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Biomedical subjects

Thomas E Joiner

Publications and source records attributed to Thomas E Joiner.

At least 19 recordsLinked to original sources
PubMed2006

Suicide attempts among individuals with opiate dependence: the critical role of belonging.

This study explored the role of three theoretically important interpersonal variables in attempted suicide and unintentional overdose using a diverse sample of one hundred thirty-one (69 women) methadone patients at an urban university hospital. Subjects completed a standardized interview including self-report measures of perceived 1) belonging 2) burdensomeness, and 3) loneliness. In separate multivariate logistic regression analyses, individuals with a history of attempted suicide were compared to non-attempters, and individuals with a history of unintentional overdose were compared to individuals without such a history. As hypothesized, low belonging distinguished suicide attempters but not individuals with a history of unintentional overdose, after accounting for covariates. Results concerning burdensomeness and suicide attempt were also suggestive. Findings underscore the relevance of a sense of belonging to vulnerability to suicidal behavior, and lend further support to the notion that suicide attempts and unintentional overdose have dissimilar correlates.

Adult↗
PubMed2006

Does a brief training on suicide prevention among general hospital personnel impact their baseline attitudes towards suicidal behavior?

OBJECTIVE: To evaluate a brief training program on suicide prevention for front-line general hospital personnel in terms of its impact on their attitudes and beliefs towards suicidality. METHOD: Forty non-clinical (e.g., security staff), and 102 clinical (e.g., nursing attendants) professionals employed in a university hospital in Brazil were evaluated with the Suicide Behavior Attitude Questionnaire [SBAQ] before the start and immediately after a 3-hour training on suicide prevention. RESULTS: Surprisingly, there were no significant differences for the great majority of the SBAQ items (i.e., 20 of 21) between clinical and non-clinical staff both pre- and post-training. Furthermore, their attitudes and beliefs towards suicidality were significantly improved after training in the majority of SBAQ items, with p-values ranging from 0.01 to <0.0001. LIMITATIONS: Relatively small sample size, and absence of a randomized controlled design and long-term follow-up. CONCLUSIONS: Our study suggests that attitudes and beliefs of clinical and non-clinical general hospital personnel towards suicidality were unexpectedly similar, and reinforces the need for suicide awareness training programs in the general hospital setting. Additionally, we have shown that it is feasible to provide such basic knowledge concerning suicidal behavior to this specific population. This is particularly important for the development of suicide prevention programs in under-resourced countries. However, our results are preliminary, and further studies are needed to address a number of important questions in the field.

Adult↗
PubMed2006

Double depression in adult psychiatric outpatients in Brazil: distinct from major depression?

This study examines whether distinct symptom profiles, patterns of comorbidity, and suicidal symptoms uniquely characterize individuals diagnosed with double depression (DD) by comparing Brazilians with DD to those with major depressive disorder (MDD). One hundred forty two psychiatric outpatients (ages 20-77 mean=48.8, S.D.=13.2; DD, n=23; MDD, n=119) participated in structured diagnostic interviews and completed self-report measures of depressive symptoms, suicidality, and family history of mental disorders. Patients with DD exhibited a more severe symptom profile than those with MDD, as evidenced by a higher number of depressive symptoms and more intense suicidal ideation. They also appeared to be qualitatively different from individuals with MDD, as evidenced by distinct comorbidity patterns, quality of life reports, and anhedonic features. These results may be important in understanding the phenomenology of DD in psychiatric outpatients by informing diagnostics, psychotherapy, and psychotherapeutic treatment of DD.

Adult↗
PubMed2006

Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts.

Non-suicidal self-injury (NSSI) is a prevalent behavioral problem, yet many fundamental aspects of NSSI remain unknown. This case series study reports on the diagnostic correlates of adolescents with a recent history of NSSI and examines the relation between NSSI and suicide attempts. Data are from clinical interviews with 89 adolescents admitted to an adolescent psychiatric inpatient unit who engaged in NSSI in the previous 12 months. Results revealed that 87.6% of adolescents engaging in NSSI met criteria for a DSM-IV Axis I diagnosis (M=3.0, S.D.=2.2, range=0 to 8 diagnoses), including externalizing (62.9%), internalizing (51.7%), and substance use (59.6%) disorders. Most adolescents assessed also met criteria for an Axis II personality disorder (67.3%). Overall, 70% of adolescents engaging in NSSI reported a lifetime suicide attempt and 55% reported multiple attempts. Characteristics of NSSI associated with making suicide attempts included a longer history of NSSI, use of a greater number of methods, and absence of physical pain during NSSI. These findings demonstrate the diagnostic heterogeneity of adolescents engaging in NSSI, highlight the significant overlap between NSSI and suicide attempts, and provide a point of departure for future research aimed at elucidating the relations between non-suicidal and suicidal self-injury.

