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Descriptors:
Addictive Behavior; Hermeneutics; Suicide; Phenomenology; Pathology; Personality Problems; Self Concept; Research Methodology; Case Studies; Females; Trauma

Abstract:
The purpose of this article is to examine the phenomenon of pathological gambling and addiction from the perspective of writer and teacher A.H Almaas. By drawing on his Diamond Mind approach we trace the origin of addictive behaviors and pathological gambling to narcissistic wounding, which constitutes the loss of connection with the Essential Identity. A phenomenological hermeneutic methodology was applied in the research process in which Penny, the subject of this case study, willingly shared her life journey through addiction. A thematic analysis clustered into 5 themes revealed a link between her experiences of childhood trauma, addiction, pathological gambling, and the manifestation of fundamental narcissism. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Ethnicity; Counseling Techniques; Mental Health Workers; Mental Health; Asian American Students; Immigration; Counseling Services; College Students; Suicide; Family Relationship; Marriage; Cultural Traits; Self Concept

Abstract:
The goal of this article is to provide information on the assessment and treatment of South Asian college students for mental health practitioners. We provide a brief historical review of the cultures from which these students come and the process of migration to the United States and also make recommendations for work with these students in the college counseling setting. Topics addressed include family dynamics, arranged marriage, ethnic identity development, and suicide. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Gender Differences; Suicide; Predictor Variables; Depression (Psychology); Undergraduate Students; Drinking; Social Support Groups; Risk; Symptoms (Individual Disorders); Prevention; Program Development; Measures (Individuals); Correlation

Abstract:
The correlates and predictors of suicidal ideation were examined in 303 male and 691 female undergraduates. Results indicated that hopelessness predicted suicidal ideation in both samples; however, depression was found to be a significant suicide risk factor only in women. In contrast, alcohol-related problems and social support from family predicted suicidal ideation in men, but not in women. In addition, for both men and women perceived burdensomeness was a suicide risk factor and reasons for living a protective factor. When assessing risk for suicide, our results suggest that practitioners may need to focus more on depressive symptoms in women and more on alcohol-related problems in men, while considering hopelessness, perceived burdensomeness, and reasons for living regardless of gender. Prevention programs which target these identified risk and protective factors for suicidality should be developed specifically for college men and women. (Contains 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Psychopathology; Health Services; Self Destructive Behavior; Behavior Modification; Therapy; Personality Problems; Resource Allocation; Counseling Services; Student Problems; Surveys; Suicide; Hospitals; Outcomes of Treatment; College Students

Abstract:
Trends in college mental health literature suggest many college and university counseling centers are facing increased demands for services. Moreover, survey data suggest that counseling center directors and staff perceive increases in serious psychopathology, suicidality, and nonsuicidal self-injurious behavior, along with other typical student problems. At Sarah Lawrence College, a marked increase in the number of students hospitalized for psychiatric reasons, many meeting criteria for borderline personality disorder (BPD), required Health Services to rethink clinical service delivery, staff training, and resource allocation. Owing to its proven efficacy in the treatment of BPD, dialectical behavior therapy (DBT) was adapted at our setting. An overview of DBT is presented, followed by a brief history and a detailed description of the Sarah Lawrence College DBT Program, initial data on its impact for student retention and hospitalizations, and a discussion of the potential benefits of employing DBT with students in other collegiate settings. As one of few college counseling centers offering such treatment, the DBT Program at Sarah Lawrence College represents a promising model of treatment for college students with BPD. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Accidents; Injuries; Mortality Rate; College Students; Online Surveys; Suicide; Cancer; Homicide; Drinking; Death; Gender Differences

Abstract:
This pilot study from self-selected institutions of higher education provides an estimate of the causes and rates of mortality among college students between the ages of 18 and 24 years old. One hundred fifty-seven 4-year colleges participated in an online survey of student deaths during one academic year. A total of 254 deaths were reported. The mortality rates (per 100,000) were as follows: total accidental injuries, 10.80; suicide, 6.17; cancer, 1.94; and homicide, 0.53. Within the accident and injury category, alcohol-related vehicular deaths (per 100,000) were 3.37 and alcohol-related nontraffic injuries were 1.49. Men had significantly higher rates of suicide (10.46) than women (2.34). Suggestions for future research and implications of these findings are discussed. (Contains 4 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Adolescents; Behavior Modification; Behavior Disorders; Mental Disorders; Emotional Disturbances; Suicide; Self Destructive Behavior; Adults; Psychological Studies; Outcomes of Treatment

Abstract:
Dialectical behavior therapy (DBT) was originally developed for chronically suicidal adults with borderline personality disorder (BPD) and emotion dysregulation. Randomized controlled trials (RCTs) indicate DBT is associated with improvements in problem behaviors, including suicide ideation and behavior, non-suicidal self-injury (NSSI), attrition, and hospitalization. Positive outcomes with adults have prompted researchers to adapt DBT for adolescents. Given this interest in DBT for adolescents, it is important to review the theoretical rationale and the evidence base for this treatment and its adaptations. A solid theoretical foundation allows for adequate evaluation of content, structural, and developmental adaptations and provides a framework for understanding which symptoms or behaviors are expected to improve with treatment and why. We first summarize the adult DBT literature, including theory, treatment structure and content, and outcome research. Then, we review theoretical underpinnings, adaptations, and outcomes of DBT for adolescents. DBT has been adapted for adolescents with various psychiatric disorders (i.e., BPD, mood disorders, externalizing disorders, eating disorders, trichotillomania) and problem behaviors (i.e., suicide ideation and behavior, NSSI) across several settings (i.e., outpatient, day program, inpatient, residential, correctional facility). The rationale for using DBT with these adolescents rests in the common underlying dysfunction in emotion regulation among the aforementioned disorders and problem behaviors. Thus, the theoretical underpinnings of DBT suggest that this treatment is likely to be beneficial for adolescents with a broad array of emotion regulation difficulties, particularly underregulation of emotion resulting in behavioral excess. Results from open and quasi-experimental adolescent studies are promising; however, RCTs are sorely needed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Academic Achievement; Underachievement; Program Effectiveness; Achievement Need; Substance Abuse; Adolescents; African Americans; Asian Americans; Suicide; High Achievement; Correlation; Measures (Individuals); Risk; Grades (Scholastic); Mental Health; Violence; Comparative Analysis; Models

