NeuroBiology of Trauma

Self-Mutilation and Trauma

Title: Stuck in the past.
Author(s): Putnam, Frank W., Mayerson Center for Safe and Healthy
Children, Children's Hospital Medical Center, Cincinnati, OH, US,
frank.putnam@cchmc.org
Address: Putnam, Frank W., Mayerson Center for Safe and Healthy
Children, Children's Hospital Medical Center, MLC 3008, 3333 Burnet
Avenue, Cincinnati, OH, US, frank.putnam@cchmc.org
Source: Psychiatry: Interpersonal & Biological Processes, Vol 67(3), Fal
2004. pp. 235-238.

Journal URL:
http://www.guilford.com/cartscript.cgi?page=periodicals/jnps.htm&cart_id
=547216.21319
Publisher: US: Guilford Publications

Publisher URL: http://www.guilford.com
ISSN: 0033-2747 (Print)
Digital Object Identifier: 10.1521/psyc.67.3.235.48987
Language: English
Keywords: paradoxical response; sexual trauma; attachment;
sexuality; sexual abuse; early childhood trauma
Abstract: Comments on an article by Penelope Hollander (see record
2004-20220-001). When I received this paper by Hollander, I was in the
midst of a difficult consultation. An experienced inpatient unit was
caught up in both an internal and an external struggle over the best
approach to care for a troubled teenage girl. More or less continuously
in treatment for almost five years with much of it in residential or
inpatient units, she had made numerous serious suicide attempts, engaged
in intense self-mutilation, and had mastered the ability to swallow a
large and potentially lethal object commonly available on inpatient
units--which she did repeatedly in moments of crisis. A divided staff
argued about whether her periodic destructive behavior could be
understood as controlled and manipulative or the result of a major
mental illness. The author of this courageous essay seeks to help us
understand the "paradoxical" response, the ambiguity, the power
disparity, the role-reversed nature of these relationships. That such an
upside- down relationship should be confusing to a young child and
subsequently become a source of unending shame, guilt, and
self-deprecation for a teenager is not surprising. What is surprising is
that experienced staff and trained professionals can not see this when
it is being acted out daily in front of them.
  _____ 

Record: 2

Title: Self-mutilation as an affect regulation strategy: The role of
attachment and childhood sexual abuse.
Author(s): Kimball, Joan S., Seattle Pacific U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(8-B), 2004. pp. 4045.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAI3103493
Language: English
Keywords: self-mutilation; achachment role; childhood sexual
abuse; detrimental; affect regulation
Abstract: Self-mutilation is a highly effective method of affect
regulation, with consequences that are both physically and socially
detrimental. Despite its significant prevalence among college students
nationwide, self-mutilation in this population has received little
research attention. By examining self-mutilation among college students,
the present study contributes to a growing body of research dedicated to
understanding and treating individuals who engage in these
self-destructive behaviors. This study analyzed a number of variables
within the framework of attachment theory. These variables include
childhood sexual abuse, adult attachment, affect regulation, and
self-mutilation. Childhood sexual abuse and adult attachment were
measured using the Childhood Trauma Questionnaire (CTQ) and Attachment
Style Questionnaire (ASQ), respectively. Affect regulation in general,
and self-mutilation in particular, were measured using the Affect
Regulation Scale (ARS) and Deliberate Self-Harm Inventory (DSHI).
Participants in the study were 216 individuals drawn from a pool of
students enrolled in undergraduate psychology courses at a public
university in the Pacific Northwest. Results of the study indicated that
attachment styles are significantly related to affect regulation in
adults. Secure attachment is associated with the use of interpersonal
and emotionally expressive affect regulation strategies. Anxious and
avoidant attachment are both associated with
somatic/self-destructive/isolated affect regulation, and anxious
attachment, in particular, is associated with self-mutilation. Childhood
sexual abuse was not related to maladaptive affect regulation or
self-mutilation. However, childhood emotional abuse and neglect were
both associated with maladaptive affect regulation. Results of this
study provide evidence for the theoretical importance of attachment in
explaining the etiology of self-mutilation. Moreover, the results
suggest that attachment styles in adults should be considered when
providing clinical assistance in an effort to improve affect regulation.
Limitations of the study include the use of self-report data, a
cross-sectional design, and a lack of common method variance. It is
recommended that future research efforts include longitudinal studies of
affect regulation and self-mutilation, varied methods of sampling and
measuring these behaviors, and treatment outcome studies.
  _____ 

