Background Executive dysfunction, distinct from other cognitive deficits in depression, has been associated with suicidal behavior. However, this dysfunction is not found consistently across samples. Method Medication-free subjects with DSM-IV major depressive episode (major depressive disorder and bipolar type I disorder) and a past history of suicidal behavior (n=72) were compared to medication-free depressed subjects with no history of suicidal behavior (n=80) and healthy volunteers (n=56) on a battery of tests assessing neuropsychological functions typically affected by depression (motor and psychomotor speed, attention, memory) and executive functions reportedly impaired in suicide attempters (abstract/contingent learning, working memory, language fluency, impulse control). Results All of the depressed subjects performed worse than healthy volunteers on motor, psychomotor and language fluency tasks. Past suicide attempters, in turn, performed worse than depressed non-attempters on attention and memory/working memory tasks [a computerized Stroop task, the Buschke Selective Reminding Task (SRT), the Benton Visual Retention Test (VRT) and an N-back task] but not on other executive function measures, including a task associated with ventral prefrontal function (Object Alternation). Deficits were not accounted for by current suicidal ideation or the lethality of past attempts. A small subsample of those using a violent method in their most lethal attempt showed a pattern of poor executive performance. Conclusions Deficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated. Broader executive dysfunction in depression may be associated with specific forms of suicidal behavior, rather than suicidal behavior per se.

Research Summary The Florida Department of Juvenile Justice has implemented a disposition matrix to guide recommendations made by juvenile probation officers to the court. This study examines whether recidivism rates for dispositions/placements made within the suggested range of this matrix differ from those outside of the suggested range. Using a sample of 38,117 juvenile offenders, we found that the dispositions/placements within the suggested range had an average recidivism rate of 19.4%, whereas those whose dispositions were outside the range had an average recidivism rate twice as high (38.7%). Furthermore, dispositions/placements that were the least restrictive option within the suggested range performed best. Dispositions above the suggested range (more restrictive) performed poorly, although those below the suggested range (less restrictive than suggested) performed the worst. These results held for males and females, across race/ethnicity, and across risk to reoffend levels. Policy Implications Implementation of structured decision‐making tools leads to questions from stakeholders and front‐line staff charged with using those tools regarding their effectiveness. Research and theory‐based justifications do not hold the weight actual data from the implementation population provide. These tools help control costs, facilitate planning, and can improve outcomes. Monthly monitoring of adherence rates, development of override and management oversight protocols, and regular feedback to front‐line staff are critical components of success.

Recent practice guidelines and meta-analyses have designated eye movement desensitization and reprocessing (EMDR) as a first-line treatment for trauma. Eye movement desensitization and reprocessing is an eight-phase therapeutic approach guided by an informationprocessing model that addresses the combat veteran's critical incidents, current triggers, and behaviors likely to prove useful in his or her future. Two case examples of combat veterans illustrate the ability of EMDR to achieve symptom reduction in a variety of clinical domains (e.g., anxiety, depression, anger, physical pain) simultaneously without requiring the patient to carry out homework assignments or discuss the details of the event. The treatment of phantom limb pain and other somatic presentations is also reviewed. The ability of EMDR to achieve positive effects without homework indicates that it can be effectively employed on consecutive days, making it especially useful during combat situations. & 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64:947-957, 2008.

An integrative neurobehavioral model for "compassion stress injury" is offered to explain the "double-edge sword" of empathy and inherent vulnerability of helping professionals and care-givers. One of the most strikingly robust, yet largely invisible scientific findings to emerge over the past decade is identifying the neurophysiological mechanisms enabling human beings to understand and feel what another is feeling. The compelling convergence of evidence from multidisciplinary lines of primary research and studies of paired-deficits has revealed that the phenomenon of human beings witnessing the pain and suffering of others is clearly associated with activation of neural structures used during first-hand experience. Moreover, it is now evident that a large part of the neural activation shared between self-and other-related experiences occurs automatically, outside the observer's conscious awareness or control. However, it is also well established that full blown human empathic capacity and altruistic behavior is regulated by neural pathways responsible for flexible consciously controlled actions of the observer. We review the history, prevalence, and etiological models of "compassion stress injury" such as burnout, secondary traumatic stress, vicarious traumatization, compassion fatigue, and empathic distress fatigue, along with implications of the neurobehavioral approach in future research.

Russell, M. C. (2008). Scientific resistance to research, training and utilization of eye movement desensitization and reprocessing (EMDR) therapy in treating post-war disorders.