Considering the importance of 'Communities of Practice' and Health Promotion Constructs for Upstream Suicide Prevention

Background

Suicide is a serious and growing health inequity for Alaska Native (AN) youth (ages 15-24), who experience suicide rates significantly higher than the general U.S. youth population. In low-resourced, remote communities, building on the local and cultural resources found in remote AN communities to increase uptake of prevention behaviors like lethal means reduction, interpersonal support, and postvention can be more effective at preventing suicide than a risk-referral process. This study expands the variables we hypothesize as important for reducing suicide risk and supporting wellbeing. These variables are: 1) perceived suicide prevention self-efficacy, 2) perceived wellness self-efficacy, and 3) developing a 'community of practice' (CoP) for prevention/wellness work.

Method

With a convenience sample (N = 398) of participants (ages 15+) in five remote Alaska Native communities, this study characterizes respondents' social roles: institutional role if they have a job that includes suicide prevention (e.g. teachers, community health workers) and community role if their primary role is based on family or community positioning (e.g. Elder, parent). The cross-sectional analysis then explores the relationship between respondents' wellness and prevention self-efficacy and CoP as predictors of their self-reported suicide prevention and wellness promotion behaviors: (1) working together with others (e.g. community initiatives), (2) offering interpersonal support to someone, (3) reducing access to lethal means, and (4) reducing suicide risk for others after a suicide death in the community.

Results

Community and institutional roles are vital, and analyses detected distinct patterns linking our dependent variables to different preventative behaviors. Findings associated wellness self-efficacy and CoP (but not prevention self-efficacy) with 'working together' behaviors, wellness and prevention self-efficacy (but not CoP) with interpersonal supportive behaviors; both prevention self-efficacy and CoP with higher postvention behaviors. Only prevention self-efficacy was associated with lethal means reduction.

Conclusions

The study widens the scope of suicide prevention. Promising approaches to suicide prevention in rural low-resourced communities include: (1) engaging people in community and institutional roles, (2) developing communities of practice for suicide prevention among different sectors of a community, and (3) broadening the scope of suicide prevention to include wellness promotion as well as suicide prevention.

Capitalisation, motivational effectiveness, and regulatory mode: a daily diary study of romantic partners

Positive events play an essential role in people's wellbeing. Capitalisation - disclosing such events to others - bolsters such salutary effects. To understand capitalisation-related motivational processes in romantic partners' daily lives, we adopted Higgins' motivational perspective; namely, that people's primary motivation is to feel effective with respect to Value (achieving the desired outcome), Truth (understanding what is true), and Control (managing what happens). We were particularly interested in clarifying how these aspects of effectiveness are reflected in people's daily positive experiences, their partners' responses to their disclosure, and the matching between the two. The role of subject's motivational regulatory mode (assessment vs. locomotion) in these processes was also examined. The results of a diary study of 83 couples showed that assessors (those with motivation to engage in critical evaluation) characterised their positive experiences as high on truth effectiveness but reported greater benefits from partner's responses focusing on control effectiveness. Locomotors (those with motivation to initiate action) were more likely to characterise their positive experiences as high on control effectiveness, but reported greater benefit from partner's responses focusing on value effectiveness. Finally, response mismatching, in particular an "under-focused" response (partner's response effectiveness focus < recipient's event-related motivational effectiveness focus) was rated as less beneficial.

Adolescent Endorsement of the "Weak-Not-Sick" Stereotype for Generalised Anxiety Disorder: Associations with Prejudice, Discrimination, and Help-Giving Intentions toward Peers

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). There is also a lack of research into adolescent anxiety stigma, despite adolescence being a key period for early intervention for anxiety disorders, and research showing that stigma has been implicated in low rates of help-seeking and problematic peer relationships among adolescents with mental illness. Stigma has also been negatively associated with help-giving responses toward those with mental illness. Initial studies suggest that the ‘weak-not-sick’ (WNS) stereotype may be central to anxiety stigma. The present study aims to examine the endorsement of the WNS stereotype in the context of GAD, and its relationship to prejudice, discrimination, and help-giving responses among adolescents. A vignette-based survey measure was completed by 242 adolescents (74 male, 165 female, and three participants who recorded their gender as “other”) in Ireland aged between 15 and 19 years. The results of the study found that endorsement of the WNS stereotype was significantly associated with higher prejudice and discrimination, as well as lower levels of help-giving intentions. A multiple mediator model is presented showing both a direct relationship between endorsement of WNS and help-giving, and an indirect relationship between WNS and help-giving mediated by the prejudicial components of anger, fear and pity, and discrimination as assessed by desired social distance. This study adds to the limited knowledge base on stigma towards GAD in adolescents and provides a model for how anxiety stigma may relate to help-giving. This has implications for interventions to reduce stigmatising and increase help-giving responses.

Influence of Norm-Based Messages on College Students' Binge Drinking Intentions: Considering Norm Type, Regulatory Mode, and Level of Alcohol Consumption

This study examined the influence of norm-based messages on U.S. college students' binge drinking intentions, focusing on norm type, locomotion and assessment regulatory modes, and level of alcohol consumption as possible moderators. Results of an online experiment (N = 519) revealed significant three-way interactions among regulatory mode (assessment/locomotion), level of alcohol consumption, and norm type (i.e., descriptive vs. injunctive norms) on binge drinking intentions. The relative persuasiveness of descriptive vs. injunctive norm-based messages was contingent upon an individual's locomotion/assessment regulatory mode and overall alcohol consumption level. Findings from this study extend research on social norms and regulatory mode and provide useful suggestions for the norm-based college drinking intervention.

