Object Loss and Pathological Consequence: A Study in the Psychological Treatment of Loss and Self-Injury

2014 ◽  
pp. 233-248
Author(s):  
Heather T. Schatten ◽  
Kenneth J. D. Allen ◽  
Michael F. Armey

As emotion is a dynamic construct, ecological momentary assessment (EMA) methods, which gather data at multiple time points in individuals’ real-world environments, in the moment, are particularly well suited to measure emotion dysregulation and related constructs. EMA methods can identify contextual events that prompt or follow an emotional response. This chapter provides an overview of traditional methods of studying emotion dysregulation and how EMA can be used to capture emotion dysregulation in daily life, both within and independent of psychiatric diagnoses. It reviews the literature on emotion dysregulation and related constructs within specific diagnoses (e.g., depression, bipolar disorder, borderline personality disorder, and eating disorders) and behaviors (e.g., suicide, nonsuicidal self-injury, and alcohol use). Finally, it discusses future directions in EMA research, as well as its implications for psychological treatment.


2007 ◽  
Vol 63 (11) ◽  
pp. 1081-1089 ◽  
Author(s):  
Matthew K. Nock ◽  
Romi Teper ◽  
Michael Hollander

1990 ◽  
Vol 6 (3-4) ◽  
pp. 223-238
Author(s):  
Louis Birner

2013 ◽  
Vol 18 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Robert J. Barth

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.


2007 ◽  
Vol 41 (4) ◽  
pp. 36
Author(s):  
TIMOTHY F. KIRN
Keyword(s):  

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 318-325 ◽  
Author(s):  
Barbara Stanley ◽  
Glenn W. Currier ◽  
Megan Chesin ◽  
Sadia Chaudhury ◽  
Shari Jager-Hyman ◽  
...  

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.


Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Christopher M. Bloom ◽  
Shareen Holly ◽  
Adam M. P. Miller

Background: Historically, the field of self-injury has distinguished between the behaviors exhibited among individuals with a developmental disability (self-injurious behaviors; SIB) and those present within a normative population (nonsuicidal self-injury; NSSI),which typically result as a response to perceived stress. More recently, however, conclusions about NSSI have been drawn from lines of animal research aimed at examining the neurobiological mechanisms of SIB. Despite some functional similarity between SIB and NSSI, no empirical investigation has provided precedent for the application of SIB-targeted animal research as justification for pharmacological interventions in populations demonstrating NSSI. Aims: The present study examined this question directly, by simulating an animal model of SIB in rodents injected with pemoline and systematically manipulating stress conditions in order to monitor rates of self-injury. Methods: Sham controls and experimental animals injected with pemoline (200 mg/kg) were assigned to either a low stress (discriminated positive reinforcement) or high stress (discriminated avoidance) group and compared on the dependent measures of self-inflicted injury prevalence and severity. Results: The manipulation of stress conditions did not impact the rate of self-injury demonstrated by the rats. The results do not support a model of stress-induced SIB in rodents. Conclusions: Current findings provide evidence for caution in the development of pharmacotherapies of NSSI in human populations based on CNS stimulant models. Theoretical implications are discussed with respect to antecedent factors such as preinjury arousal level and environmental stress.


Crisis ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Nir Madjar ◽  
Nicole Segal ◽  
Gilad Eger ◽  
Gal Shoval

Abstract. Background: Nonsuicidal self-injury (NSSI) has been found to be associated with poor emotion regulation. Aims: The goal of this study was to examine the association of multidimensional cognitive emotion regulation strategies with NSSI among adolescents and compare the different patterns of NSSI. Method: A sample of 594 high-school students (54.4% boys; mean age = 14.96 years), from five regional schools across Israel, were assessed for five facets of cognitive emotion regulation strategies (acceptance, refocus on planning, positive refocusing, putting into perspective, and positive reappraisal) and NSSI behaviors using validated scales. Participants were allocated into three groups: repetitive NSSI (more than six occasions of NSSI; 7.1%), occasional NSSI (at least one incident but less than six; 8.3%), and no NSSI (84.6%). Results: Analysis of covariance, controlling for gender and depression symptoms, revealed that students with NSSI reported higher levels of acceptance, but lower levels of refocus on planning and putting into perspective. Limitations: The study used a cross-sectional design, which was a limitation. Conclusion: These findings demonstrate that particular cognitive emotion regulation strategies differ substantially in their relationship with NSSI. Adolescents who focus on planning and putting stressful situations into perspective may have increased resilience, whereas adolescents who are accepting of negative events that have happened may be more prone to maladaptive coping behaviors.


Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 368-377 ◽  
Author(s):  
Sean M. Mitchell ◽  
Danielle R. Jahn ◽  
Kelly C. Cukrowicz

Background: Suicide is the third leading cause of death among college students. The interpersonal theory of suicide may provide a way to conceptualize suicide risk in this population. Aims: We sought to examine relations between illegal behaviors that may act as risk factors for suicide and the acquired capability for suicide. Method: College students (N = 758) completed assessments of acquired capability and previous exposure to painful and provocative events, including illegal risk behaviors (IRBs). Linear regression, a nonparametric bootstrapping procedure, and two-tailed partial correlations were employed to test our hypotheses. Results: There was no significant relation between IRBs and acquired capability after controlling for legal painful and provocative experiences. A significant positive relation was identified between IRBs and fear/anxiety, contradicting the expected relation between increased painful and provocative experiences and lower fear/anxiety. Acquired capability explained variance in the relation between IRBs and history of suicide attempt or self-injury history. Conclusion: Further research is needed to examine links between IRBs and painful and provocative events, particularly to identify the point at which habituation begins to increase acquired capability, as our unexpected results may be due to a lack of habituation to risky behaviors or low variability of scores in the sample.


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