The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self-strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities.
Regulating emotions, refraining from impulsive, maladaptive behavior, and communicating effectively are considered primary treatment needs among jail inmates. Dialectical behavior therapy (DBT; Linehan, 1993a) skills address these deficits and have been implemented in long-term correctional settings, but have yet to be adapted for general population inmates in short-term jail settings. This study assessed the feasibility and acceptability of a DBT skills group in a jail setting, as well as its utility in improving coping skills and emotional/behavioral dysregulation. Male jail inmates participated in an 8-week DBT skills group and completed pre- and posttest assessments of coping skills, emotional/behavioral dysregulation, and measures of treatment acceptability. Out of 27 who started therapy, 16 completed it, primarily due to involuntary attrition such as transfer to another correctional facility. Although several logistical issues arose during this pilot study, preliminary results suggest that a brief DBT skills group is feasible and acceptable in a jail setting, and may improve coping skills and reduce externalization of blame among general population jail inmates. This study lays the groundwork for larger, controlled trials of abbreviated DBT skills groups for general population inmates in short-term jail settings. (PsycINFO Database Record
This chapter explores common forms of mental illness, conceptualizing hyper-egoicism as a transdiagnostic factor that has primary relevance to multiple disorders in the Diagnostic and Statistical Manual of Mental Disorders. It discusses the degree to which major approaches to psychotherapy (psychodynamic, behavioral, cognitive-behavioral, and mindfulness-based therapies) appear to be hyper- or hypo-egoic in focus and outcome, concluding with a discussion of common characteristics of effective clinicians, arguing that they bring to the therapy hour a foundational hypo-egoic mindset but must be able to skillfully and selectively engage in hyper-egoic processes that can inform treatment. The premise of this chapter is that the clinical psychologist’s waiting room is the land of the hyper-egoic—a room rife with people painfully mired in hyper-egoic mindsets.
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