Suicide risk in outpatients with specific mood and anxiety disorders

The present study examined the relationships between specific anxiety, mood disorders, levels of hopelessness, and suicide ideation. The sample consisted of 606 outpatients recruited from several psychiatric settings. It was found that dysthymia was significantly associated with hopelessness. Patients presenting major depressive episode with higher anxiety symptoms had significantly increased scores on the hopelessness scale. Major depressive episode and bipolar disorder, but not dysthymia, were significantly associated with higher levels of suicide ideation. Increased levels of anxiety symptoms in patients with dysthymia were associated with increased levels of suicide ideation, while increased depressive symptoms in patients with specific phobia and generalized anxiety disorder were associated with significantly lower levels of suicide ideation. The findings suggest that depressive disorders, but not anxiety disorders, constitute risk for suicide. Moreover, the differentiation between a depressive and an anxiety disorder as the principal diagnosis, as well as the assessment of anxiety-level symptoms in patients with major depressive episode and dysthymia, seems of special relevance when assessing suicide risk.     

Set for Instability: Prospects for Conflict and Cooperation between Israel and Jordan

This article argues that since 1949, the relationship between Israel and Jordan has depended primarily on their interactions with a Third Actor--identified as Egypt from 1949 to the mid-1970s, and as the Palestinians thereafter. Conflict between Israel and Jordan always follows conflict one or both nations have with the Third Actor. The analysis suggests a cyclical and hierarchical allegiance condition, in which Jordan switches from an alliance with Israel to an alliance with the Third Actor. Jordan cooperates with Israel--even if it itself engages in conflict with the Third Actor--until Israel engages in conflict with the Third Actor, at which point Jordan realigns with the Third Actor against Israel. This analysis suggests that to avoid an Israeli-Jordanian conflict, Israel must reach an agreement with the Palestinians regarding the existence and borders of a Palestinian state. Such an agreement, however, may not guarantee permanent peace between Israel and Jordan, as regional tensions fueled by controversy regarding the existence and legitimacy of the Jordanian Hashemite monarchy may rise again. Thus, even if a Palestinian state were established, the current peace between Israel and Jordan might be transitory.     

Lebanese Christians'Attitudes Toward Israel and the Peace Process

The objectives of this article were (1) to examine what Lebanese Christians think about peace with the Jewish state, not what their officials say about it; (2) to determine whether Lebanese Christians have a distinct position that separates them from their Muslim counterparts vis-à-vis the peace process and normalization of relations with Israel. The findings revealed that Lebanese Christians accept different forms of interaction with Israelis. However, most respondents support peace with Israel, clearly oppose the idea of confrontation with the Jewish state, and call for a unilateral peace treaty with their southern neighbor. Most Lebanese Christians view peace as a major reshuffling force capable of restoring their lost politcal role in the country.     

Notes on contributors

‘Women's empowerment’, as used by international development organisations, is a fuzzy concept. Historical textual analysis and interviews with officials in development agencies reveal its adaptability and capacity to carry multiple meanings that variously wax and wane in their discursive influence. Today a privileging of instrumentalist meanings of empowerment associated with efficiency and growth are crowding out more socially transformative meanings associated with rights and collective action. In their efforts to make headway in what has become an unfavourable policy environment, officials in development agencies with a commitment to a broader social change agenda juggle these different meanings, strategically exploiting the concept's polysemic nature to keep that agenda alive. We argue for a politics of solidarity between such officials and feminist activists. We encourage the latter to challenge the prevailing instrumentalist discourse of empowerment with a clear, well articulated call for social transformation, while alerting them to how those with the same agenda within international development agencies may well be choosing their words with care, even if what they say appears fuzzy.     

Deliberate self-harm patients with alcohol disorders: characteristics, treatment, and outcome

Deliberate self-harm (DSH) patients with alcohol problems present a considerable challenge for clinical services. In a study of a sample of 150 DSH patients who were representative of all such patients seen at a general hospital during the study period, 40 patients with an ICD-10 diagnosis of alcohol dependence or harmful use of alcohol were compared with the remainder of the sample. The treatment of the patients with alcohol disorders before and after the episode of DSH and the outcome 12-20 months later were also investigated. Compared with other DSH patients, those with an alcohol diagnosis were older and more often male, living alone, unemployed, sick, disabled, or with a past history of DSH. They also had higher scores on measures of anger, aggression, and impulsivity. Comorbid psychiatric disorder was present in 37 (92.5%) patients, this being depression in three-quarters of those cases. Fourteen (35.0%) patients were receiving treatment from the psychiatric services prior to DSH, and 33 (82.5%) were subsequently offered treatment. Of the patients who were followed up, 37.9% remained in contact with psychiatric services, 55.2% showed poor compliance with treatment and 44.8% reported a further episode of DSH. All patients presenting after DSH need to be carefully screened for alcohol disorders and for comorbid psychiatric diagnoses. Treatment of DSH patients with alcohol disorders should include the treatment of any comorbid depressive illness.     

