Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness.

Development of effective treatments for patients following deliberate self-harm (self-poisoning or self-injury) is a very important element in suicide prevention. The randomized controlled trial (RCT) is the mainstay of evaluation of treatments. In a systematic review of the literature, the effectiveness of treatments based on RCTs was examined and the quality of the RCTs was assessed. Twenty trials were identified, and where possible, these were grouped on the basis of similarities among the types of treatment. In this paper, we examine the methodological aspects of the trials and consider what may be learned that will assist in the design of future studies in this field. The methodological quality of the trials was reasonable, but most trials included too few participants to detect clinically important differences in rates of repeated self-harm. In planning future trials, the following major issues should be addressed: investigators should perform power calculations to determine the number of subjects necessary to detect clinically important effects, provide information on method of randomization and interventions, use standard measures of outcome, and focus on homogeneous subgroups of patients. Improving the methodology of future studies in this field will be essential if sound evidence is to be obtained which can inform effective service provision for deliberate self-harm patients.     

The strings on David’s Harp: religious ritual as a container for spirituality

ABSTRACT

Religion and spirituality have often been defined over against each other. The spontaneous, emotional and experiential nature of the spirit has been seen as preferential to the structured, fixed, and predictable nature of religious ritual. Religion education for children has moved away from the performance of ritual behaviour toward creating an environment to nurture the innate spiritual nature of children. This paper questions whether the pendulum has swung too far, neglecting rituals that have sustained religious and communal life for generations, and considers ways of reimagining traditional ritual as a way to encounter the spirit and build community.     

Book reviews

Cutting, J. E. Perception with an eye for motion. Cambridge, Mass: The MIT Press, 1986. Pp. 321.ISBN 0-262-03119-1. £29.95.

Kimble, G. A. and Schlesinger, K. (Eds.). Topics in the history of psychology, Volume 1. Hillsdale, N.J.: Lawrence Erlbaum Associates, Inc., 1985. Pp. 409. ISBN 0-89859-312-3. £36.00.

Bruce, V. and Green, P. (1985). Visual perception :Physiology, psychology and ecology. London : Lawrence Erlbaum Associates Ltd. Pp. 369. ISBN 0-86377-012-6. Hardback £26.95; paperback £8.95.

Pylyshyn, Z. W. & Demopoulos, W. (Eds.). Meaning and cognitive structure : Issues in the computational theory of mind. Norwood, N.J.: Ablex Publishing Corporation, 1986. Pp. xi + 264. ISBN 0-89391-372-3.£36.50.

Pylyshyn, Z. W. (Ed.). The robot's dilemma: The frame problem in artificial intelligence. Norwood, N.J.: Ablex Publishing Corporation, 1987. Pp. xi +156. ISBN 0-89391-371-5. £25.50.

Beaton, A. (1985). Left side, right side : A review of laterality research. London: Batsford. Pp. 364. ISBN 0-7134-4389-8. £25.00.