Deliberate Self-Poisoning,Unemployment, and Public Health

The purpose of the present investigation was to explore further the known relationship between deliberate self-poisoning and social deprivation. Each individual who attended one of Cork city's three casualty departments following an act of deliberate self-poisoning in 1988 was examined. The place of residence (ward) of each city resident patient was established. The social status of the city's 34 wards was estimated using a number of indices obtained from the 1981 and 1986 census reports and social service records. A comparison was made between the 1988 self-poisoning rate for each ward and the rate found in a 1982 study of the city. Correlations between self-poisoning rate and seven social deprivation indices were found to be significant. Multiple regression, factor, and partial correlation analyses were carried out to examine more closely the interrelationships between the social deprivation indices. With respect to explaining the variation in the self-poisoning rate, unemployment alone performed almost as well as all of the indices together and as well as the factors derived using factor analysis. The correlation between unemployment and self-poisoning rate remained highly significant when the other related variables were controlled for. However, at fixed levels of unemployment, these variables were found to be independent of the self-poisoning rate. It is suggested that whereas clinical intervention may benefit the individual, deliberate self-poisoning as an issue requires a public health approach for its resolution.     

Continuity of change in Kant’s dynamics

Since his Metaphysische Anfangsgründe der Naturwissenschaft was first published in 1786, controversy has surrounded Immanuel Kant’s conception of matter. In particular, the justification for both his dynamical theory of matter and the related dismissal of mechanical philosophy are obscure. In this paper, I address these longstanding issues and establish that Kant’s dynamism rests upon Leibnizian, metaphysical commitments held by Kant from his early pre-Critical texts on natural philosophy to his major critical works. I demonstrate that, throughout his corpus and inspired by Leibniz, Kant endorses the a priori law of continuity of alteration as a truth of metaphysics, according to which all alterations in experience must occur gradually through all intervening degrees. The principle thus legislates against mechanical philosophy’s absolutely impenetrable atoms, as they would would involve instantaneous changes of velocity in impact. This reveals the metaphysical incoherencies in mechanical philosophy and leaves Kant’s own dynamical theory of matter, grounded on material forces, as the only viable approach to physical explanation. Subsequently, I demonstrate that Kant nevertheless made conceptual space in his system for the theoretical consideration of mechanical explanations, which makes manifest one of the positive roles that the faculty of reason can play with respect to natural science.

     

Consistency Theory for the General Nonparametric Classification Method

Psychometrika - Parametric likelihood estimation is the prevailing method for fitting cognitive diagnosis models—also called diagnostic classification models (DCMs). Nonparametric concepts...     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.