{"title":"From unplanned attempts to planned deaths: A comparative analysis of suicidal behavior in rural Türkiye.","authors":"Müge Topcuoğlu, Mustafa Nogay Coşkun, Ali Erdoğan","doi":"10.1521/bumc.2026.90.2.109","DOIUrl":"https://doi.org/10.1521/bumc.2026.90.2.109","url":null,"abstract":"<p><p>Suicidal behavior involves thoughts, plans, and acts aimed at self-harm and remains a major public health issue in rural settings due to limited mental health access and social isolation. This study analyzed 610 adults who presented with suicidal behavior in rural Türkiye between January 2020 and May 2024, comparing 538 nonfatal attempts with 72 deaths. Deaths were mostly premeditated (66.6%) and violent acts among older men (mean age 38.6 years; 88.9%), often widowed or divorced. Nonfatal attempts were primarily unplanned (82.2%) medication overdoses (92%) among younger women. Logistic regression showed that higher age, male sex, widowhood or divorce, retirement, and violent methods predicted mortality, while current psychiatric medication use was protective. Substance misuse and lack of psychiatric follow-up increased risk. These findings highlight gender and cultural differences in suicidal behavior and emphasize the need for stronger outpatient continuity, addiction services, and lethal means restriction in rural communities.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 2","pages":"109-125"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly A Harnsberger, Ann L Carroll, Whitney M Muscat, Samuel Justin Sinclair
{"title":"Exploring the treatment process correlates of the Spectra: Indices of Psychopathology's Psychosocial Functioning scale in a clinical sample.","authors":"Kelly A Harnsberger, Ann L Carroll, Whitney M Muscat, Samuel Justin Sinclair","doi":"10.1521/bumc.2026.90.1.23","DOIUrl":"10.1521/bumc.2026.90.1.23","url":null,"abstract":"<p><p>Assessing adaptive psychosocial functioning is vital in psychological evaluation and treatment. The Psychosocial Functioning (PF) scale from the Spectra: Indices of Psychopathology captures key areas such as well-being, agency, social support, and access to basic needs. While initial research supports its use, its role in guiding complex treatment decisions remains underexplored. This study examined associations between the PF scale and treatment indicators from the Personality Assessment Inventory (PAI) in a mixed sample (N = 89) of psychiatric inpatients and outpatients. Findings revealed meaningful correlations between the PF scale and PAI indicators of suicide and violence risk, stress, support, treatment motivation, and care needs. Hierarchical regressions showed the PAI Level of Care Index and Non-Support Scale were most strongly associated to the PF scale. Results suggest assessing psychosocial functioning can inform clinical decisions and improve treatment outcomes. Study limitations and future research directions are discussed.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 1","pages":"23-41"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Austin G Starkey, Halle S Fowler, Tyler Hendley, Alyson Rivers, Ryan M Hill
{"title":"An evaluation of factor structure, measurement invariance, and psychometric properties of the Psychache Scale.","authors":"Austin G Starkey, Halle S Fowler, Tyler Hendley, Alyson Rivers, Ryan M Hill","doi":"10.1521/bumc.2026.90.2.144","DOIUrl":"10.1521/bumc.2026.90.2.144","url":null,"abstract":"<p><p>The Psychache Scale (PAS) was developed to assess the core construct of Shneidman's model, but the empirical literature shows discrepancy regarding its factor structure. This investigation evaluated whether a unidimensional, two-factor, or bifactor structure best fit the data. Once established, measurement invariance across sexuality, race, and ethnicity, as well as longitudinal invariance, was evaluated. A sample of 1,882 college students completed self-report assessments at baseline and 1-week follow-up. Factor analysis and multigroup factor analysis were conducted. Psychometric properties, including test-retest reliability, concurrent validity, internal consistency, and predictive validity, were evaluated. Results favored a modified bifactor model. Multigroup CFA analyses yielded measurement invariance across groups. Additionally, the PAS was found to have excellent internal consistency and good concurrent validity. Finally, the PAS was predictive of future suicidal ideation even when accounting for related constructs. These results indicate that the PAS is a valid, reliable, and measurement-invariant tool for assessing psychache using a bifactor structure.