Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Oquendo, M. A., et al. (2024).

JAMA psychiatry, e235672.

Advance online publication.

https://doi.org/10.1001/jamapsychiatry.2023.5672

Abstract

Importance: Not all people who die by suicide have a psychiatric diagnosis; yet, little is known about the percentage and demographics of individuals with lifetime suicide attempts who are apparently psychiatrically healthy. If such suicide attempts are common, there are implications for suicide risk screening, research, policy, and nosology.

Objective: To estimate the percentage of people with lifetime suicide attempts whose first attempt occurred prior to onset of any psychiatric disorder.

Design, setting, and participants: This cross-sectional study used data from the US National Epidemiologic Study of Addictions and Related Conditions III (NESARC-III), a cross-sectional face-to-face survey conducted with a nationally representative sample of the US civilian noninstitutionalized population, and included persons with lifetime suicide attempts who were aged 20 to 65 years at survey administration (April 2012 to June 2013). Data from the NESARC, Wave 2 survey from August 2004 to September 2005 were used for replication. Analyses were performed from April to August 2023.

Exposure: Lifetime suicide attempts.

Main outcomes and measures: The main outcome was presence or absence of a psychiatric disorder before the first lifetime suicide attempt. Among persons with lifetime suicide attempts, the percentage and 95% CI of those whose first suicide attempt occurred before the onset of any apparent psychiatric disorders was calculated, weighted by NESARC sampling and nonresponse weights. Separate analyses were performed for males, females, and 3 age groups (20 to <35, 35-50, and >50 to 65 years).

Conclusions and relevance: In this study, an estimated 19.6% of individuals who attempted suicide did so despite not meeting criteria for an antecedent psychiatric disorder. This finding challenges clinical notions of who is at risk for suicidal behavior and raises questions about the safety of limiting suicide risk screening to psychiatric populations.

How digital media drive affective polarization through partisan sorting

Törnberg, P. (2022).

PNAS of the United States of America,

119(42).

https://doi.org/10.1073/pnas.2207159119

Abstract

Politics has in recent decades entered an era of intense polarization. Explanations have implicated digital media, with the so-called echo chamber remaining a dominant causal hypothesis despite growing challenge by empirical evidence. This paper suggests that this mounting evidence provides not only reason to reject the echo chamber hypothesis but also the foundation for an alternative causal mechanism. To propose such a mechanism, the paper draws on the literatures on affective polarization, digital media, and opinion dynamics. From the affective polarization literature, we follow the move from seeing polarization as diverging issue positions to rooted in sorting: an alignment of differences which is effectively dividing the electorate into two increasingly homogeneous megaparties. To explain the rise in sorting, the paper draws on opinion dynamics and digital media research to present a model which essentially turns the echo chamber on its head: it is not isolation from opposing views that drives polarization but precisely the fact that digital media bring us to interact outside our local bubble. When individuals interact locally, the outcome is a stable plural patchwork of cross-cutting conflicts. By encouraging nonlocal interaction, digital media drive an alignment of conflicts along partisan lines, thus effacing the counterbalancing effects of local heterogeneity. The result is polarization, even if individual interaction leads to convergence. The model thus suggests that digital media polarize through partisan sorting, creating a maelstrom in which more and more identities, beliefs, and cultural preferences become drawn into an all-encompassing societal division.

Significance

Recent years have seen a rapid rise of affective polarization, characterized by intense negative feelings between partisan groups. This represents a severe societal risk, threatening democratic institutions and constituting a metacrisis, reducing our capacity to respond to pressing societal challenges such as climate change, pandemics, or rising inequality. This paper provides a causal mechanism to explain this rise in polarization, by identifying how digital media may drive a sorting of differences, which has been linked to a breakdown of social cohesion and rising affective polarization. By outlining a potential causal link between digital media and affective polarization, the paper suggests ways of designing digital media so as to reduce their negative consequences.

Spheres of immanent justice: Sacred violations evoke expectations of cosmic punishment, irrespective of societal punishment

Goyal, N., Savani, K., & Morris, M. W. (2023).

