Biomedical subjects

M David Rudd

Publications and source records attributed to M David Rudd.

At least 19 recordsLinked to original sources

PubMed2006

In severely suicidal young adults, hopelessness, depressive symptoms, and suicidal ideation constitute a single syndrome.

BACKGROUND: Despite voluminous research on the role of hopelessness and depression in suicidality, a systematic examination of various causal models pertaining to these variables is conspicuous in its absence. METHOD: The directions of relationships between the three variables were examined by means of a prospective-longitudinal, cross-lagged, three-wave design in a severely suicidal young adults. RESULTS: Structural Equation Modeling (SEM) analyses revealed synchronous, but not longitudinal, associations between hopelessness, depressive symptoms, and suicidal ideation. CONCLUSIONS: In severely suicidal young adults, the three clinical constructs appear to constitute a single depressive syndrome.

Adult↗

PubMed2006

Suicidality in clinical practice: anxieties and answers.

This issue of the Journal of Clinical Psychology: In Session is devoted to suicidality in clinical practice, with coverage of a broad range of topics. After summarizing some of the problems and recent advances in clinical suicidology, I provide a brief overview of the articles. Included are the more broadly defined issues of risk management and psychotherapy with suicidal individuals, along with more specific topics such as risk assessment, no-suicide contracts, and the risk of suicide with the use of selective serotonin reuptake inhibitors (SSRIs) by children and adolescents. Most of the articles feature case vignettes and provide practitioners with clinical recommendations, and all of the articles have clear and important clinical implications.

Anxiety↗

PubMed2006

Advances in the assessment of suicide risk.

This article reviews and integrates empirically grounded advances in the assessment of suicidality. The practices discussed are consistent with existing standards of care, practice guidelines, and applicable research. The authors differentiate between risk assessment and prediction and then emphasize the important role of time in risk assessment. We present and illustrate a continuum of suicidality for risk assessment and offer practical recommendations for clinical decision making and treatment.

Humans↗

PubMed2006

The case against no-suicide contracts: the commitment to treatment statement as a practice alternative.

This article reviews the literature on the use of "no-suicide contracts" in clinical practice, including conceptual discussions, patient and clinician surveys, and a few empirical studies on clinical utility. Our primary conclusion is that no-suicide contracts suffer from a broad range of conceptual, practical, and empirical problems. Most significantly, they have no empirical support for their effectiveness in the clinical environment. The authors provide and illustrate the commitment to treatment statement as a practice alternative to the no-suicide contract.

Contracts↗

PubMed2006

Responding to and treating negative interpersonal processes in suicidal depression.

The authors discuss the active engagement of suicidally depressed individuals in several interpersonal processes that elicit the rejection of others and withdrawal of interpersonal support. In addition, such processes may increase future risk for suicidal behavior. These processes include ways in which suicidal individuals group themselves (e.g., assortative relationship formation) and relate to others (e.g., help negation, negative feedback seeking, excessive reassurance seeking). Implications of these behaviors for the therapeutic setting are discussed, as well as potential ways to respond to and treat them.

Adult↗

PubMed2006

Pilot sample of very early onset bipolar disorder in a military population moderates the association of negative life events and non-fatal suicide attempt.

OBJECTIVE: To examine the moderating effects of very early onset diagnostic status (<or= 13 years) upon the association between life events and non-fatal suicide attempt. METHODS: Measures of negative life events, suicidal ideation and current suicide attempt were administered to 298 military-based young adults at entry to treatment for suicidality. Current and lifetime diagnoses were assigned using the Diagnostic Interview Schedule. The predictive ability of negative life events for non-fatal suicide attempt was examined separately for the total sample and for those with retrospectively determined histories of very early onset bipolar disorder (VEOBPD; n = 16), very early onset major depressive disorder (VEOMDD; n = 21) and very early onset anxiety disorder (VEOANX; n = 53). RESULTS: Negative life events and suicide attempt were significantly and positively associated among those with no history of VEOBPD (OR = 1.30, 95% CI = 1.02-1.65, p < 0.05), including those with VEOMDD and VEOANX. Consistent with expectation, VEOBPD moderated the association between negative life events and suicide attempt (OR = 0.88, 95% CI = 0.78-0.99, p < 0.05), such that negative life events were non-significantly and negatively associated with the presence of a suicide attempt (OR = 0.21, 95% CI = 0.04-1.02, p = 0.09) among patients with a history of VEOBPD. CONCLUSIONS: Despite similar rates of suicide attempt among all diagnostic groups, life stress did not contribute to attempt among those with VEOBPD. These findings are consistent with the severity and chronicity of VEOBPD. Potential explanations of these findings include a scarring effect on coping skills and increased sensitization to life stress.