Abstract:
The present study tested the model minority and inferior minority assumptions by examining the relationship between academic performance and measures of behavioral health in a subsample of 3,008 (22%) participants in a nationally representative, multicultural sample of 13,601 students in the 2001 Youth Risk Behavioral Survey, comparing Asian Americans (N = 408) and African Americans (N = 2,600). Specifically, the study examined associations of students' self-reported grades with suicide risk, substance abuse, and violent behaviors. The findings revealed that high academic performance is a protective factor against behavioral health problems for both ethnic groups. The results raise questions about the focus on high achievement among Asian Americans versus academic underachievement among African Americans. Implications for theory, research, training and practice in addressing the mental health implications of achievement behavior in Asian American and African American youth are discussed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Health Services; Mental Health; Adolescents; Public Agencies; Suicide; Grounded Theory; Constructivism (Learning); Mental Health Programs; Agency Cooperation; At Risk Persons; Counseling Techniques; Foreign Countries; Intervention; Access to Health Care

Abstract:
Child and youth care (CYC) professionals often provide care to children, youth and families in conjunction with professionals from other disciplines. How CYC professionals engage other service providers in the provision of care for suicidal adolescents requires examination. The purpose of the overall study was to understand and explain the process of CYC professionals' mental health literacy practices with suicidal adolescents. Findings presented here provide insight into the process of CYC professionals' practice with other service providers in the context of their encounters with suicidal adolescents. Using a constructivist grounded theory method, data were collected and analysed from interviews with CYC professionals, supervisors within youth-serving community agencies, educators within Schools of Child and Youth Care, and extant texts of relevance to suicide, such as organisational policies, assessment tools, and suicide education curricula. One practice identified during analysis, flooding the zone, is the focus of the present paper. Flooding refers to the process of contacting and informing a myriad of professionals or services of the adolescent's suicidality, and was comprised of making decisions as to whom to contact, informing the adolescent, and negotiating with services. Professionals' perceptions of their role and the availability and accessibility of mental health services influenced the practice of flooding. Based on analysis of the data, flooding the zone has the potential to disrupt CYC professionals' relational proximity to the adolescent and may reinforce a devalued role for CYC professionals in suicide intervention within the larger mental health system of care. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Suicide; Foreign Countries; Discourse Analysis; Educational Change; Labor Force; Educational Policy; Newspapers; Teachers; Government Role; Work Environment; Teaching Conditions; Speeches

Abstract:
According to Fanny Law Fan Chiu-fun, the former Permanent Secretary for Education and Manpower, the most significant education policy in recent years in Hong Kong was undoubtedly the new academic structure commonly known as "334." As schools, universities, and the community at large seemed to accept the new academic structure in principle, the areas of contention would mostly lie in the timing and details. Sparked by the suicides of two teachers, a wave of unprecedented protests and opposition against the government's education policy followed, which led to the departure of the former Permanent Secretary for Education and Manpower Fanny Law Fan Chiu-fun and the Secretary for Education and Manpower Arthur Li Kwok-cheung from the education portfolio. This situation suggests that something was wrong with the teachers' working environment. This article aims to make sense of these discursive events through a critical discourse analysis of the "334" education policy with materials taken from documents, speeches, and press releases published by the government as well as newspaper articles drawn from "South China Morning Post," which is a rich source of contested ideas. An eclectic approach is drawn from both "state-centered" and "policy cycle" perspectives synthesized and adopted for this article. Upon this contested terrain in which individual policy actors struggle to achieve the desired political outcomes, the intention of this article is to explore how the state and other interest groups acted, reacted, and interacted in the policy processes of the 334 Education Reform. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Outcome Measures; Substance Abuse; Depression (Psychology); Suicide; Drug Therapy; Comorbidity; Therapy; Caseworkers; Social Work; Measures (Individuals); Symptoms (Individual Disorders); Scores; Mental Health

Abstract:
This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to enhanced case management (ECM) (n = 64) or treatment as usual (TAU) (n = 56). Both groups were followed up at six and 12 months. Participants' current clinical status across a broad range of domains in the past 90 days was assessed using the Global Appraisal of Individual Needs and included their Depressive Symptom Scale, Homicidal-Suicidal Thought Index, and Mental Health Treatment Index scores. The findings did not reveal any statistically significant effects of ECM on outcome measures. However, in view of the high rates of adverse treatment outcomes among comorbid groups, including suicide, the finding of a clinically significant reduction in homicidal and suicidal thoughts warrants further research; the comprehensive approach to treatment tested may be especially helpful to depressed substance abusers with such ideations. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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