Journal of Experimental Social Psychology, 106, 104458.

https://doi.org/10.1016/j.jesp.2023.104458

Abstract

People like to believe that misdeeds do not escape punishment. However, do people expect that some kinds of sins are particularly punished by “the universe,” not just by society? Five experiments (N = 1184) found that people expected more cosmic punishment for transgressions of sacred rules than transgressions of secular rules or conventions (Studies 1–3) and that this “sacred effect” holds even after violations have been punished by society (Study 4a-4b). In Study 1, participants expected more cosmic punishment for a person who had sex with a cousin (sacred taboo) than sex with a subordinate (secular harm) or sex with a family associate (convention violation). In Study 2, people expected more cosmic punishment for eating a bald eagle (sacred violation) than eating an endangered puffin (secular violation) or a farm-raised emu (convention violation). In Study 3, Hindus expected more cosmic punishment for entering a temple wearing shoes (sacred violation) rather than entering a temple wearing revealing clothing (secular violation) or sunglasses (convention violation). In all three studies, this “sacred effect” was mediated by the perceived blasphemy rather than the perceived harm, immorality, or unusualness of the violations. Study 4a measured both expectations of societal and cosmic punishment, and Study 4b measured expectations of cosmic punishment after each violation had received societal punishment. Even after violations received societal punishment, people expected more cosmic punishment for sacred violations than secular or convention violations. Results are discussed in relation to models of immanent justice and just world beliefs.

A pdf is here.

This is an article about people’s expectations of punishment for violating different social norms. It discusses the concept of immanent justice, which is the belief that people get what they deserve. The authors propose that people expect harsher cosmic punishment for violations of sacred norms, compared to secular norms or social conventions. They conducted five studies to test this hypothesis. In the studies, participants read stories about people who violated different types of norms, and then rated how likely they were to experience various punishments. The results supported the authors’ hypothesis: people expected harsher cosmic punishment for sacred norm violations, even after the violations had been punished by society. This suggests that people believe in a kind of cosmic justice that goes beyond human punishment.

Antagonistic AI

A. Cai, I. Arawjo, E. L. Glassman

arXiv:2402.07350

Originally submitted 12 Feb 24

The vast majority of discourse around AI development assumes that subservient, "moral" models aligned with "human values" are universally beneficial -- in short, that good AI is sycophantic AI. We explore the shadow of the sycophantic paradigm, a design space we term antagonistic AI: AI systems that are disagreeable, rude, interrupting, confrontational, challenging, etc. -- embedding opposite behaviors or values. Far from being "bad" or "immoral," we consider whether antagonistic AI systems may sometimes have benefits to users, such as forcing users to confront their assumptions, build resilience, or develop healthier relational boundaries. Drawing from formative explorations and a speculative design workshop where participants designed fictional AI technologies that employ antagonism, we lay out a design space for antagonistic AI, articulating potential benefits, design techniques, and methods of embedding antagonistic elements into user experience. Finally, we discuss the many ethical challenges of this space and identify three dimensions for the responsible design of antagonistic AI -- consent, context, and framing.

The article is here.

Here is my summary:

This article proposes a thought-provoking concept: designing AI systems that intentionally challenge and disagree with users. It argues against the dominant view of AI as subservient and aligned with human values, instead exploring the potential benefits of "antagonistic AI" in stimulating critical thinking and challenging assumptions. While acknowledging the ethical concerns and proposing responsible design principles, the article could benefit from a deeper discussion of potential harms, concrete examples of how such AI might function, and how it would be received by users. Overall, "Antagonistic AI" is a valuable contribution that prompts further exploration and discussion on the responsible development and societal implications of such AI systems.

Whitehouse floats congressional intervention for SCOTUS fact-finding adventurism

Benjamin S. Weiss

www.courthousenews.com

Originally posted 21 Feb 24

One of the Senate’s most prominent Supreme Court critics on Wednesday floated the idea that Congress could step in to block the high court from what he characterized as efforts to manipulate facts in cases that benefit Republican special interests.

Under the leadership of Chief Justice John Roberts, the Supreme Court has had a “near-uniform pattern of handing down rulings benefitting identifiable Republican donor interests” on a smattering of issues including reproductive rights, immigration and health care, wrote Rhode Island Senator Sheldon Whitehouse in an article published in the Ohio State Law Journal.

The Roberts court has presided over more than 80 5-4 rulings on issues advancing GOP policy priorities with few exceptions, he said, contending that the high court’s current conservative supermajority has pursued “results-oriented jurisprudence” for Republican political operatives.

A pattern of “extra-record fact finding” has contributed to these decisions, Whitehouse said — arguing that justices have repeatedly and improperly undertaken efforts to manipulate the facts of cases in which a lower court, or Congress, has already established a factual record.

