Joseph H. Obegi

California Department of Corrections and Rehabilitation · California Correctional Health Care Services

Suicidality-specific diagnoses have been proposed recently, but suicidologists are only just beginning to evaluate their merits. To advance this discussion, I introduce the term suicidal syndrome to describe the underlying entity, present a rationale for why a formal diagnosis is necessary, define the major features of the syndrome, and show how th...

The text of DSM-5 includes a new heading—Suicide Risk—meant to educate users about the suicide risk posed by specific mental disorders. But, how well do the Suicide Risk sections fulfill their didactic intent? A review of the sections shows that topical coverage is uneven, noteworthy disorders are omitted, and there are inaccurate statements. In ad...

Feigning suicidality is common among patients in correctional settings, but there has been little discussion on the differences between genuine and feigned presentations of suicidality. Differentiating suicidality from feigned suicidality is among the riskiest diagnostic challenges. Still, some headway can be made if we compare features of genuine...

On occasion, a patient may refuse to cooperate with a suicide risk assessment or is unable to participate due to the severity of a psychiatric or medical condition. In such situations, how can we conduct an assessment that meets our ethical, professional, and legal obligations?

Objective It is sometimes stated that most people who die by suicide deny suicidal thoughts before their deaths. This narrative review examines the empirical basis for this assertion. Methods Studies from 2000 to 2021 that examined the prevalence of the denial of suicidal thoughts among ideators in general, denial before suicide, and denial before...

Correctional mental health clinicians are sometimes asked to assess disciplinary responsibility, that is, to ascertain whether an inmate is culpable for violating prison rules. This assessment of disciplinary responsibility is akin to insanity determinations in criminal proceedings. In this article, I review the moral, legal, and practical aspects...

In their editorial, “Universal screening may not prevent suicide,” Nestadt et al. argue that screening for suicidal ideation will not prevent suicide because ideation is a poor predictor of suicide. However, is identifying suicide risk the purpose of universal screening?

Background: It is a peculiar fact that the deadliest psychiatric disturbance - suicidality - cannot be formally diagnosed. Suicidal behavior disorder (SBD), a condition for further study in the DSM-5, is the field's first attempt to capture suicidality in a diagnosis. Aims: To provoke discussion about the standing of suicidality as a diagnosable...

The legal standard of care for assessing and responding to suicide risk has historically been ambiguous, creating inconsistency in the testimony of forensic experts and uncertainty about clinical responsibilities among practitio- ners. In this article, I rigorously apply the legal concept of reasonable care to identify clinical activities that cour...

Suicidologists and legal experts implore clinicians to document their suicide risk assessments (SRAs) thoroughly. It's difficult, however, to find practical guidance on how to write a clinically sound, legally defensible SRA.

Reviews the book, Clinical applications of the Adult Attachment Interview edited by Howard Steele and Miriam Steele (see record 2008-04549-000). Although the Adult Attachment Interview (AAI), created by Mary Main and her colleagues, is among the most important research instruments in developmental and clinical psychology, the details of its admin...

The bond between client and therapist, a component of the global alliance, is widely believed to play a crucial role in supporting the work of therapy. However, we know little about how the client-therapist bond becomes established and have few theoretical tools to conceptualize its development. Attachment theory, with its focus on the development...

Thesis (Psy.D.) -- Alliant International University, California School of Professional Psychology, San Diego, 2005. Bibliography: leaves 74-78.

We examined intergenerational transmission of attachment organization in the context of adult romantic relationships. Similarities and differences in adult attachment style between young female adults and their parents were investigated. Results generally supported the hypothesis that mothers’ adult attachment organization, but not fathers’, is rel...