This article explores the alternate meanings of attitudinal neutrality in the context of the bipolarity-reciprocal antagonism issue. Specifically, it proposes a modification of the semantic differential technique wherein the "liking" and "disliking" components of attitude can be separately measured. A geometrical model is developed in which three nondirectional attitude variables ("total affect," "ambivalence," and "polarization") are distinguished from the usual attitude variable. Reliability and validity data are presented, and an application of the model is discussed.
Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures.This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients.
Do people believe that it is morally acceptable to protest against God? This question was examined in Internet studies with two samples: undergraduates (n = 358) and a broad-based adult sample (n = 471), both from the United States. Analyses were limited to participants who reported some belief in God. As predicted, seeing protest toward God as acceptable was associated with lower religiosity and more negative views of God (e.g., harsh, distant, cruel). Participants also made moral distinctions between various forms of protest toward God: Assertive responses (questioning and complaint) were rated more acceptable than anger and associated negative feelings (frustration, disappointment). Negative feelings, in turn, were rated more acceptable than exit responses (rebellion, holding on to anger; rejecting God; questioning God's authority; terminating the relationship). To the extent that participants saw protest toward God as acceptable, they reported more anger toward God. On the surface, zero-order correlations suggested that positive emotions and attitudes regarding God were associated with seeing anger toward God as wrong; however, this association disappeared when exit and assertion were taken into account via regression. These regressions revealed that positive emotions and attitudes toward God were strongly linked with seeing exit as wrong but also (modestly but consistently) with seeing assertion as acceptable. These findings suggest a parallel between perceived relationships with God and human relationships: When such bonds are close and resilient, they often allow room for some questioning and complaint, provided that there is a clear commitment to preserve (i.e., not exit) the relationship.
Midazolam misuse is increasing among injecting drug users in Bangkok and appears to be used primarily as a substitute for heroin. Midazolam injection was associated independently with various risk factors for injection-related complications. Given the many deleterious effects of midazolam injection, novel interventions for midazolam injectors are needed urgently.
We studied three characteristics or dimensions of delusions in schizophrenia patients living in the community, including their influence on work and community functioning. The 149-patient sample included 57 delusional schizophrenia and nonschizophrenia outpatients, 50 nondelusional outpatient controls, and 42 delusional inpatient controls. The data indicated the strength and prominence of acute-phase psychopathology on characteristics of delusions, with large significant differences in intensity of delusions between the acute inpatient phase and the postacute inpatient and outpatient phases. Contrary to some views, the data indicate that the overall presence of any delusions in general, and the various dimensions of delusions, both influence work performance and community functioning, with the greater part of the variance due to the presence of delusions in general. Despite their outpatient status, delusional outpatients showed surprisingly poor self-monitoring about whether others would regard their delusional ideation as unrealistic. Schizophrenia and affectively disordered patients with high emotional commitment to their delusions showed significantly poorer work functioning and were significantly more likely to be rehospitalized (p < 0.05), indicating the important impact on functioning of patients' feelings of immediacy and urgency about their unrealistic beliefs.
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