Such malfeasance means taking the Supreme Court’s decisions on faith “is no longer automatically justified,” he said. “Too many decisions are delivered goods, not judicial work.”

The info is here.

Here is a summary:

Senator Sheldon Whitehouse suggests potential congressional intervention to address concerns about the Supreme Court's increasing reliance on "extra-record fact-finding" in recent rulings. He argues that this practice, where justices seemingly manipulate or ignore established facts, undermines the Court's credibility.

Whitehouse argues that a pattern of disregard for congressional findings and longstanding appellate court norms is evident in several recent Supreme Court decisions. He believes this approach benefits certain special interests and erodes trust in the Court's impartiality.

The article highlights the need for a potential response from Congress to curb this perceived judicial overreach by the Supreme Court.

Why the largest transgender survey ever could be a powerful rebuke to myths, misinformation

Susan Miller

USAToday.com

Originally posted 23 Feb 24

Here is an excerpt:

Laura Hoge, a clinical social worker in New Jersey who works with transgender people and their families, said the survey results underscore what she sees in her daily practice: that lives improve when access to something as basic as gender-affirming care is not restricted.

“I see children who come here sometimes not able to go to school or are completely distanced from their friends,” she said. “And when they have access to care, they can go from not going to school to trying out for their school play.”

Every time misinformation about transgender people surfaces, Hoge says she is flooded with phone calls.

The survey now gives real-world data on the lived experiences of transgender people and how their lives are flourishing, she said. “I can tell you that when I talk to families I am able to say to them: This is what other people in your child’s situation or in your situation are saying.”

Gender-affirming care has been a target of state bills

Gender-affirming care, which can involve everything from talk sessions to hormone therapy, in many ways has been ground zero in recent legislative debates over the rights of transgender people.

A poll by the Trevor Project, which provides crisis and suicide prevention services to LGBTQ+ people under 25, found that 85% of trans and nonbinary youths say even the debates about these laws have negatively impacted their mental health.

In January, the Ohio Senate overrode the governor’s veto of legislation that restricted medical care for transgender young people.

The bill prohibits doctors from prescribing hormones, puberty blockers, or gender reassignment surgery before patients turn 18 and requires mental health providers to get parental permission to diagnose and treat gender dysphoria.

The info is here.

Here are my thoughts:

A landmark study is underway: the largest survey of transgender individuals in the United States. This comprehensive data collection holds the potential to be a powerful weapon against harmful myths and misinformation surrounding the transgender community. By providing a clear picture of their experiences, the survey can challenge misconceptions, inform policy, and ultimately improve the lives of transgender individuals. This data-driven approach has the potential to foster greater understanding and acceptance, paving the way for a more inclusive society.

Jean Maria Arrigo, Who Exposed Psychologists’ Ties to Torture, Dies at 79

Trip Gabriel

The New York Times

Originally published 19 March 24

Jean Maria Arrigo, a psychologist who exposed efforts by the American Psychological Association to obscure the role of psychologists in coercive interrogations of terror suspects in the aftermath of the Sept. 11, 2001, attacks, died on Feb. 24 at her home in Alpine, Calif. She was 79.

The cause was complications of pancreatic cancer, her husband, John Crigler, said.

A headline about her as a whistle-blower in The Guardian  in 2015 put it succinctly: “‘A National Hero’: Psychologist Who Warned of Torture Collusion Gets Her Due.”

A decade earlier, Dr. Arrigo had been named to a task force by the American Psychological Association, the largest professional group of psychologists, to examine the role of trained psychologists in national security interrogations.

The 10-member panel was formed in response to news reports in 2004 about abuse at the American-run Abu Ghraib prison in Iraq and at Guantánamo Bay in Cuba, which included details about psychologists aiding in interrogations that, according to the International Committee of the Red Cross, were “tantamount to torture.”

Dr. Arrigo later asserted that the A.P.A. task force was a sham — a public relations effort “to put out the fires of controversy right away,” as she told fellow psychologists in a wave-making speech in 2007.

The info is here.

Not all heroes wear capes.

Jean Maria Arrigo, a psychologist known for exposing the American Psychological Association's involvement in obscuring psychologists' roles in coercive interrogations post-9/11, passed away at 79 due to complications from pancreatic cancer. She was a whistleblower who revealed the APA's efforts to downplay psychologists' participation in interrogations deemed as torture. Arrigo criticized the APA's task force, stating it was a sham with ties to the Pentagon and conflicts of interest. Despite facing backlash and attacks from colleagues, she persisted in her crusade against APA complicity with brutal interrogations. Arrigo's work highlighted the ethical dilemmas faced by psychologists in national security contexts and emphasized the need for clear boundaries on involvement in such practices.