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 2","pages":"144-167"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How do parents and teachers predict oppositional defiant disorder and conduct disorder in primary school children?","authors":"Eyüp Sabri Ercan, Taciser Uysal, Akın Tahıllıoğlu, Öznur Bilaç","doi":"10.1521/bumc.2026.90.1.1","DOIUrl":"10.1521/bumc.2026.90.1.1","url":null,"abstract":"<p><p>This study examined the diagnostic accuracy of parent and teacher reports for oppositional defiant disorder (ODD) and conduct disorder (CD) in 417 primary school children. Using the Disruptive Behavior Disorders Rating Scale (DBDRS) and a semistructured diagnostic interview, both informant groups were also asked about children's overall functioning. A best estimate procedure-combining all reports, interviews, and impairment ratings-served as the gold standard. Both parents and teachers predicted ODD and CD similarly and accurately. For girls, parents significantly predicted better ODD symptoms, while teachers were more accurate for CD symptoms. Parents with lower education levels showed poorer diagnostic accuracy for CD than both teachers and parents with higher education levels. This study highlights the importance of multi-informant assessments in diagnosing DBDs and is the first to use a comprehensive, structured method in a community-based sample to compare the redictive value of parent and teacher reports when evaluating children's DBDs.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"90 1","pages":"1-22"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherina Arteaga, Ty S Schepis, Ashley B Cole, Alessandro S De Nadai
{"title":"National treatment utilization among racially and ethnically diverse patients with PTSD.","authors":"Katherina Arteaga, Ty S Schepis, Ashley B Cole, Alessandro S De Nadai","doi":"10.1521/bumc.2025.89.1.1","DOIUrl":"10.1521/bumc.2025.89.1.1","url":null,"abstract":"<p><p>Research suggests that racial/ethnic minoritized individuals have elevated risk for experiencing trauma and developing posttraumatic stress disorder (PTSD) but are less likely to utilize mental health treatment compared to their non-Hispanic White counterparts. However, possessing health insurance may mitigate these disparities. We investigated this issue using a subsample of data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 2,339), to estimate the likelihood of utilizing PTSD-specific and general mental health treatment among a racially/ethnically diverse sample of individuals diagnosed with PTSD. Insurance status was included as a moderating factor. Across racial/ethnic groups, insured individuals had more than twice the odds of utilizing PTSD-specific and general treatment than those without insurance. Black, Hispanic, and Asian/Native Hawaiian/Pacific Islander participants were significantly less likely to utilize PTSD-specific and general mental health treatment regardless of insurance status. These findings can inform targeted public health interventions to address mental health care disparities.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 1","pages":"1-26"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Promoting mental health equity through cultural competence.","authors":"Kenneth Po-Lun Fung, Soyeon Kim","doi":"10.1521/bumc.2025.89.4.262","DOIUrl":"10.1521/bumc.2025.89.4.262","url":null,"abstract":"<p><p>Cultural competence is crucial for achieving health equity in mental health care, as systemic barriers and sociocultural factors significantly impact access, diagnosis, and treatment. This paper examines cultural competence and related concepts, including cultural humility, cultural safety, and structural competence, while addressing critiques and misconceptions. We examine its applications at micro, meso, and macro levels, emphasizing its role in diverse clinical settings. In mental health assessment, frameworks like the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision's (DSM-5-TR) Outline for Cultural Formulation and the Contextual Formulation highlight the importance of understanding patients' cultural identities and values. In psychotherapy, cultural adaptations, including mindfulness-based interventions such as acceptance and commitment therapy (ACT), can enhance effectiveness. At the systemic level, we advocate for inclusive organizational practices, ongoing training, and policies that address structural inequities. Integrating cultural competence into mental health care enables clinicians and institutions to better serve diverse populations.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 4","pages":"262-281"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olivia Woodson, Junjia Xu, Martha J Falkenstein, Jennie M Kuckertz
{"title":"Baseline characteristics and treatment outcomes for people accessing a virtual partial hospital program versus a residential program for obsessive-compulsive disorder.","authors":"Olivia Woodson, Junjia Xu, Martha J Falkenstein, Jennie M Kuckertz","doi":"10.1521/bumc.2025.89.3.175","DOIUrl":"10.1521/bumc.2025.89.3.175","url":null,"abstract":"<p><p>Exposure and response prevention (ERP) is the first-line treatment for obsessive-compulsive disorder (OCD). While previous literature supports the effectiveness of higher levels of specialized ERP-based care for OCD (i.e., partial hospital, residential), little is known about how outcomes for these levels of care compare to each other, or who is accessing different levels of specialized care. The present study compared treatment outcomes and baseline demographic, clinical, and prior treatment characteristics between adults with OCD or a related disorder accessing a virtual partial hospital program (VPHP; n = 63) or a residential (n = 128) program. Analyses revealed no significant clinical differences between the programs at either baseline or across treatment. Programs significantly differed on whether patients had children or not. Findings suggest that both VPHP and residential treatment for OCD are effective forms of care, and future research should consider how demographic factors may influence treatment access and preferences.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 3","pages":"175-193"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ben King, Yahaira Suchil, Omolola E Adepoju, Winston Liaw
