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The Suicide Cognitions Scale (SCS) assesses suicide-specific cognitions which may drive suicide risk. Nonetheless, prior work has been mixed regarding optimal factor structure. Additionally, this measure has not been validated for use with veterans with military sexual trauma-related posttraumatic stress disorder (MST-related PTSD), a population that is at elevated risk for suicidal self-directed violence (SDV). This study sought to determine the optimal factor structure of the SCS for use with veterans with MST-related PTSD as well as its psychometric properties. An exploratory factor analysis revealed a four-factor structure, including unlovability, unbearability, unsolvability, and negative urgency. The SCS also demonstrated excellent internal consistency and good convergent validity. This study identified a novel factor, negative urgency, which may explain some of the predictive power of the SCS found in previous research. This paper provides initial support for a four-factor structure of the SCS among those with MST-related PTSD. Additional work remains necessary in evaluating the SCS as a tool for detecting risk for future suicidal SDV among veterans with MST-related PTSD. [ABSTRACT FROM AUTHOR]

Medical students’ early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd-year medical students on required clinical rotations. Using content analysis, the authors analyzed the essays’ thematic content. The authors then used chi-squared analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. One hundred twenty out of 802 essays described a geriatric patient. The most common geriatric themes were (1) death and dying, (2) decision making, (3) meaningful physician-patient interactions, (4) quality of care, and (5) professional development. Geriatric essays were more likely to discuss death/dying and risk-benefit themes and less likely to discuss abuse. Geriatric essays were more likely to describe students’ moral distress. Geriatric essays with moral distress were more likely to include empathy themes compared to geriatric essays without moral distress. Geriatric patients may pose unique ethical challenges for early clinical students. [ABSTRACT FROM AUTHOR]

Theory: We explored the theory that measures of medical students’ well-being and stress from different types of preclinical curricula are linked with performance on standardized assessment.Hypotheses: Self-reported stress and quality of life among sophomore medical students having different types of preclinical curricula will vary in their relationships to USMLE Step 1 scores.Method: Voluntary surveys in 2010 and 2011 compared self-reported stress, physical and mental health, and quality of life with Step 1 scores for beginning sophomore students in the final year of a traditional, discipline-based curriculum and the 1st year of a revised, systems-based curriculum with changed grading system. Wilcoxon rank sum tests and Spearman rank correlations were used to analyze data, significant atp<.05.Results: New curriculum students reported worse physical health, subjective feelings, leisure activities, social relationships and morale, and more depressive symptoms and life stress than traditional curriculum students. However, among curriculum-related stressors, few differences emerged; revised curriculum sophomores reported less stress working with real and standardized patients than traditional students. There were no class differences in respondents’ Step 1 scores. Among emotional and physical health measures, only feelings of morale correlated negatively with Step 1 performance. Revised curriculum students’ Step 1 scores correlated negatively with stress from difficulty of coursework.Conclusions: Although revised curriculum students reported worse quality of life, general stress, and health and less stress from patient interactions than traditional students, few measures were associated with performance differences on Step 1. Moreover, curriculum type did not appear to either hinder or help students’ Step 1 performance. To identify and help students at risk for academic problems, future assessments of correlates of Step 1 performance should be repeated after the new curriculum is well established, relating them also to performance on other standardized assessments of communication skills, professionalism, and later clinical evaluations in clerkships or internships. [ABSTRACT FROM AUTHOR]

This study explored television viewing of the September 11 attacks in 99 survivors of the Oklahoma City bombing and examined the relationships of event-related television viewing with concerns about safety and danger in survivors with and without bombing-related posttraumatic stress disorder. The number of hours of viewing September 11 television coverage was related to worry about personal and family danger and to increased checking on loved ones but not to September 11–related posttraumatic responses. Some bombing survivors discontinued September 11 media contact due to fear. The findings suggest the importance of monitoring television viewing in survivors of prior incidents. [ABSTRACT FROM PUBLISHER]

Trauma is thought to interfere with normal grief by superimposing symptoms of posttraumatic stress disorder. This exploratory pilot study examined the association between traumatic grief and objectively measured physiological reactivity to a trauma interview in 13 children who lost relatives in the Oklahoma City bombing as well as a potential link between children and their maternal figures in physiological reactivity. Although the authors found no association between posttraumatic stress and objectively measured physiological reactivity among children, they found significant differences in objectively measured reactivity associated with loss and grief. Children who lost “close” relatives evidenced greater objectively measured reactivity than those who lost “distant” relatives. For the most part, children with higher levels of grief evidenced greater objectively measured reactivity than those with lower levels of grief. The most interesting of the findings was the parallel pattern in objectively measured physiological reactivity between children and their maternal figures along with a positive association between children's objectively measured physiological reactivity and maternal figures’ self-reported physiological reactivity. Research using larger representative samples studied early and over time is indicated to determine the potential significance of these findings. [ABSTRACT FROM PUBLISHER]

Three impaired health care provider groups (N = 84) (nurses, pharmacists, and providers with prescriptive authority) referred for a substance abuse evaluation at an outpatient-based program were compared on demographic and family factors, substance abuse patterns, and psychiatric symptomology as assessed by the Personality Assessment Inventory. Nurses had the highest rates of family history of addiction, problems with benzodiazepines, and psychiatric comorbidity. Overall, health care professionals endorsed opioids twice as often as alcohol as a preferred substance. Family history of addiction, sex, and psychiatric comorbidity emerged as salient factors among these health care professionals. Clinical implications are examined in light of the current findings. [ABSTRACT FROM AUTHOR]

Focus groups were conducted with 23 children and adolescents, aged 9 to 17 years, who relocated from Louisiana to Texas following Hurricane Katrina to explore their disaster, evacuation, and resettlement experiences. The resilience described by some was remarkable and, despite evidence of cultural disparity and stigma, many identified positive aspects of the new communities in which they resided. Attempts to help displaced children must begin with a full understanding of the individual experiences and reactions of those being served rather than being based on assumptions about what may have occurred. [ABSTRACT FROM AUTHOR]

Focus groups with 23 New York City children examined their reactions to the September 11 terrorist attacks, their parents' reactions, and their expectations about the future. We identified an initial set of six topics; these topics were reviewed and assigned to a final set of thematic categories - understanding the events and motives, emotional responses, boredom, and coping. This final set was used to independently code the transcripts. The children reported using distraction and avoidant emotion-focused coping strategies. They were confused about some aspects of the events, but they understood the magnitude and gravity of what had occurred. [ABSTRACT FROM AUTHOR]

A focus group of New York City adolescents was conducted 21 months after the September 11, 2001, terrorist attacks to examine their emotional responses to the incidents. The adolescents had vivid memories of the attacks and articulated their reactions, their perspectives on the potential motives for the attacks, and their concerns about ongoing danger. Impressive was the maturity and thoughtfulness of their discourse, which revealed their efforts to process and integrate the events and a realization that their world had changed. [ABSTRACT FROM AUTHOR]