From a Psych Hospital to Harvard Law: One Black Woman’s Journey With Bipolar Disorder

Krista L. R. Cezair

Ms. Magazine

Originally posted 22 Feb 24

Here is an excerpt:

In the spring of 2018, I was so sick that I simply couldn’t consider my future performance on the bar exam. I desperately needed help. I had very little insight into my condition and had to be involuntarily hospitalized twice. I also had to make the decision of which law school to attend between trips to the psych ward while ragingly manic. I relied on my mother and a former professor who essentially told me I would be attending Harvard. Knowing my reduced capacity for decision‐making while manic, I did not put up a fight and informed Harvard that I would be attending. The next question was: When? Everyone in my community supported me in my decision to defer law school for a year to give myself time to recover—but would Harvard do the same?

Luckily, the answer was yes, and that fall, the fall of 2018, as my admitted class began school, I was admitted to the hospital again, for bipolar depression this time.

While there, I roomed with a sweet young woman of color who was diagnosed with schizophrenia, bipolar disorder and PTSD and was pregnant with her second child. She was unhoused and had nowhere to go should she be discharged from the hospital, which the hospital threatened to do because she refused medication. She worried that the drugs would harm her unborn child. She was out of options, and the hospital was firm. She was released before me. I wondered where she would go. She had expressed to me multiple times that she had nowhere to go, not her parents’ house, not the child’s father’s house, nowhere.

It was then that I decided I had to fight—for her and for myself. I had access to resources she couldn’t dream of, least of all shelter and a support system. I had to use these resources to get better and embark on a career that would make life better for people like her, like us.

After getting out of the hospital, I started to improve, and I could tell the depression was lifting. Unfortunately, a rockier rock bottom lay ahead of me as I started to feel too good, and the depression lifted too high. Recovery is not linear, and it seemed I was manic again.

The info is here.

Here are some thoughts:

In this powerful piece, Krista L. R. Cezair candidly shares her journey navigating bipolar disorder while achieving remarkable academic and professional success. She begins by describing her history of depression and suicidal thoughts, highlighting the pivotal moment of diagnosis and the challenges within mental health care facilities, particularly for marginalized groups. Cezair eloquently connects her personal experience with broader issues of systemic bias and lack of understanding around mental health, especially within prestigious institutions like Harvard Law School. Her article advocates for destigmatizing mental health struggles and recognizing the resilience and contributions of those living with mental illness.

How prosocial actors use power hierarchies to build moral reputation

Inesi, M. E., & Rios, K. (2023).

Journal of Experimental Social Psychology,

106, 104441.

https://doi.org/10.1016/j.jesp.2022.104441

Abstract

Power hierarchies are ubiquitous, emerging formally and informally, in both personal and professional contexts. When prosocial acts are offered within power hierarchies, there is a widespread belief that people who choose lower-power beneficiaries are altruistically motivated, and that those who choose higher-power beneficiaries hold a self-interested motive to ingratiate. In contrast, the current research empirically demonstrates that people can also choose lower-power beneficiaries for self-interested reasons – namely, to bolster their own moral reputation in the group. Across three pre-registered studies, involving different contexts and types of prosocial behavior, and including real financial incentives, we demonstrate that people are more likely to choose lower-power beneficiaries when reputation concerns are more salient. We also provide evidence of the mechanism underlying this pattern: people believe that choosing a lower-power beneficiary more effectively signals their own moral character.

Highlights

• How do prosocial actors choose their beneficiaries in hierarchies?

• People increasingly choose lower-power beneficiaries when concerned with reputation

• This pattern is driven by a desire to signal high moral character to others

• This implies a short-term re-distribution of resources to lower-power individuals

Some thoughts:

This research challenges the common assumption that prosocial behavior towards lower-status individuals always stems from altruism, while helping those with higher power reflects self-interest. It explores how actors navigate power hierarchies to build their moral reputation.

Key findings:

Reputation matters: People are more likely to choose lower-power beneficiaries when their moral reputation is salient (e.g., being observed by others).

Strategic signaling: Choosing lower-power recipients is seen as a stronger signal of good character, even if the motivation is self-serving.

Not just altruism: Prosocial behavior can be used strategically to gain social approval and build a positive reputation, regardless of the beneficiary's status.