The Role of Social Support in Motivating Reductions in Alcohol Use: A Test of Three Models of Social Support in Alcohol-Impaired Drivers

BACKGROUND

Social support has been linked to many therapeutic benefits (e.g., treatment retention, reduced posttreatment relapse) for individuals with alcohol use disorder. However, the positive impacts of social support have not been well understood in the context of alcohol-impaired driving. This article examines the role of social support in motivating those with histories of driving while intoxicated (DWI) arrest to reduce alcohol use by testing 3 major models of social support: the Main-Effects model, the Buffering model, and the Optimal Matching model.

METHODS

One hundred and nineteen participants with histories of DWI arrest were recruited from a correctional treatment facility (n = 59) and the local community (n = 60). Participants completed interviews to assess alcohol consumption, psychiatric/physical conditions, and psychosocial factors associated with drinking behavior (e.g., social support, alcohol-related problems, and motivation to change). Hierarchical regression analyses were conducted to test the 3 models. Additionally, the relative magnitude of the effects of general and recovery-specific social support was compared based on the approach of statistical inference of confidence intervals.

RESULTS

Overall social support was positively associated with some motivation to change (i.e., importance of change, confidence in change) among alcohol-impaired drivers, supporting the Main-Effects model. However, the impact of overall social support on motivation to change was not moderated by alcohol-related problems of individuals arrested for DWI, which did not confirm the Buffering model. Last, recovery-specific social support, rather than general social support, contributed to increasing motivation to reduce alcohol use, which supported the Optimal Matching model.

CONCLUSIONS

These findings highlight the benefits of social support (i.e., increased motivation to change alcohol use) for alcohol-impaired drivers. Regardless of the severity of alcohol-related problems of alcohol-impaired drivers, social support had direct positive impacts on motivation to change. In particular, the results underscore that social support can be more effective when it is matched to the recovery effort of individuals, which is consistent with the Optimal Matching model.

Linguistic Synchrony Predicts the Immediate and Lasting Impact of Text-Based Emotional Support

Emotional support is critical to well-being, but the factors that determine whether support attempts succeed or fail are incompletely understood. Using data from more than 1 million support interactions enacted within an online environment, we showed that emotional-support attempts are more effective when there is synchrony in the behavior of support providers and recipients reflective of shared psychological understanding. Benefits of synchrony in language used and semantic content conveyed were apparent in immediate measures of support impact (recipient ratings of support effectiveness and expressions of gratitude), as well as delayed measures of lasting change in the emotional impact of stressful life situations (recipient ratings of emotional recovery made at a 1-hr delay). These findings identify linguistic synchrony as a process underlying successful emotional support and provide direction for future work investigating support processes enacted via linguistic behaviors.

The Dyadic Nature of Self-Evaluations: Self-Esteem and Efficacy Shape and Are Shaped by Support Processes in Relationships

The current research tested an important way one person’s self-evaluations could shape their intimate partner’s self-evaluations. We predicted that greater self-esteem would predict greater efficacy and esteem support when partners needed support, which would facilitate greater efficacy and self-esteem in partners. We examined these processes within discussions in which one partner could provide support (support provider) to the other (support recipient). Study 1 illustrated that self-esteem was specifically associated with esteem support. Study 2 demonstrated that support providers higher in self-esteem experienced greater efficacy during couples’ support discussions and thus delivered greater esteem support to their partners. Greater esteem support, in turn, was associated with recipients experiencing greater efficacy within couples’ discussions and greater self-esteem across time. Analyses of alternative explanations indicated these processes were unique to self-esteem and esteem support. The results provide initial evidence that self-esteem and efficacy shape, and are shaped by, esteem-related support processes within relationships.

No Assistance Desired: How Perceptions of Others’ Self-Esteem Affect Support-Seeking

Seeking social support from close others often instantiates effective support transactions that foster coping with negative events. However, people often do not solicit the support they require. The present research expands on this phenomenon by examining how perceptions of providers’ self-esteem influences support recipients’ willingness to seek help in times of need. Across five correlational, experimental, and dyadic investigations, we found that people were less willing to seek support from providers who they perceived to be lower (vs. higher) in self-esteem. Moreover, this effect was mediated by perceptions of efficacy in all studies, revealing that perceptions of providers’ self-worth affect the extent that recipients view them as capable and thus are willing to turn to them for help.

Social Support in Intimate Relationships: The Role of Relationship Autonomy

Prior research on effective support interactions in intimate relationships often focuses on support provision rather than how people seek support. The current study investigated how differences in relationship autonomy—authentic and self-determined relationship motivations—predicted the behavior and outcomes of couples ( N = 80) in support interactions. Results indicated that support seekers’ motivation and behavior were the primary contributor to effective support interactions. Support seekers who were autonomously motivated tended to seek support in a more direct and positive manner, which in turn promoted greater levels of emotional, informational, and tangible support from their partners. The relationship autonomy of both the support provider and the support seeker also predicted better subjective experiences regardless of behavior, such as perceiving the interaction as more supportive. These results illustrate how relationship autonomy promotes well-being in relationships via support seeking behaviors, as well as positive interpretations and experiences of important relationship interactions.