The Need for Gender-Sensitive Medical Interpreters for Victims with Limited English Proficiency in Sexual Assault Examinations

Abstract

The difficulties and trauma associated with sexual violence are exacerbated by language difficulties. Language difficulties pose particular barriers in accessing legal, social, medical and support services. This presents additional challenges for sexual assault response teams (SART). The SART members serve critical functions in supporting a victim of sexual violence from trauma to trial.

This paper addresses the need for trained gender-sensitive medical interpreters for adult female victims with limited English proficiency (LEP) in sexual assault examination, and thus the need for inclusion of trained medical interpreters in SART. Such needs were articulated from interviews with advocates and medical interpreters in the US, from literature reviews and conversations with women with LEP in the US. The paper closes with a set of specific recommendations that will promote comfortable accessible service to female victims of sexual violence with LEP.     

Standard of Living and Disability in Cambodia

Little is known about the extra costs faced by households with disabled members in low resource settings and the impact of these costs on living standards. In this paper we estimate the direct cost associated with disability for households in Cambodia. Using the Standard of Living approach, the direct cost associated with having a member with disabilities is estimated to be 19 per cent of monthly household consumption expenditure. Accounting for the direct cost of disability doubles the poverty rate amongst households with disabled members from 18 per cent to 37 per cent, and increases the poverty gap from 3 to 8 per cent. A comparison of the direct cost associated with disability and income support received from government and family sources reveals that only 7 per cent of the costs of disability are met. Our findings suggest that, in the absence of increased coverage of public income support, households with disabled members will continue to experience a lower standard of living compared to households without disability in Cambodia.     

Fairness and Efficiency in Smallholder Farming: The Relation with Intrahousehold Decision-Making

Agricultural households face collective action dilemmas when making decisions about investments in their common household farm and the allocation of resources and benefits derived from it. We relate intrahousehold decisions, as measured in a lab-in-the-field experiment conducted with spouses in agricultural households in western Uganda, with actual investments and intrahousehold resource allocation. Intrahousehold decision-making that supports cooperation and equitable sharing is associated with greater investment in the intensification of cash and food crop production, and more equitable access and control over income. Freeriding behaviour by husbands is associated with the intensification of cash crop production, but not with equitable sharing.     

Nomads,Islamists, and Soldiers: The Struggles for Northern Mali

Mali has been faced with a series of uprisings by its Tuareg over a number of years. Although each of these rebellions was ended by a cease-fire, the Malian government never succeeded in instituting longer term peace agreements. The 2012 Tuareg rebellion has presented even more significant security threats. The environment in northern Mali now is marked by multiple armed groups, with multiple competing agendas. This complex situation, with Tuareg rebels, Islamists with varying goals, and local militias, with a pattern of varying levels of cooperation and conflict, will at best be very difficult to resolve in the long term. Combined with an almost complete security vacuum in northern Mali on the part of the government, this situation could be intractable even with external intervention. At the same time, the focus on counterterrorism in northern Mali may not be conducive to a long-term resolution of what in reality is a much more complicated security environment.     

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.     

Blood types and national suicide rates

In a sample of 51 nations, the suicide rates were negatively associated with the proportion of people with Type O blood, while homicide rates were positively associated with this proportion.     

Coping and Resilience during the Food,Fuel, and Financial Crises

This article aggregates qualitative field research from sites in 17 developing countries to describe crisis impacts and analyse how people coped with the food, fuel, and financial crises during 2008–2011. The research uncovered significant hardships behind the apparent resilience, with widespread reports of food insecurity, debt, asset loss, stress, and worsening crime and community cohesion. There were important gender and age differences in the distribution of impacts and coping responses, with women often acting as shock absorbers. The more common sources of assistance were family, friends, community-based and religious organisations with formal social protection and finance less important. The traditional informal safety nets of the poor became depleted as the crisis deepened, pointing to the need for better formal systems for coping with future shocks.     

The Contested Terrain of the Parallel Society: The Other Natives in Contemporary Greece and Germany

This article takes issue with two assumptions associated with the permanent return migration of ethnic Greeks and ethnic Germans from the former Soviet Union. It suggests that their return has turned out to be less ethnically motivated than policy makers have assumed and that many returnees, immigrating permanently as fully fledged citizens, continue to retain elements of circularity in their lives, of different nature and intensity. Both returnee groups experience varying degrees of social and economic exclusion and this might explain why some members maintain links with their area of origin. Adopting a comparative approach, this article draws on insights from ongoing fieldwork, with particular focus on interviews with return migrants in both countries.     

