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Biomedical subjects

K S Adam

Publications and source records attributed to K S Adam.

At least 19 recordsLinked to original sources
PubMed1999

Assessing attachment: convergent validity of the adult attachment interview and the parental bonding instrument.

OBJECTIVE: The aim of this study was to determine whether or not the Parental Bonding Instrument (PBI) can provide information about parent-child attachment that is comparable to information obtained from the Adult Attachment Interview (AAI), a more complex measure of attachment. METHOD: One hundred and thirty emotionally and/or behaviourally disturbed adolescents (73 male, 57 female; ages 13-19 years, x = 15.3 +/- 1.47 years) participating in a study of attachment and suicidality completed the PBI and the AAI. Data from these measures were compared within participants. RESULTS: Maternal care and overprotection on the PBI differed significantly by AAI attachment classification (F3,122 = 2.79, p = 0.012), with autonomous participants showing the most optimal and unresolved participants the least optimal PBI results. Maternal love and maternal involvement/role reversal on the AAI were significant predictors of maternal care and maternal overprotection, respectively, on the PBI (R2 = 0.15; R2 = 0.16). These predictions improved when AAI scales measuring idealisation and involving anger towards the mother were included in the regression analyses (R2 = 0.35; R2 = 0.20). Autonomous participants on AAI showed the highest scale correlations across instruments. CONCLUSIONS: Attachment information obtained from the PBI and the AAI is comparable in participants with optimal attachment histories, but not in participants showing idealisation or anger towards their mothers. Caution is, therefore, advisable when using the PBI to obtain attachment information in clinical samples where suboptimal attachment histories are likely.

Adolescent↗
PubMed1999

Relationship between attachment-felt security and history of suicidal behaviours in clinical adolescents.

OBJECTIVE: This study was designed to test the hypothesis that adolescents who perceive their attachment figures as unavailable (low felt security) would be overrepresented in the case group of adolescents with a history of suicidal behaviours. METHOD: One hundred and eighty-seven adolescents in psychiatric treatment participated in this retrospective case-comparison study of attachment-felt security and history of suicidal behaviours. All participants completed the following measures: Adolescent Attachment Questionnaire, Perceived Social Support From Friends Scale, Rosenberg Self-Esteem Scale, Beck Hopelessness Scale, the depression syndrome scale of the Youth Self Report, and Adam's Suicidal Ideation and Behavior protocol. RESULTS: The comparison group comprised 101 adolescents who had never experienced suicidal ideation or behaviour; the case group included 86 adolescents with a history of suicidal behaviour. We found that perceived unavailability and high levels of depressive symptomatology were predictive of suicidal behaviours. We also found a strong association between being older and having high levels of angry distress in adolescents with a history of suicidal behaviours. CONCLUSION: The advantage of including an assessment of parent-adolescent attachment with clinical adolescents is noted.

Adolescent↗
PubMed1996

Attachment organization and history of suicidal behavior in clinical adolescents.

One hundred thirty-three adolescents in psychiatric treatment participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. The comparison group comprised 64 adolescents who had never experienced suicidal ideation or behaviors; the case group included 69 adolescents with histories of suicidal behavior (n = 53) and severe suicidal ideation (n =16). Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison adolescents in psychiatric treatment had experienced attachment-related trauma. Lapses in the monitoring of reasoning or discourse occurred during the attempted discussion of these events in 73% of adolescents in the case group but in only 44% of adolescents in the clinical comparison group (p = .002), suggesting that cognitive disorganization may be an important variable mediating between traumatic experience and suicidal behavior. Female adolescents and older adolescents were significantly more likely than other adolescents to be in the case group. Preoccupied attachment, in interaction with unresolved-disorganized attachment, was associated with the case group, whereas dismissing attachment was associated with the comparison group.

Adolescent↗
PubMed1994

Parental representation in suicidal adolescents: a controlled study.

One hundred and eighty-seven adolescents referred to outpatient and residential services in three Canadian cities were assessed for lifetime suicidal ideation and attempt, and administered the Parental Bonding Instrument (PBI). Suicidal adolescents of both genders reported lower care and higher over-protection in relation to their mothers than non-suicidal subjects, and female subjects reported this pattern for their fathers as well. Male subjects did not show clear differentiation between groups on PBI ratings for their fathers. Mean PBI scores for female subjects indicated subjects with no suicidal ideation, those with suicidal ideation only, and those having made suicide attempts to be on a continuum, but findings for males did not. The findings extend previous reports of higher "affectionless control" in suicidal adults, but suggest that this pattern may be stronger in females than males, and that maternal influences may be stronger than paternal influences.

Adolescent↗
PubMed1987

Evaluation of the effectiveness of suicide prevention programs: a methodological perspective.

Many studies that attempt to evaluate the effectiveness of treatment programs for suicidal patients are methodologically deficient in one or more areas. This paper outlines six criteria that should be met in designing such investigations: Patients should be randomly assigned to groups; at least 80% of the subjects who were initially enrolled should be followed up; the results should be both statistically significant and clinically important; all clinically relevant outcomes should be reported; the patients must be adequately described; and the new intervention should be feasible in other settings. It is shown that these criteria are both necessary and achievable.