Record: 3

Title: Abuse and Neglect in Childhood: Relationship to Personality
Disorder Diagnoses.
Author(s): Bierer, Linda M., Department of Psychiatry, Mount Sinai
School of Medicine, New York City, NY, US, linda.bierer@med.va.gov

Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York City, NY, US

Schmeidler, James, Department of Psychiatry, Mount Sinai School of
Medicine, New York City, NY, US

Mitropoulou, Vivian, General Clinical Research Center, Mount Sinai
School of Medicine, New York City, NY, US

New, Antonia S., Department of Psychiatry, Mount Sinai School of
Medicine, New York City, NY, US

Silverman, Jeremy M., Department of Psychiatry, Mount Sinai School of
Medicine, New York City, NY, US

Siever, Larry J., Department of Psychiatry, Mount Sinai School of
Medicine, New York City, NY, US
Address: Bierer, Linda M., Bronx Veterans Affairs Medical Center,
OOMH, 116-A, 130 West Kingsbridge Rd, Bronx, NY, US,
linda.bierer@med.va.gov
Source: CNS Spectrums, Vol 8(10), Oct 2003. pp. 737-740,749-754.

Journal URL: http://www.cnsspectrums.com/index.php3
Publisher: US: MBL Communications, Inc

Publisher URL: http://mblcommunications.com
ISSN: 1092-8529 (Print)
Language: English
Keywords: childhood abuse; personality disorder; self injury;
child neglect; suicidality; self-mutilation; sexual abuse; attempted
suicide; suicide gestures
Abstract: Background: Childhood history of abuse and neglect has
been associated with personality disorders and has been observed in
subjects with lifetime histories of suicidality and self-injury. Most of
these findings have been generated from inpatient clinical samples.
Methods: This study evaluated self-rated indices of sustained childhood
abuse and neglect in an outpatient sample of well-characterized
personality disorder subjects (n=182) to determine the relative
associations of childhood trauma indices to specific personality
disorder diagnoses or clusters and to lifetime history of suicide
attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses
and 24% reported past suicide attempts. The Childhood Trauma
Questionnaire was administered to assess five dimensions of childhood
trauma exposure (emotional, physical, and sexual abuse, and emotional
and physical neglect). Logistic regression was employed to evaluate
salient predictors among the trauma measures for each cluster,
personality disorder, and history of attempted suicide and self-harm.
All analyses controlled for gender distribution. Results: Seventy-eight
percent of subjects met dichotomous criteria for some form of childhood
trauma; a majority reported emotional abuse and neglect. The
dichotomized criterion for global trauma severity was predictive of
cluster B, borderline, and antisocial personality disorder diagnoses.
Trauma scores were positively associated with cluster A, negatively with
cluster C, but were not significantly associated with cluster B
diagnoses. Among the specific diagnoses comprising cluster A, paranoid
disorder alone was predicted by sexual, physical, and emotional abuse.
Within cluster B, only antisocial personality disorder showed
significant associations with trauma scores, with specific prediction by
sexual and physical abuse. For borderline personality disorder, there
were gender interactions for individual predictors, with emotional abuse
being the only significant trauma predictor, and only in men. History of
suicide gestures was associated with emotional abuse in the entire
sample and in women only; self-mutilatory behavior was associated with
emotional abuse in men. Conclusion: These results suggest that childhood
emotional abuse and neglect are broadly represented among personality
disorders, and associated with indices of clinical severity among
patients with borderline personality disorder. Childhood sexual and
physical abuse are highlighted as predictors of both paranoid and
antisocial personality disorders. These results help qualify prior
observations of the association of childhood sexual abuse with
borderline personality disorder.
  _____ 

