Why Do People Hurt Themselves?: New Insights Into the Nature and Functions of Self-Injury

ABSTRACT— Nonsuicidal self-injury (NSSI) is a prevalent but perplexing behavior problem in which people deliberately harm themselves without lethal intent. Research reveals that NSSI typically has its onset during early adolescence; most often involves cutting or carving the skin; and appears equally prevalent across sexes, ethnicities, and socioeconomic statuses. Less is known about why people engage in NSSI. This article presents a theoretical model of the development and maintenance of NSSI. Rather than a symptom of mental disorder, NSSI is conceptualized as a harmful behavior that can serve several intrapersonal (e.g., affect regulation) and interpersonal (e.g., help-seeking) functions. Risk of NSSI is increased by general factors that contribute to problems with affect regulation or interpersonal communication (e.g., childhood abuse) and by specific factors that influence the decision to use NSSI rather than some other behavior to serve these functions (e.g., social modeling). This model synthesizes research from several different areas of the literature and points toward several lines of research needed to further advance the understanding of why people hurt themselves.     

Suicidality Protective Factors Among Black College Students: Which Cultural and Personal Resources Matter?

This study examined the influence of cultural resources (ethnic identity, Afrocentric worldview, and religiosity) on suicidal thoughts and behaviors among Black college students and the role of personal resources (ego resiliency and optimism) as mediators of this link. Data collected from 257 participants were analyzed. A bivariate correlational analysis showed that ethnic identity was significantly associated with lower levels of suicidality. In addition, ego resiliency mediated the relationships between Afrocentric worldview, ethnic identity, and religiosity and suicidality. Este estudio examinó la influencia que tienen los recursos culturales (identidad étnica, visión del mundo afrocéntrica y religiosidad) sobre los pensamientos y comportamientos suicidas entre estudiantes universitarios negros, así como el papel de los recursos personales (resiliencia del ego y optimismo) como mediadores de esta conexión. Se analizaron los resultados recogidos de 257 participantes. Un análisis correlacional bivariado mostró que la identidad étnica estaba asociada significativamente a niveles más bajos de tendencias suicidas. Además, la resiliencia del ego medió la relación entre la visión del mundo afrocéntrica, la identidad étnica y la religiosidad y las tendencias suicidas.     

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel

ABSTRACT

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.     

Association between loneliness and suicidality during middle childhood and adolescence: longitudinal effects and the role of demographic characteristics

The association between loneliness and suicidality has been documented in many studies, but these studies have been limited by cross-sectional designs and the use of adult-only populations. The purpose of the current study was to overcome these limitations by (a) investigating whether the link between loneliness and suicidal thoughts and behaviors occurs cross-sectionally, longitudinally, or both and (b) investigating how the link between loneliness and suicidality might be influenced by different demographic variables, including gender, ethnicity, and socioeconomic status. Logistic regression analyses were used to analyze data from a large sample (N = 937) of youth from the NICHD Study of Early Child Care. Results indicated that loneliness at age 15 years was concurrently associated with both suicidal ideation and suicidal behavior at age 15 years. Loneliness in middle childhood was longitudinally associated with suicidal behaviors at age 15 years, but not with suicidal ideation at age 15 years. None of the demographic characteristics influenced these associations.     

Introduction

Abstract

Managed health care policy has created dramatic changes in current clinical practice, and all too frequently, impacts the overall treatment plan. Clinicians making referrals for emergency hospitalizations can no longer rely on an in-patient, safe, holding environment. Rather the hospital's relationship and stance with managed care insurance providers determines the length of the hospitalization and the case management plan for patients, instead of the patient's need.     

The Moral Foundations of Equipoise and Its Role in International Research

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with so-called early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of (late onset) Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care.     

The Theater of Terror

Summary

Modern terrorists became aware of the new opportunities for exerting mass psychological impact using the latest means of mass communications. Academic observers remarked increasingly on the theater-like nature of terrorist operations. According to this notion, modern terrorism can be understood in terms of the production requirements of theatrical engagements. Several terrorist organizations realized the potentials of media-oriented terror, in terms of effectively reaching huge audiences. This article examines the strategies and tactics of this new pattern of media-oriented terrorism and their impact on the audiences who, through the media's mediation, join the widening circles of victims of terrorism.     

Suicidal ideation,affective lability,and religion in depressed adults

Suicidal ideation is a strong precursor to suicidal acts and like depression is complex with many risk and protective factors. The purpose of this study is to determine if affect lability, positive and negative religion/spirituality (RS) are related to suicidal ideation and if RS mediates the relationship between affect lability and suicidal ideation. RS are used synonymously to reflect a multidimensional construct. In this cross-sectional study of 183 depressed psychiatric patients, we confirm that depression and affective lability both contribute to suicidal ideation. Positive RS is associated with lower suicidal ideation. Negative RS is associated with higher suicidal ideation; however, this occurs through its association with affective lability. Affective lability and negative aspects of RS are two factors related to suicide ideation that could be addressed in the treatment of depressed patients.     

‘Between the bridge and the brook’

Abstract

That suicide was a damnable sin in Reformation England has been emphasized so far in the historiography of self-killing, but in practice the clergy were equivocal over the question of whether all self-killers were damned. This article re-examines English Protestant beliefs about suicide and salvation from the mid-sixteenth to the mid-seventeenth century. It suggests that clerical statements about the damnableness of suicide need to be understood in the context of the threat posed by Stoic philosophy. Religious writers rejected the notion of noble suicide and reiterated Augustinian theology that premeditated self-killing was a form of murder. However, the harsh rhetoric was mitigated by a number of factors that brought into question the idea that all suicides were destined for Hell. These included changing medical opinion about mental states, evidence of the good character of many suicides, belief in the overpowering influence of demonic forces and basic Christian charity and compassion.     

Eichberg’s ‘Phenomenology’ of Sport: A Phenomenal Confusion

This paper defends philosophical phenomenology against a hostile review in the previous issue of this journal. It tries to explain what philosophical phenomenology is, and the possibilities for its empirical application; whilst also showing that Eichberg’s method is idiosyncratic, problematic and not interested in philosophical phenomenology at all. It presents the phenomenological concept of phenomenon, which is neither concrete nor abstract, and contrasts it to Eichberg’s understanding of empirical concrete phenomena. Finally, the paper scrutinises Eichberg’s empirical method, which has deep problems of its own, and in any case, finds unsuitable its characterisation as ‘phenomenology’