Adolescent↗
PubMed2006

Mixed anxiety depression: taxometric exploration of the validity of a diagnostic category in youth.

BACKGROUND: Mixed anxiety depression (MAD) is a provisional diagnosis in the DSM-IV. This study determined whether MAD represents a discrete category thereby evaluating the validity of MAD as a diagnostic entity. METHODS: Taxometric analyses and mixture modeling were used to discern whether MAD indicators constitute a distinct psychopathological category (i.e., a taxon) in a large school-based sample of adolescents (N=706). RESULTS: Each taxometric procedure (MAXCOV, MAMBAC) identified a taxon with a prevalence of 13%+/-2%. A non-taxometric procedure (multivariate mixture modeling) also supported the existence of a taxon with a prevalence of 12%. Bootstrapping procedures were used to construct a measure of MAD (i.e., MAD-T). Scale construction suggested that MAD may be best represented by 12 criteria that largely overlap with the DSM-IV, though some modifications were suggested. Examination of the construct validity of the MAD taxon indicated that it is associated mood and anxiety symptoms. Taxon membership was predictive of the development of mood and anxiety disorders over a 14-month longitudinal follow-up. LIMITATIONS: This category should be studied in other populations including adult samples. CONCLUSIONS: MAD appears to be a viable diagnostic category for youth though it is recommended that future revisions of the DSM emphasize somewhat different criteria for this diagnosis.

Adolescent↗
PubMed2006

The impact of client race on clinician detection of eating disorders.

Eating disorders are thought to occur less among African-American women than among women of other ethnic groups. Ninety-one clinicians read 1 of 3 passages (differing only with regards to the girl's race: African-American, Caucasian, or Hispanic) describing disturbed eating patterns of a fictional character named Mary. Participants were then asked to indicate if they thought Mary had a problem and to rate her anxiety, depression, and eating disorder symptoms based upon the passage they had read. The results suggest that clinicians may have race-based stereotypes about eating disorders that could impede their detection of symptoms in African-American girls.

Adolescent↗
PubMed2006

Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship.

BACKGROUND: Research to date has indicated that childhood abuse is associated with suicide, though little research has examined the unique contribution of specific types of abuse to suicidal behavior. We predict that childhood physical and violent sexual abuse will have a greater effect on suicide attempts than molestation and verbal abuse. METHODS: The National Comorbidity Survey data were used to test these predictions while controlling for a number of psychiatric and psychosocial variables. RESULTS: As expected, childhood physical and violent sexual abuse showed similar effects on lifetime suicide attempts, which were stronger than the effects of molestation and verbal abuse. LIMITATIONS: This was a cross-sectional, retrospective study, so true causality cannot be shown. Some measurement limitations exist. Additionally, effect sizes were small but still significant. CONCLUSIONS: While all forms of childhood abuse are troubling and create risk for future psychopathology and suicidality, the present study indicates that childhood physical and violent sexual abuse should be seen as greater risk factors for future suicide attempts than molestation and verbal abuse.

Adult↗
PubMed2006

Factors of suicide ideation and their relation to clinical and other indicators in older adults.