Adaptation, Psychological↗

PubMed2006

Warning signs for suicide: theory, research, and clinical applications.

The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical and research applications.

Expert Testimony↗

PubMed2006

Warning signs for suicide on the Internet: a descriptive study.

The issue of suicide warning signs on the Internet is considered. In addition to reviewing some of the relevant conceptual issues about warning signs, a random sample of Internet sites was selected and reviewed. Warning signs were grouped and agreement across sites was examined, with results confirming broad disparity in what is presented to the public. The implications of a lack of consensus on warning signs for suicide are discussed.

Humans↗

PubMed2006

A test of the effectiveness of a list of suicide warning signs for the public.

In this study we examined the effect that reading a list of warning signs for suicide has on beliefs about suicide, including the belief that one can recognize a suicidal crisis. All participants read two sets of warning signs (with only the experimental group reading the suicide warning signs) and then answered questions concerning beliefs related to three health problems. Results indicate that participants who read the suicide warning signs reported greater abilities to recognize if someone is suicidal but did not report stronger beliefs that suicidal individuals are partly to blame, nor did they report lower likelihoods of befriending suicidal individuals. Results suggest that reading the list of warning signs may be effective in increasing the public's ability to recognize suicidal crises without creating or magnifying stigmatizing beliefs about suicidal individuals.

Culture↗

PubMed2006

The emotional impact and ease of recall of warning signs for suicide: a controlled study.

In light of concerns about potential iatrogenic effects of information about suicide, in the current study we examined the emotional impact of reading a list of warning signs for suicide in comparison to comparable lists for heart attacks and diabetes. All participants read two sets of warning signs, with the experimental group reading the suicide warning signs. Results confirm no difference in emotional impact across groups, along with providing evidence that warning signs for suicide are as easy to recall after exposure as warning signs for heart attack. Implications for pubic health campaigns are discussed.

Adolescent↗

PubMed2005

Four studies on how past and current suicidality relate even when "everything but the kitchen sink" is covaried.

T. E. Joiner's (2004, in press) theory of suicidal behavior suggests that past suicidal behavior plays an important role in future suicidality. However, the mechanism by which this risk is transferred and the causal implications have not been well studied. The current study provides evaluation of the nature and limits of this relationship across 4 populations, with varying degrees of suicidal behavior. Across settings, age groups, and impairment levels, the association between past suicidal behavior and current suicidal symptoms held, even when controlling for strong covariates like hopelessness and symptoms of various Axis I and II syndromes. Results provide additional support for the importance of past suicidality as a substantive risk factor for later suicidal behavior.

Humans↗

PubMed2005

Comparison of compensation and capitalization models when treating suicidality in young adults.

The current study examined compensation and capitalization treatment models with specific reference to problem-solving appraisal and problem-solving treatment of suicidal behavior (M. D. Rudd, T. Joiner, & M. H. Rajab, 2000). A sample of 98 young adults (mean age = 22), who had recently attempted suicide or ideated about suicide to the degree that they came to clinical attention, were randomly assigned to either problem-solving or control treatment. Participants with poorer problem-solving appraisal at baseline responded better than did participants with greater problem-solving appraisal to problem-solving treatment at 6-month follow-up, as would be predicted by the compensation model. Results suggest that treatment of suicidality for individuals with problem-solving skill deficits may be most effective by targeting these deficits rather than capitalizing on strengths.

Adult↗

PubMed2005

Predictive and treatment validity of life satisfaction and the quality of life inventory.

The clinical and positive psychology usefulness of quality of life, well-being, and life satisfaction assessments depends on their ability to predict important outcomes and to detect intervention-related change. These issues were explored in the context of a program of instrument validation for the Quality of Life Inventory (QOLI) involving 3,927 clients from various clinical settings. Clinical norms were also generated that supplement existing nationwide norms. The predictive validity of the QOLI and life satisfaction in a university counseling center was supported in terms of its ability to predict academic retention both by itself and in conjunction with cumulative grade point average 1 to 3 years in advance. The QOLI was also found to be sensitive to treatment-related change in two naturalistic clinical settings and samples. The interpretation and intervention utility of measures of quality of life, well-being, and life satisfaction are discussed with respect to clinical and positive psychology research.

