The construction of self-injury in the clinical literature: a sociological exploration

This article presents a sociologically informed critique of a range of academic literatures relating to self-injury. It is noted how a lack of consensus on definitional issues, together with the inaccurate portrayal of the "typical self-injurer" in the clinical literature, has impeded the development of a sound understanding of self-injury. Some of the more problematic explanations for self-injury are explored. The individualistic focus of existing research is found to be inadequate, since it fails to account for the social context in which self-injury occurs. Social scientific approaches critically examine psychiatric and psychological constructions of self-injury, explore wider social and cultural meanings of the behavior, and examine its distribution across different social groups. The inclusion of social scientific perspectives into current debates will greatly improve understanding of self-injury.     

Disentangling the course of epistemic development: parsing knowledge by epistemic content

Over the past three decades, research into the developmental course by means of which persons come to an increasingly mature conception of the knowing process has yielded an highly defracted picture. Despite some concert of opinion about the general bill of particulars, what remains deeply problematic is the increasingly radical disagreement that has arisen regarding the ages at which major milestones in the course of epistemic development are said to be reached. As a way of making some sense of these competing claims, it is argued that the emerging insight that knowledge is ineluctably shaped by those doing the knowing (i.e., that there is an unavoidable “world-to-mind direction of fit” (J.R. Searle, Intentionality: An Essay in the Philosophy of Mind, Cambridge University Press, Cambridge, 1983) between things in the world and the manner of their understanding) does not arrive in a single piece. Instead, as the data presented here help to illustrate, an appreciation of the constructed character of knowledge more commonly arrives piecemeal and at different ontogenetic moments, the times of which are governed by the place that different objects of knowledge occupy along an envisioned continuum of diverse epistemic contents. On this account, not all “facts of the matter” are ordinarily seen to occupy the same epistemic footing. Rather, some so-called facts are commonly understood to be of an “institutional” sort, where “representational” diversity is early expected and widely tolerated. By contrast, other objects of knowledge are imagined to be more like “brute” facts that, on some less mature readings, fully escape the clutches of subjective opinion. Viewed against the backcloth of this proposed continuum, a developmental sequence hypothesized according to which growing persons first come to view “institutional” facts as humanly constructed before subsequently coming to a similar view about presumptively “brute” facts. To test this hypothesis, 242 young persons were administered a paper and pencil measure of epistemic reasoning (the EDQ). Results strongly support the hypothesis that respondents understood the interpretive nature of beliefs about “institutional” facts at an earlier age than so-called “brute” facts.     

Learning by imagining

Five experiments were conducted to investigate the relative effectiveness of 2 alternative instructional strategies. Students who were engaged in studying worked examples that emphasized understanding and remembering procedures and concepts were compared with students who were engaged in imagining worked examples that emphasized imagining procedures and concepts. It was hypothesized that students who held prerequisite schemas would find imagining to have a beneficial effect on learning, compared with studying the material, whereas students who were less knowledgeable would find imagining to have a negative effect on learning, compared with studying. Experimental results were in accord with our hypotheses. It was concluded that, under specific circumstances, encouraging students to imagine procedures and concepts can substantially facilitate learning.     

I.P. Pavlov and W. B. Cannon: Founders of modern physiological thought relative to behavior and the autonomic nervous system

It was almost a half century ago that I last attended an International Congress in Moscow and Leningrad—the IUPS Congress of 1935. My wife and I traveled far and saw the majesty of this land and its peoples. Here I met the great Pavlov and heard him present his thoughts concerning the conditioning of behavior. Cannon presented his concepts of transmitters and receptors. There were many other famous physiologists present, A. V. Hill and Lord Adrian; Kato of Japan demonstrated single nerve fiber studies. Someone talked of conditioned diuresis; I read a paper on hypothalamic control of the hypophysis. That was the dawn of neuroendocrinology, studies of hypothalamic function, sensory receptors, and the transmitter-receptor era. It was, like now, a time of great scientific endeavor, but there were clouds in the sky—Stalin and Hitler were coming to power, but the U.S.S.R. and America were friends, and in science it is still so. I wonder what some young man here will be able to report 50 years from now.     

Sickness in the System: The Health Costs of the Harvest

Cherie Moraga's play, Heroes and Saints, and Helena Maria Viramontes' novel, Under the Feet of Jesus, offer readers perspectives on the lives of migrant farm workers in California that challenge the moral imagination and conscience. Both focus on health hazards of pesticides and on the often prohibitive difficulty of getting health care for those who fall ill as a result of exposure. This paper offers a reflection on the direct political and moral appeal these works present to readers who may not see or acknowledge the sacrifices sustained by those whose undercompensated labors are an integral part of our food systems.     

Correctional treatment for co-occurring disorders: results of a national survey

The significant expansion of correctional populations in the last decade, coupled with the gradual erosion of community treatment infrastructure and health insurance, have brought greater attention to the needs of offenders who have co-occurring mental health and substance use disorders. Individuals with co-occurring disorders frequently cycle through acute care facilities in the community and increasingly are placed in jails or prisons. Approximately 16% of inmates in correctional facilities have major mental health disorders (Bureau of Justice Statistics, 1999), and a large majority of these inmates have co-occurring substance use disorders. Few studies have examined the effectiveness of correctional treatment for co-occurring disorders, and there is little information available regarding clinical and programmatic approaches used with this population. The current study provides findings from a comprehensive national survey of co-occurring disorder treatment programs in correctional settings. A total of 20 co-occurring disorder treatment programs from 13 state correctional systems were identified and surveyed. Many of the programs featured modified therapeutic communities, but there was significant diversity in the duration of treatment and type of services provided. Several unique structural and clinical modifications to treatment have been developed in these settings. Implementation of co-occurring disorder treatment programs has led to enhanced collaboration with prison health services and community supervision and treatment agencies, and greater use of interdisciplinary staff to provide outreach and case management services. Research is now being conducted to examine outcomes in several of these correctional treatment programs.