Clinical Trials as Topic↗
PubMed1986

Changing motivation in severely suicidal patients.

While the ambiguity of suicidal patients' stated motivations has been studied in some detail, less attention has been given to the changeability of their motivations. Twenty-six patients who had taken an overdose of paraquat, a highly lethal herbicide, were questioned about their motivation at the time of admission and 24 hours and 3, 7 and 10 days later. Although 25 patients claimed that they wished to die at the time of admission, all of the 14 surviving patients wished to live at the time of discharge from hospital. Of the 12 patients who died, 6 stated that they no longer wished to die in the last interview before their death. During the following year 3 of the 14 surviving patients killed themselves. The findings emphasize the importance of thoroughly assessing all aspects of the suicidal patient's situation in determining risks. The patient's stated intentions should be but one factor considered.

Adolescent↗
PubMed1985

Attempted suicide.

Attempted suicide, a common clinical problem with complex origins, makes heavy demands on psychiatric services. Familiarity with established principles of assessment and management can facilitate decision-making, increase treatment engagement, and reduce the risk of subsequent attempts.

Antidepressive Agents↗
PubMed1983

Follow-up of attempted suicide in Christchurch.

Ninety-eight subjects who had attempted suicide and 102 general practice controls previously interviewed were followed-up at 18-24 months. The former continued to show greater social and psychiatric disability than controls and more than one-third made repeat suicide attempts. Nevertheless, as a group, the attempted suicides showed significant improvement in mental state, and familial and interpersonal relationships, whereas controls reported little change in most measures. Persistence of suicidal ideation and repeat attempts were correlated with the diagnosis of psychosis and personality disorder and predictions about the likelihood of further suicidal activity were accurate. Although 92% of patients were referred for further treatment, 38% of these were judged to have dropped out prematurely. Completion of treatment and being in ongoing treatment were positively correlated with patients' self reports of improvement. The findings are compared to experience elsewhere and to a previous Christchurch follow-up study.

Follow-Up Studies↗
PubMed1982

Parental loss and family stability in attempted suicide.

Ninety-eight persons who had attempted suicide were compared wih 102 matched controls for the incidence of parental loss and family stability before the age of 25 years. Parental loss was significantly more common in the attempted suicides than in the controls, especially death of the father and divorce or separation of parents, reaching peaks during the age periods of 0 to 5 years and 17 to 20 years. The women within this group had experienced significantly more loss from parental death than did the men. Among attempted suicides, there was also a high incidence of family instability, whether or not a loss had occurred. The degree of instability, however, was significantly less among those from intact homes. Suicidal ideation was strongly correlated with family instability in both groups.

Adolescent↗
PubMed1982

Early parental loss and suicidal ideation in university students.

This study examined the relationship of early parental loss to suicidal ideation and suicide attempts in a group of university students attending a university mental health clinic. Seventy-five subjects with a history of parental loss before the age of 16 were compared to a control group of 61 subjects from intact homes for the presence of suicidal ideation and overt suicidal behaviour. Subjects with a history of early loss demonstrated significantly more suicidal ideation and more had made suicide attempts than had subjects from intact homes, and this relationship was even more marked when the consequences of the loss in terms of the subsequent family environment were considered. Where the loss resulted in the long-term disruption of family life, suicidal trends were prominent; where the family life stabilized, they were minimal. Suicidal ideation and suicide attempts occurred significantly more often among female subjects than males, and the loss of father and both parents was in excess of loss of mother among those with significant suicidal ideation. The findings support the hypothesis that early parental loss, under certain conditions, is a significant variable in the predisposition to suicidal behaviour and suggest avenues for further research.

Adolescent↗
PubMed1981

Attempted suicide in Christchurch: three-year follow-up of 195 patients.

Of 195 consecutive patients who had been admitted to hospital for suicide attempt, five died later from a further attempt, and 144 were available for a three-year follow-up study. Twenty-nine patients made subsequent suicide attempts. On discharge from hospital psychiatric treatment was carried out and completed in 40.3 percent, partially completed in 11.1 percent and 18.8 percent did not complete treatment. On a self-rating basis, 8 percent thought they were worse, 32 percent unchanged and 42 percent were improved. There were extensive interpersonal disturbances and a high percentage of patients had changed relationships in the follow-up period. The high persistence of suicidal activity in these patients is discussed.

Follow-Up Studies↗
PubMed1981

Depression in young women who have attempted suicide. An international replication study.

In accord with a recent Australian study, a greater proportion of young women who attempted suicide in 4 centres in Australia, Canada and New Zealand were designated as manifesting a depressive syndrome by a depression questionnaire than would have been anticipated on the basis of previous clinical reports. Furthermore, on the basis of a decision-rule applied to the questionnaire responses, one-third of subjects in each centre were allocated to the "endogenous' category of depression.

Adolescent↗
PubMed1980

Attempted suicide in Christchurch: a controlled study.

The results of a comparison of a sample of consecutive admissions for attempted suicide to matched patients from a general practice are presented. Significant differences were found in the degree of social and psychiatric disturbance, the quality of current interpersonal relationships, and the family backgrounds of the two groups. The implications of these findings for the clinical management of attempted suicide patients are discussed.

Adolescent↗