BACKGROUND: Research on the factor structures of the Scale for Suicidal Ideation (SSI; [Beck, A.T., Kovacs, M., Weissman, M., 1979. Assessment of suicidal intention: the Scale for Suicide Ideation. J. Consult. Clin. Psychol. 47, 343-352]) and the Modified Scale for Suicide Ideation (MSSI; [Miller, I.W., Norman. W.H., Bishop, S.B., and Dow, M.G., 1986. The modified scale for suicidal ideation: reliability and validity. J Consult Clin Psychol, 54, 724-725]) in younger adults have tended to yield two factor solutions. The purpose of the current study was to examine the factor structure of the SSI in an older population in order to determine whether the factor structure was similar and, if so, whether the factors related to other clinical and demographic correlates. METHODS: 199 participants (M age 57, S.D.) were selected from a combined database of psychiatric outpatients and inpatients over the age of 49 currently experiencing suicidal ideation. Principal axis factoring was used in order to determine the factor structure of the SSI. In addition, we ran correlations and regression analyses to determine the relation of each factor with other clinical and demographic correlates. RESULTS: Consistent with prediction, we found a two-factor solution. Also consistent with predictions, clinical and demographic correlates related differentially to each of the factors. LIMITATIONS: The relatively small sample size and the fact that our sample was predominantly Caucasian. CONCLUSION: The current study has provided data on the factor structure of the SSI in an older population, demonstrating that suicidal ideation in this group is similar to younger age groups.

Age Factors↗
PubMed2006

Associations of phenylthiocarbamide tasting to alcohol problems and family history of alcoholism differ by gender.

Past research associating phenylthiocarbamide/propylthiouracil (PTC/PROP) taste status with alcoholism has produced equivocal results. Some have found higher proportions of nontasters among those with a family history of alcoholism than controls, whereas others have not. The purpose of this study was to investigate the relationship between PTC taste status, alcohol problems, and family history of alcoholism. A total of 244 undergraduate students participated in this study, with a gender distribution of 75% female and 25% male. We found support for our hypothesis that male supertasters would report fewer problems with alcohol and a less significant family history of alcoholism. Interestingly, we also found that female supertasters had a greater family history of alcoholism and more current problems associated with alcohol use. Implications for the genetic link between PTC taste status and alcoholism are discussed.

Adult↗
PubMed2006

Bias and accuracy of children's perceptions of peer acceptance: prospective associations with depressive symptoms.

Are depressive symptoms in middle childhood associated with more or less realistic social self-perceptions? At the beginning and end of the school year, children in grades 3 through 5 (n=667) rated how much they liked their classmates, predicted the acceptance ratings they would receive from each of their classmates, and completed self-report measures of perceived acceptance and depressive symptoms. Accuracy of perceived acceptance was indexed by the mean difference between pairs of predicted and received ratings (absolute values). Standardized residual scores created by regressing self-reported perceived acceptance (either predicted ratings or children's responses to a questionnaire measure of perceived peer acceptance) onto peer acceptance ratings formed two measures of bias. Bi-directional associations were found for accuracy of perceived acceptance and depressive symptoms; inaccurate perceptions predicted increases in depressive symptoms and depressive symptoms predicted decreased accuracy. Neither measure of bias predicted changes in depressive symptoms. Depressive symptoms predicted increases in negatively biased perceptions as assessed via questionnaire.

Association↗
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

Analysis of bulimic symptomatology across age and geographic locations.

The purpose of this study was two-fold: a) to investigate the relationship between age and bulimic symptoms among a sample of women with a broad age range; and b) to investigate the relationship between geographic location within the United States and bulimic symptoms. The sample consisted of 1807 female health professionals from six different states (NC, VA, OH, LA, TN, and MO). Analyses revealed that there were no differences between the age groups on bulimic symptoms. There were differences across geographic locations on bulimic symptoms, such that the South Atlantic (NC, VA) states reported the most bulimic symptoms. Findings suggest that age may not serve as a protective factor against bulimic symptoms as some previous studies have suggested. These findings also provide further evidence on the influence of environment on bulimic symptoms among a sample of women.

Adolescent↗
PubMed2006

Propagation of major depressive disorder: relationship between first episode symptoms and recurrence.

Major depressive disorder is a highly recurrent disorder, with long-term estimates of recurrence ranging as high as 80%. The impact of first episode depressive symptoms on later recurrence has not been previously examined. The present study sought to identify risk factors for recurrent major depressive episodes by investigating first episode symptoms. It was predicted that the presence of depressed mood and sleep disturbance in the first episode would increase the likelihood of recurrence. Four hundred eighty-seven randomly selected community participants who met DSM-III-R criteria for at least one major depressive episode were assessed twice during adolescence and once in young adulthood. We examined the association between first major depressive episode symptoms and the presence of a recurrent episode. Recurrence was significant predicted by the presence of depressed mood and increased appetite at episode 1. A nonsignificant trend suggested that female gender may also be associated with recurrence. First episode depressed mood, increased appetite, and female gender may serve as specific risk factors for recurrence. The centrality of depressed mood to major depressive disorder is highlighted.

