Suicide is a leading cause of death around the world. Yet research seeking to uncover the causes of suicide has made little advancement. The purpose of this dissertation is to advance the understanding of one understudied but critical component of suicidal behaviors: how individuals move down the pathway from first thinking about suicide to ultimately attempting to take their own lives. A secondary goal of this work is to examine some flawed methods used in prior research in this area. This ancillary goal results in potential solutions provided in each paper that will allow researchers to collect more reliable data and to draw more valid inferences from these data to better understand the pathway to suicide. In Paper 1, I examine the validity of single-item measurement, a commonly used approach in this area of research in which key suicidal behaviors are assessed with one brief question. The primary finding in that paper is that single-item measurement is associated with significant misclassification of suicidal behavior. In addition, in that paper, I offer and examine an approach that improves validity for self-reported suicidal behaviors. In Paper 2, I attempt to improve on prior research examining suicide planning prior to a suicide attempt and present descriptive data showing how people transition from thinking about suicide to actually attempting (i.e. planning steps they take during this transition). This study revealed that the vast majority of steps occur within 2 weeks and most within 12 hours of an attempt. However, the results also revealed heterogeneous individual differences in the order and timing of planning steps as people moved from thinking about suicide to attempting suicide. In Paper 3, I examine the association between impulsiveness and suicidal behavior, using more comprehensive measures of both constructs than prior studies. Unlike most prior studies, this study also recruits groups that are able to test whether increased impulsiveness could help explain why, among people that think about suicide, some people attempt to kill themselves and others do not. In a secondary goal, I examine whether questions regarding past suicidal behaviors influence self-report measurement potentially causing invalid assessment. The findings from that paper reveal only one dimension of impulsiveness – negative urgency – that differs between suicidal and control participants and none that differ between ideators and attempters. Thus, dimensions of impulsiveness in Paper 3 do not appear to influence attempts among ideators. I also find that answering questions about suicide before self-report measures of impulsiveness influences the degree of impulsiveness reported by suicide attempters and suicide ideators. Specifically, attempters report increased levels impulsiveness compared with ideators when suicide questionnaires are asked first but there is no difference between the groups when participants’ answer impulsiveness questionnaires prior to questions about suicide. In all three papers, I criticize prior research but provide approaches that could lead to modest improvements in methodology and, hopefully, lead to new discoveries in understanding how and why people transition from thinking about killing themselves to attempting suicide. / Psychology

These three studies seek to contribute to the neurological characterization of the development of schizophrenia as well as begin to branch into understanding how neuroanatomical structure and function may relate to specific deficits in social cognition and social functioning within in this population. Paper #1 investigates the relationship between brain structure in young adults at clinical high risk for schizophrenia and social functioning. Paper #2 expands upon the findings of paper #1 by looking at brain structure, social cognition, and social functioning in children and risk for psychosis. Finally, paper #3 focuses on brain function for theory of mind in typically developing children and its relationship to social cognition and social functioning. Investigating the neural mechanisms underlying social cognitive deficits and social functioning impairment in young adults and children at risk for schizophrenia will contribute to the field’s understanding of the development of this disorder. / Psychology

This study investigated the role of culture on suicidal thoughts and behaviors by examining (i) differences in explicit reporting of suicidal thoughts and behaviors, (ii) differences in implicit association of suicidal thoughts (iii) correlation of implicit-explicit reporting of suicidal thoughts and behaviors (iv) correlation between religion, religiosity level and reporting of suicidal thoughts between community samples from India and the USA. The study also tested the feasibility of using a measure of cognitive processing (i.e. the Implicit Association Task) as opposed to a self-report measure to identify implicit or hidden associations with suicidal thoughts or behaviors. Given the scarcity of available research on cross-cultural suicidal thoughts and behaviors, this study aims to bridge the current gap and provide evidence on the cultural variability in expression and development of suicidal thoughts and behaviors. The study hypothesized a lower level of explicit reporting of suicidal thoughts and behaviors in the Indian sample (as compared to the USA sample), but equivalent or higher level of implicit association with death/suicide related stimuli. Further, a significant difference in the correlation between religiosity level and suicidal behaviors, moderated by religion, was expected between the two countries. Participants were recruited online using Mechanical Turk to target individuals from India and the USA. A self-report questionnaire format was used to capture information about the participants’ explicit reporting of suicidal thoughts and behaviors, associated risk factors, religious affiliations and country of birth. Implicit cognition towards suicide was measured using an online version of the Death/Suicide IAT. The results showed a significantly lower level of explicit reporting in India as compared to the USA sample but comparable implicit reporting levels. Further, the results also reported a significantly different correlation of religiosity and suicidal thoughts between the two country samples. This study provides initial evidence suggesting a significant role of cultural setting in the reporting and expression of suicidal thoughts and behaviors. This study is also the first to test the feasibility of using the Death/Suicide IAT for measuring implicit suicide related cognition in India.

<p> Few studies have examined the experiences of sexually trafficked victims and survivors in the United States.</p><p> As the population increases it is important to understand how sexually trafficked victims and survivors cope with trauma, experience recovery, and respond to therapy. Research indicates that factors of hope and resilience play a vital role in the way individuals cope with trauma and experience recovery (Masten &amp; Narayan, 2012).</p><p> This study examined factors of hope and resilience of 12 sexually trafficked victims and survivors, ages 14 to 21. Interviews were conducted and a mixed-methods design was employed to establish common themes related to how sex trafficking victims comprehend and experience hope and resilience within their lives. </p><p> Significant quantitative and qualitative results were found in this study. Six significant qualitative themes were derived from the interviews describing various ways that participants experienced hope and resilience. The themes included (a) Need for positive attachment (b) Positive Self-Portrayal (c) Introspection (d) Adaptability (e) Need for money, and (f) Desire for change. </p><p> Additionally, participants also completed the Connor-Davidson Resilience Scale, the Children&rsquo;s Hope Scale or Adult Hope Scale, and the Hopkins Symptom Checklist-25. Quantitative results indicate a strong positive correlation between depression and anxiety (<i>r</i> = .52, <i>p</i> &lt; .01), a strong positive correlation between hope and resilience (<i>r</i> = .70, <i>p</i> &lt; .04), and a strong negative correlation between resilience and anxiety (<i>r</i> = -.63, <i> p</i> &lt; .03).</p><p> The implications of this study may be used to direct clinical focus when working with victims and survivors, placing emphasis on the importance of developing hope and resilience throughout the rehabilitation process.</p><p>

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<p> The literature was studied with a historical consideration to examine trends that began with analysts being required to undergo their own analysis, to modern day where a recommendation holds firm to suggest personal therapy for therapists, but is not always enforced. This study bridges the gap on a quantitative study on the effect of personal therapy on self-perceived clinical self-efficacy and other psychodynamic constructs. Self-perceived clinical self-efficacy, confidentiality and the importance of therapy in a clinical psychology graduate program were analyzed with respect to those participants in a clinical psychology program who had personal therapy and those who had not. Results showed that there was an overall benefit to personal therapy on clinical practice and that students believed that personal therapy should be part of clinical psychology programs. The data findings suggest that personal therapy is valuable for professional practice, that students believe it should be part of an academic program in clinical psychology, and that fears of confidentiality being breached are mostly unfounded.</p><p>

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