Achievement↗

PubMed2004

Empirically informed approaches to topics in suicide risk assessment.

The purpose of this article is to approach topics in suicide risk assessment from a scientifically informed standpoint. We summarize and elaborate a general framework for an empirically supported best practice recommendation in evaluating suicide potential and minimizing risk. This risk assessment framework provides a concise heuristic for assessment of suicidal symptoms, points the way to relatively routinized clinical decision-making and activity, and is compatible with best practices relevant to the legalities of suicide risk assessment. Having established a general and scientifically based framework for risk assessment, we go on to address the other questions noted above, with reference to the framework and to our ongoing scientific work. We conclude by summarizing all the work and providing clear and concise clinical recommendations based thereon.

Decision Making↗

PubMed2004

A national survey of trainee impairment in clinical, counseling, and school psychology doctoral programs and internships.

The purpose of this study was to assess the frequency, type, and management of trainee impairment at a national level across doctoral programs in clinical, counseling, and school psychology and predoctoral internships. A total of 199 surveys were completed, returned, and usable. In general, doctoral programs reported a greater frequency of trainee impairment than internships. However, a greater percentage of internships had a policy and program in place for managing impairments than did doctoral programs. These findings are compared with past studies and reviews of this issue. In light of these findings, specific implications for training programs are discussed, with the recommendation that training programs address more attention to the assessment and management of such problems.

Counseling↗

PubMed2004

Kindling and behavioral sensitization: are they relevant to recurrent suicide attempts?

BACKGROUND: Data from a sample of suicidal young adults were used to examine the relevance of the kindling and behavioral sensitization models to suicide attempts. Three predictions derived from the kindling and sensitization models were tested: a higher number of suicide attempts would be associated with (a) lower levels of pre-attempt stress; (b) higher suicidal intent; and (c) greater lethality of the current attempt. METHODS: Measures of life stress and suicidal intent were collected among 123 young adults who attempted suicide just prior to entering treatment. Data on the total number of suicide attempts and the lethality of the current attempt were also collected. RESULTS: Number of suicide attempts was significantly and positively associated with pre-suicidal crisis life stress and suicidal ideation, but was not significantly associated with lethality of the most recent attempt. LIMITATIONS: The young sample drawn from a military medical setting may not accurately represent suicide attempters in the general population. Only total negative life events in the year preceding suicide attempt were examined, not the increase in negative life events immediately prior to suicide attempt. CONCLUSIONS: The kindling and sensitization models may not accurately describe the progression of recurrent suicide attempts.

Adult↗

PubMed2004

Childhood diagnoses and later risk for multiple suicide attempts.

The relationship between childhood diagnosis, personality psychopathology and suicidal behavior in young adulthood was explored in a sample of 327 suicide ideators, single attempters, and multiple attempters. Of the total sample, 174 received at least one childhood diagnosis; the 153 without a diagnosis provided a comparison group. Results suggest that a childhood history of an anxiety disorder or major depression predispose a person to both later multiple suicide attempts and personality psychopathology. Gender was found to play a significant role, with females being predisposed to multiple attempts in young adulthood but only as a function of childhood anxiety, not major depression. Additionally, childhood anxiety disorders were found to predispose to multiple attempts as a function of personality psychopathology, with distinctly different paths for males and females. Implications are discussed in terms of etiology, prevention, and treatment.

Adult↗

PubMed2003

Worst-point suicidal plans: a dimension of suicidality predictive of past suicide attempts and eventual death by suicide.

Among 440 psychiatric outpatients with current suicidal ideation, we examined the empirical distinction between the "plans" vs. "desire" dimensions of suicidality, focusing for conceptual and empirical reasons on a worst-point assessment strategy. Factor analyses were consistent with the distinction, but more importantly, among the current ideators included in this study, the worst-point "plans" dimension was the only predictor significantly related to both of two important indices, history of past attempt and eventual suicide. These findings bear on the trajectory of suicidal behavior over time, as well as inform the clinical assessment of suicidal patients.

Adult↗