Self-harm among adolescents with developmental disabilities. What are they trying to tell us?

Self-harm behavior exhibited by adolescents with developmental disabilities can be the most challenging behavior for caregivers and health care professionals to address. Past interventions have taken a behavioral approach and focused on functional analysis to guide assessment and treatment. However, self-harm behavior is becoming more recognized as a means of communication. Therefore, it is important for health care professionals and caregivers to listen to adolescents' attempts to communicate and try to understand the meaning of the behavior. Early assessment is crucial to understanding the meaning of the behavior, and early intervention is necessary to prevent escalation or chronicity. Thorough assessment guides interventions and must be implemented in the context of clients' families and social world, and the broader community. Establishment of trusting relationships among adolescents, their families, and health care professionals is imperative. This article discusses self-harm behavior from a psychosocial perspective related to prevalence, onset, purpose, maintenance, and escalation. It also introduces a comprehensive framework to guide assessment and intervention.     

Engaging Intercollegiate Athletes in Preventing and Intervening in Sexual and Intimate Partner Violence

Abstract

Objective: The object of this exploratory evaluation was to evaluate the “Bringing in the Bystander” sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. Participants and Methods: Fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control group. All completed pretest, posttest, and 2-month follow-up surveys, including assessment of rape myth acceptance, intent to engage in bystander behaviors, bystander confidence, and bystander behaviors. Results: The program worked overall and for both women and men, improved bystander confidence and intent to engage in bystander behaviors, and did not create significant backlash effects (ie, worsening of attitudes as a result of program). Conclusions: The program fits with the intent of the National Collegiate Athletic Association CHAMPS/Life Skills program regarding its focus on the overall development of student-athletes and demonstrates the promising bystander approach compatible with the 2007 American College Health Association toolkit, Shifting the Paradigm: Primary Prevention of Sexual Violence.     

Recursive location and scale estimators

It is shown that a recursive estimator with the same asymptotic properties as the median has convergence properties in finite samples which depend heavily on the scale of the data. A simple modification which adjusts for the scale is suggested and its application illustrated on simulated data. The modified estimator has much improved properties which are similar to those of the sample (non-recursive) median.     

Aging with HIV: Historical and Intra-Community Differences in Experience of Aging with HIV

Gay men living with HIV/AIDS face a complex of health issues, including those associated with the aging process, long-term HIV infection (25 years or more), and side effects from Highly Active Anti-Retroviral Therapy (HAART). If aging can increase marginalization, this is more likely for the aging HIV positive gay man, who is already marginalized for being queer and living with a stigmatizing disease. This article presents findings from a study of a long-running HIV support group. It locates the members, all gay men living with HIV, in a specific historical and political context to explore how feelings of loss and the struggle to sustain community affect long-term survivors and other older HIV+ gay men. We identify specific challenges presented by aging for men who contracted HIV early in the epidemic, contrasting them with those faced by men infected with the virus later in life. While both groups appear to struggle with a vision of what life could have been, had AIDS not forced loss and change, they also celebrate the community their shared plight has enabled.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

Old Chicago and new France

It is only when theories are located in history, when we view the demands for verification in highly particular contexts of a historical kind that we are freed from either dogmatism or capitulation to scepticism (MacIntyre 1977: 471). The world has problems; the university has disciplines whose boundary lines inhibit our abilities to address those problems. The boundaries acquire such seeming validity that it becomes necessary to defend problem-oriented research as “interdisciplinary,” when the real point is to examine social reality, rather than defer to academic turf (and scientistic scruples). Faced with the contemporary range of global problems, it is helpful to re-assess and re-construct our history. The artificiality of the disciplinary lineages within the U.S. has diminished Old Chicago. Yet the problems which it addressed have remained pertinent not only to the U.S., and not only to France, but throughout the world. Because the French disciplinary lines have been other than ours, and their nation has been confronting a set of social problems akin to those faced by the Chicagoans, some of their social scientists have sought to draw upon that heritage. The abstract and allusive discourses of a Derrida or Lacan tend to distract observers from the engaged character of the best French intellectual discourse. Park was engaged in the best sense, but he had observed too many campaigns of urban reform which simply clothed the attempt of a culturally dominant group to impose its ethos upon a socially subordinated populace. Underlying Park’s disparagement of “do-good” campaigns and “evangelical sociology” was a moral insistence on respecting the varieties of social life. 19 This is manifest in his life trajectory and in his role as teacher. To me he is cast in the heroic figure of Bernard Rieux in Camus’ The Plague. After undergraduate studies (B.S., 1942) at University of Chicago, Murray L. Wax returned there to teach and undertake doctoral studies (Ph.D., 1959)- He has taught at several universities and is now emeritus Professor, Washington University, St. Louis. The author wishes to express his gratitude for their advice and encouragement to Joan Cassell, Jean-Michel Chapoulie, Lawrence T. Nichols, and Paule Verdet.     

Modeling the Effects of Expressed Emotion,Psychiatric Symptomology,and Marital Quality Levels on Male and Female Verbal Aggression

Previous research has linked expressed emotion (EE) levels and psychiatric symptomology, whereas other empirical efforts have examined the relationship between EE and marital relationship variables. Still other research has linked psychological conditions with acts of aggression, and the impact of marital issues within this domain of inquiry also has been explored. The study presented here examined the combined effects of EE, marital quality, and psychiatric symptomology on displays of verbal aggression by both relationship partners. Both husbands' and wives' reports of marital quality were predictive of both husbands' and wives' verbal aggression levels; here, reports of lower marital quality were associated with higher levels of verbal aggression. Additionally, husbands' and wives' reports of psychological symptomology in self and partner were important paths to marital quality, as were husbands' and wives' reports of EE levels. Further, some evidence was generated that supports the mediating role of marital quality with regard to EE and psychological symptomology. However, the overall fit indices of the models tested in this empirical effort were modest. Limitations that concern the instruments utilized in the present study are discussed in this regard.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

Student Drinking-Related Problems in an Urban Campus: Implications for Research and Prevention

Abstract

Objective: Researchers who study the etiology of college drinking typically employ measures of alcohol-use behaviors as outcomes; however, relatively little is known about the properties of alcohol-related problems (AP). This study aims to develop a single continuous measure of AP. Participants: The sample included 531 undergraduate college students who were surveyed in March 2007. Methods: The Rasch model was employed for dichotomous variables to analyze the measurement properties of 17 AP items. Results: Although issues with respect to differentiation at low levels of problem severity were identified, based on most strategies, the Rasch-based scale was shown to be a valid and reliable measure of AP among college students. Conclusions: Although there may be some need for slight modification and adjustment in the future, the AP scale developed here can potentially serve as a useful measure for etiological and prevention research.     

The Neurosequential Model of Therapeutics: An Interview with Bruce Perry

In this interview with Bruce Perry, MD, PhD, Senior Fellow of The Child Trauma Academy, Laurie MacKinnon discusses with Dr Perry developmental trauma and the Neurosequential Model of Therapeutics, an approach to clinical problem solving that utilises a developmental lens and incorporates advances in neurobiological development. Dr Perry gives his perspective on the causal connection between childhood abuse and later psychiatric diagnosis, the child's contact with a violent parent post‐separation, the importance of interventions that address the organisation and functioning of lower parts of the brain and his perspective on the use and limitations of psychotropic medications, cognitive behaviour therapy and family therapy.