Organizational Commitment,Job Satisfaction and Attitudes toward Organizational Change: A Study in the Local Government

The present study investigates the direct and indirect relationships among job satisfaction, organizational commitment, and attitudes toward organizational change and their dimensions. Results indicated that employees in the investigated departments are highly satisfied with supervision and coworkers, whereas they are slightly satisfied with work conditions and job security, but they have low satisfaction with pay and promotion facets of the job. Results further demonstrated that employees in the investigated departments are remaining with their current departments either because they want to do so, or because they have to do so, but not because they feel they ought to do so.     

The New Transport Charging Powers: The (Real) Issues for Business – Credibility,Fairness and Red Tape?

Business communities have major concerns with the implementation of road user and workplace parking charges, and this contribution will help to overcome the paucity of research in this area. Close dialogue interviews in Nottingham revealed that fears regarding economic impact are based on scepticism and lack of confidence in the ability of government to spend revenues wisely. Business may also be as much concerned with fairness and equity issues associated with charging, and with its expected administrative irritations and aggravations, as with the potential for economic displacement. These findings suggest that successful implementation of schemes may depend on clearer articulation of how red-tape will be avoided, and how charging increases the ability to deliver improved transport infrastructure.     

How Many Offenses are Really Committed per Juvenile Court Offender?

This article compares juvenile court petitions and self-reported offending between ages 13 and 17 for 506 boys followed up in the Pittsburgh Youth Study. There were 2.4 self-reported offenders for every petitioned offender, and 80 self-reported offenses for every petitioned offense. The prevalence of self-reported offenders stayed constant with age, but the prevalence of petitioned offenders increased with age. Conversely, the individual offending frequency stayed constant with age according to court petitions but increased with age according to self-reports. Therefore, prevalence and frequency did not vary similarly with age, and did not vary similarly in self-reports and court records. With increasing age, more and more of the self-reported offenders were formally petitioned, but they were formally petitioned for fewer and fewer of their offenses. The probability of an offender being petitioned to court increased with the number of offenses that he committed, but the probability of each offense leading to a court petition decreased with the number of offenses committed. There was little overlap between self-reported and official chronic offenders. It is concluded that researchers should always measure both self-reports and official records in studying offending, and that the juvenile court should seek to intervene earlier in delinquency careers.     

Local Government Finance Office Orientation Revisited: Actually,It’s All About Control

In states with heavy oversight of local government finances, alternate levels of control orientation exist based on county government budget formulation and financing practices. However, previous research indicates a possible trend toward policy orientation. Using survey data from North Carolina counties, initial findings indicate high levels of finance officer budget formulation discretion as well as county manager agreement with budget decisions. Additional logit models suggest that while stakeholder influence is still present along with remnants of policy orientation, the state financial oversight mechanism along with the background, knowledge of departmental financial needs, and frequent departmental appropriation dissemination by the finance officer, continue to sustain control orientation.     

Suicidal behavior in patients with adjustment disorders

This retrospective study characterizes the suicidal behavior in 119 patients with Axis I adjustment disorders as assessed by psychiatrists at the University of Virginia Hospital. Results indicated that 72 patients (60.5%) had documented suicide attempts in the past, 96% had been suicidal during their admission to the hospital, and 50% had attempted suicide before their hospitalization. The most commonly used method of suicide attempts was overdosing. Of the sample group with suicide attempts in the past, 67% had Axis II diagnoses of borderline personality disorder and antisocial personality disorder. Adjustment disorder diagnosis in patients with the suicide attempts was associated with a high level of suicidality at admission, involuntary hospitalization and substance-abuse disorders. Axis II diagnoses in patients with adjustment disorders constituted risk factors for further suicidal behavior. Additional future prospective studies with reliability checks on diagnosis of adjustment disorders and suicidal behavior are needed.     

FOSTERING AFFECTIVE ORGANIZATIONAL COMMITMENT IN PUBLIC SECTOR AGENCIES: THE SIGNIFICANCE OF MULTIFACETED LEADERSHIP ROLES

This study examines whether the various leadership roles undertaken by public sector managers have an important association with subordinates' levels of affective commitment to the organization. Our empirical findings suggest that not all leadership practices matter. It appears that only relations‐oriented and change‐oriented leadership, and to a far lesser extent integrity‐oriented leadership, have a substantive association with affective organizational commitment. Task‐oriented leadership and, to a large degree, integrity‐oriented leadership, are found not to matter much for employees with lower levels of affective commitment, but they look to strengthen fondness of the organization among those with already high levels of affective commitment. Results also suggest that the diversity‐oriented leadership role has no association with affective commitment to the organization.     

Ethical Issues of Bioterror

Bioterrorism has global implications, especially with regard to the use of contagious bio agents or “epidemic generators” with a high potential for causing epidemics. The grave medical implications of a bioterror attack are obvious, but some of the related ethical issues are often overlooked. Moral issues associated with the threat and with the attack may carry long-term consequences, which may shake the rudiments of democratic societies. Some of these efforts may be aided by regulations, laws, and enforcement. The best results will be achieved by a sense of responsibility and understandings of the public.