{"title":"Health-harming legal needs and their relationship with mentally unhealthy days in participants screened for a medical-legal partnership.","authors":"Ben King, Yahaira Suchil, Omolola E Adepoju, Winston Liaw","doi":"10.1521/bumc.2025.89.4.297","DOIUrl":"10.1521/bumc.2025.89.4.297","url":null,"abstract":"<p><p>Medical-legal partnerships (MLPs) address social determinants of health by integrating legal services into health care settings. This study examines associations between health-harming legal needs (HHLNs) and mental health quality among family medicine clinic patients screened for MLP referral. A retrospective cohort of 475 patients completed an HHLN screening instrument, including a measure of mentally unhealthy days (MUDs). Zero-inflated negative binomial models assessed associations between HHLNs and MUDs, adjusting for demographics. Patients with any HHLN had 65% lower odds of reporting zero MUDs. Worrying about housing instability was the strongest independent predictor of increased MUDs, associated with a 56% increase. Black race was associated with greater odds of reporting zero MUDs. Housing concerns are a key driver of mental health quality, highlighting the need for targeted legal interventions. Integrating MLP screening into primary care may help identify and address legal issues impacting patient mental health.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 4","pages":"297-322"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savannah C Marshall, Andrew M Scott, Ashleigh Elcock, Brenda Key, Randi McCabe, Karen Rowa
{"title":"Investigating the psychometric properties of the Five Facet Mindfulness Questionnaire- Short Form.","authors":"Savannah C Marshall, Andrew M Scott, Ashleigh Elcock, Brenda Key, Randi McCabe, Karen Rowa","doi":"10.1521/bumc.2025.89.3.214","DOIUrl":"https://doi.org/10.1521/bumc.2025.89.3.214","url":null,"abstract":"<p><strong>Objectives: </strong>The Five Facet Mindfulness Questionnaire - Short Form (FFMQ-15) measures the tendency to be mindful and is proposed as an alternative to the original 39-item version. This study examines the psychometric properties of the FFMQ-15 in a clinical sample to provide further support for a short-form version.</p><p><strong>Method: </strong>Participants (N = 244; M<sub>age</sub> = 29.68) included in the study completed the FFMQ-39 and FFMQ-15, the Brief Experiential Avoidance Questionnaire (BEAQ), and the Adult ADHD Self-Report Scale - Part A (ASRS). A confirmatory factor analysis (CFA) examined the structure of the FFMQ-15.</p><p><strong>Results: </strong>The FFMQ-15 demonstrates moderate to excellent internal consistency. The FFMQ-15 showed significant correlations in predicted directions with the FFMQ-39, the BEAQ, and the ASRS. The CFA supports a four-factor hierarchical model, excluding the Observing subscale.</p><p><strong>Conclusion: </strong>Results indicate reasonable psychometric properties of the FFMQ-15 but suggest further examination of the Observing subscale.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 3","pages":"214-239"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Holger Zapf, Ursula Voelker, Dennis Radzuweit, Kirstin Goth, Sarah Hohmann, Carola Bindt, Johannes Boettcher
{"title":"Level of personality functioning of adolescents in an acute psychiatric treatment setting: A cohort study.","authors":"Holger Zapf, Ursula Voelker, Dennis Radzuweit, Kirstin Goth, Sarah Hohmann, Carola Bindt, Johannes Boettcher","doi":"10.1521/bumc.2025.89.3.240","DOIUrl":"https://doi.org/10.1521/bumc.2025.89.3.240","url":null,"abstract":"<p><strong>Background: </strong>Adolescents admitted as acute inpatients are a particularly vulnerable psychosocial population. This study aimed to examine their level of personality functioning in an acute psychiatric treatment setting.</p><p><strong>Methods: </strong>We evaluated personality functioning in 62 adolescents using the Level of Personality Functioning-Questionnaire 12-18 (LoPF-Q 12-18) from a patient perspective and the Level of Personality Functioning Scale (LPFS) completed by clinicians.</p><p><strong>Results: </strong>Adolescent patients exhibited a relatively high level of impaired personality functioning, with females tending to show partly higher levels of impairment than males. The agreement between self-reported and clinician reported impairment of personality functioning was low. Biopsychosocial mental health was a strong predictor of self-reported and clinician-reported levels of personality functioning, in contrast to nonsuicidal self-injurious behavior and suicidality.</p><p><strong>Conclusion: </strong>Our findings identify important characteristics of adolescents in acute psychiatric inpatient units. The LoPF-Q may serve as a valuable screening tool for diagnostics and treatment.</p>","PeriodicalId":51683,"journal":{"name":"Bulletin of the Menninger Clinic","volume":"89 3","pages":"240-258"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}