Adolescent↗
PubMed2006

Evidence for attentional bias in women exhibiting bulimotypic symptoms.

OBJECTIVE: One of the defining features of bulimia is a pervasive tendency to focus on and evaluate one's own body. The extent to which bulimotypic symptoms are associated with biases in attention to other individuals in the social world is less well known. In the current study, we examined the relation between bulimotypic symptoms and biases in attention to other men and women. METHOD: A sample of undergraduate women performed a visual cueing task designed to assess attention to target faces varying in their gender and level of attractiveness. RESULTS: Women with relatively high levels of bulimotypic symptomatology tended to dwell on attractive female faces, but not other faces. This attentional bias was not attributable to perfectionistic ideals, body dissatisfaction, or self-esteem. CONCLUSION: Findings could reflect a link between disordered eating and the perception of competitive threat in other attractive women.

Adolescent↗
PubMed2006

Two-three-year stability and interrelations of bulimotypic indicators and depressive and anxious symptoms in middle-aged women.

OBJECTIVE: There is a paucity of research examining eating disorder symptoms among middle-aged women. METHOD: This prospective study assessed the stability of bulimic symptoms and 5 associated variables (perfectionism, depressive symptoms, self-esteem, anxiety symptoms, and perceived weight status) in a sample of 150 middle-aged women (mean age = 45.19 years) over a 2.5-year time period. In addition, interrelations among bulimic, anxiety, and depressive symptoms were assessed. RESULTS: Results suggested that all 6 bulimia-related variables remained significantly stable over 2.5 years. In addition, notable relations between Time 1 and Time 2 variables emerged (e.g., anxious symptoms at Time 1 predicted bulimic symptoms at Time 2). CONCLUSION: Thus, the results indicate that bulimic symptoms exist in middle-aged women, and that they remain relatively stable over a 2.5-year time period. Clinical implications for middle-aged women with eating disorder symptoms are discussed.

Anxiety↗
PubMed2006

DSM-IV threshold versus subthreshold bulimia nervosa.

OBJECTIVE: The purpose of the present work is to determine whether bulimia nervosa (BN) and eating disorder not otherwise specified, BN type (EDNOS-BN) were qualitatively distinct in terms of eating and general psychopathology. METHOD: This study presents a comparison of 138 women with BN and 57 with EDNOS-BN from a multisite study on eating-related and general psychopathology measures. RESULTS: Although women with BN reported higher lifetime history rates of anorexia nervosa, greater binge eating and vomiting frequency, and more eating concerns, no significant differences were observed between groups on measures of perfectionism, impulsivity, obsessive-compulsiveness, anxiety, depressive symptomatology, or alcohol/substance problems. Based on the partial eta2 values, the distinction between BN and EDNOS-BN accounted for <5% of the criterion variance in general psychopathology measures. Post hoc analyses comparing EDNOS-BN with objective bulimic episodes (OBEs; n=34) versus no OBEs (n=23) found greater EDEQ-4 Restraint subscale scores for EDNOS-BN without OBEs. However, there was no significant difference on the EDEQ-4 Eating Concern subscale between the two EDNOS-BN subgroups. CONCLUSION: The findings highlight the clinical significance of BN partial syndrome and prompt reevaluation of existing BN diagnostic boundaries. Post hoc analyses also underscore the need for greater differentiation within EDNOS.

Adult↗
PubMed2006

Clinical applications of the interpersonal-psychological theory of attempted and completed suicide.

This article reviews the interpersonal-psychological theory of attempted and completed suicide and describes its applications in suicide risk assessment, crisis intervention, and skills-based psychotherapies. Three components are necessary, but not sufficient, for an individual to die by suicide: (1) the acquired capability to enact lethal self-injury, (2) a sense that one is a burden on others, and (3) the sense that one does not belong to a valued social group. We suggest that therapeutic interventions should focus on ascertaining the presence of these components and work to amend the cognitive distortions, negative interpersonal response styles, and ineffective coping behaviors that serve to maintain suicidal urges.

Adolescent↗