated the ways in which clinicians and patients perceive several theoretical dimensions related to suicide: psychological pain, external pressures/stressors, agitation/emotional upsetness, self-regard, and hopelessness. Data from the current sample suggest that clinicians and parasuicidal patients independently perceived most of these dimensions similarly, with the exception of agitation/emotional upsetness (perturbation). The implications of these findings are discussed.

Caregivers↗

PubMed1991

Empirical criteria for the determination of suicide manner of death.

A 16-item instrument was constructed as a tool to assist medicolegal official in their investigations and certifications of suicidal deaths. The Empirical Criteria for the Determination of Suicide (ECDS)--derived from a combined set of the 22 criterion items of the Operational Criteria for the Determination of Suicide (OCDS) and 33 other items obtained from experts and the professional literature--was constructed and validated by using 126 suicide and accident cases obtained from 70 medical examiner participants. Analysis of the cases confirmed that suicide is a manner of death in which there is evidence of both self-infliction and intention to die. The 16 items retained in the ECDS discriminated suicides from accidents best in relation to self-infliction and intention. In analysis of its concurrent validity, the ECDS instrument predicted 100% of the suicides and 83% of the accidents, thus correctly identifying 92% of all cases.

Cause of Death↗

PubMed1987

Improving the validity and reliability of medical-legal certifications of suicide.

On a very basic level, those who study suicide are either explicitly or implicitly concerned with the certification of suicide deaths by coroners and medical examiners. Although many authors have questioned the reliability and validity of officially reported rates, these statistics continue to be quoted as fact--a potentially problematic practice for researchers who seek accurate and true causative factors for suicidal behavior. In relation to this topic, this article provides an overview of the existing vital statistics registry system and describes and proposes innovations that could ultimately improve the quality of officially reported suicide statistics.

Accidents↗

PubMed1986

The impact of psychological autopsies on medical examiners' determination of manner of death.

This study evaluated the impact of psychological information on medical examiners' determination of manner of death in equivocal cases. Ten cases, a typical and equivocal case for each of five case types (single car, child, autoerotic, psychotic, and Russian roulette death) were evaluated for manner of death by 195 medical examiner subjects. From this sample 95 control subjects received 10 cases made up of physical and circumstantial evidence, while 100 experimental subjects received the same 10 cases expanded with brief psychological autopsies. Psychological information was shown to have a statistically significant impact on subjects' determination (and certainty) of manner of death is equivocal cases and even in some typical cases.

Accidents, Traffic↗