A Comparison of Child-sex-abuse-related and Mental-disorder-related Suicide in a Six-year Cohort of Regional Suicides: The Importance of the Child Protection-Psychiatric Interface

Correspondence to: Professor Colin Pritchard, Department of Mental Health, School of Medicine, Southampton University, Royal South Hants Hospital, Southampton SO14 0YG, UK. E-mail: cp1{at}soton.ac.uk Summary The study compares Mental-Disorder-Related (MDR) suicide rateswith Child-Sex-Abuse-Related (CSAR) suicide of ‘Victims’and ‘Perpetrators’ of child sex abuse, based uponan examination of all Coroners’ inquest files over a six-yearperiod (n = 1,017). Census data, psychiatric case register andpolice records were used to calculate the potential MDR andCSAR populations. There were five main findings: (i) male andfemale CSAR victim suicide rates were 2.2. and 2.5 times theGeneral Population Suicide Rate (GPSR), respectively; (ii) everyfemale, and 80 per cent of male CSAR victim suicides, also hada mental disorder but none of the CSAR perpetrator suicides;(iii) male and female MDR suicide rates were 5 and 6 times theCSAR Victim rates; (iv) the sex abuser perpetrators’ suiciderate was more than 3 times the male MDR rate; (v) the intra-and extra-familial perpetrator suicide rates, were 25 and 78times the GPSR, respectively. Possible explanations for thesesurprising results are briefly discussed. They confirm the overrepresentationof people with mental disorder amongst suicides, and identifyan overrepresentation of CSAR suicides, particularly perpetrators.The results have implications for suicide prevention programmes,whilst highlighting the importance of the child protection-psychiatricinterface, and indicates the futility of simple explanationsin an area of practical and moral complexity.     

Gender and racial/ethnic differences in predicting adolescent sexual risk: athletic participation versus exercise

Though often conflated, informal physical exercise and organized athletic participation have very different implications for adolescent sexual risk outcomes. The purpose of this research is to disaggregate strenuous exercise from sports, examine how each is associated with sexual risk, and explain the observed differences using the conceptual lens of cultural resource theory. Using a nationally representative sample of over 16,000 public and private high school students, we employ logistic regression to test hypotheses about the gender-specific and race-specific effects of strenuous exercise and athletic participation on adolescent sexual risk behavior. The results show that both forms of physical activity buffer sexual risk for girls. Strenuous exercise is associated with increased odds of sexual risk for boys. Sports and race interact to influence boys' sexual risk outcomes: Athletic participation is associated with lowered odds of sexual risk for white male adolescents, but heightened odds of sexual risk for black male adolescents.     

Why do People Disclose their HIV Status? Qualitative Evidence from a Group of Activist Women in Khayelitsha

Abstract

This study explores the bio-psychosocial context of HIV/AIDS in which eleven HIV-positive activist women from Khayelitsha negotiated the process of disclosing their HIV-positive status to significant others, specifically biological household members. The study is based on the narratives of a group of HIV-positive peer-educators in Cape Town, South Africa. The results suggest that community perceptions of HIV/AIDS are shaped by a wide variety of factors particular to the socio-cultural and political context of HIV/AIDS in South Africa. The process and outcomes of disclosure to others occurs within this shifting web of meanings, and in turn, reshapes them as people respond to the person who has just disclosed. Eight out of the eleven women disclosed to a close biological household member as these significant-others provided, or had the potential to provide, the appropriate support. Six of the eleven participants disclosed during the symptomatic phases of HIV/AIDS, while five were asymptomatic at the time. Four of the five who disclosed when asymptomatic were diagnosed while pregnant and had never experienced severe opportunistic infections. Additionally, these same four disclosed some time after diagnosis (nine months > t < two years). Of the six who disclosed in a state of ill-health, five disclosed immediately after diagnosis in order to access health-related social support. At this time, concerns regarding health and mortality superseded fears of rejection and discrimination due to AIDS-related stigma. The perceived potential benefits (social and health-related support) outweighed the perceived risks (stigmatisation and discrimination). When participants had never experienced serious illness, they disclosed in order to educate loved-ones, gain emotional support or challenge false popular perceptions of HIV/AIDS.     

The Interpretation of Line of Regard by Prelingually Deaf Children

The ability of 5- to 12-year-old deaf children to utilise and interpret another person's visual line of regard (where the eyes are looking) was studied in four experiments using cartoon faces. The children had little difficulty in determining whether or not a face was looking directly at them. They had more difficulty, however, with more complex tasks requiring them to infer mental states of desire and intention from line of regard and to ignore line of regard when it was inappropriate to attend to this cue. Deaf children raised in a hearing environment appear to have more difficulty with these more complex tasks than hearing children. The results are discussed in terms of the special difficulties facing some deaf children in the development of skills involving utilisation of line of regard and the implications for the development of joint attentional behaviour, theory of mind and dyadic social interaction in deaf and hearing children.