Record: 4

Title: Ecstatic stigmatics and holy anorexics: Medieval and
contemporary.
Author(s): Farber, Sharon Klayman, Private Practice,
Hastings-on-Hudson, NY, US
Source: Journal of Psychohistory, Vol 31(2), Fal 2003. pp. 182-204.
Publisher: US: Assn for Psychohistory

Publisher URL: http://www.psychohistory.com
ISSN: 0145-3378 (Print)
Language: English
Keywords: near-death experiences; destructive narcissism; high
risk behaviors; psychic functions; european culture; psychic trauma;
death anxiety; religion
Abstract: Despite our anxieties about death, the wish to know what
death feels like is universal. People want to know what death is like,
and they also want to live to tell the tale. The closest they will get
to experiencing death is in the painful ecstasies of near-death
experiences, in which they come close to dying and then miraculously
seem to be resurrected from the dead and reborn, like Jesus. This is
true both for those who flirt with death today and for the medieval
mystics, who engaged in remarkable high risk behaviors such as
self-starvation, binging and purging, and self-mutilation. Topics
discussed in this article include: death anxiety and the eroticization
of death; Jesus' suffering and the European culture of death; multiple
psychic functions of self-harm; an identification with a suffering
Jesus; trauma and addition to pain and suffering; destructive narcissism
and the erotic dance with death; the medieval mystics and the cultural
transmissions of stigmata; severe psychic trauma in the lives of the
medieval mystics; today's ecstatic stigmatics and holy anorectics.
  _____ 

Record: 5

Title: Bringing the plague: Toward a postmodern psychoanalysis.
Author(s): Betan, Ephi J., (Ed), Georgia School of Professional
Psychology, GA, US, Ejbet@aol.com
Address: Betan, Ephi J., Georgia School of Professional
Psychology, 990 Hammond Drive, 11 th Floor, Atlanta, GA, US,
Ejbet@aol.com
Source: Journal of the American Psychoanalytic Association, Vol 51(3),
Sum 2003. pp. 1054-1060.
Publisher: US: Analytic Press

Publisher URL: http://analyticpress.com
Reviewed Item: Edited by Susan Fairfleld, Lynne Layton, and Carolyn
Stack (2002). Bringing the plague: Toward a postmodern psychoanalysis;
New York: Other Press, 2002, 399 pp.,
ISSN: 0003-0651 (Print)
Language: English
Keywords: postmodern psychoanalysis; philosophy; sociopolitics;
truth; objectivity; meaning; analytic normality/abnormality; health;
pathology; sex; sexuality; perversion; self-mutilation; gender; race;
trauma
Abstract: According to the reviewer, to the credit of the authors,
this volume poses many complex questions and engages a spectrum of
postmodern and psychoanalytic topics: philosophy, sociopolitics, truth,
objectivity, meaning, analytic normality/abnormality, health/pathology,
sex, sexuality, perversion, self-mutilation, gender, race, ethnicity,
trauma, self, pluralism, subjectivity, mutilation, and
intersubjectivity. The reviewer states that this is a dense and
sophisticated text with more ideas than one could do justice to in this
review. The volume includes critiques and responses following each
article that convey the dialogical nature of postmodern thought and its
commitment to multiple perspectives. The reviewer has chosen to focus
here on the discipline of postmodern psychoanalysis in the clinical
realm, rather than attempt to summarize all of the topics this volume
addresses.
  _____ 

Record: 6

Title: Suicide attempt and self-mutilation among Turkish high school
students in relation with abuse, neglect and dissociation.
Author(s): Zoroglu, Suleyman Salih, Gaziantep U, Medical Faculty,
Dept of Child & Adolescent Psychiatry, Gaziantep, Turkey,
zoroglus@hotmail.com

Tuzun, Umran, Istanbul U, Istanbul Medical Faculty, Dept of Child &
Adolescent Psychiatry, Istanbul, Turkey

Sar, Vedat, Istanbul U, Istanbul Medical Faculty, Dept of Psychiatry,
Istanbul, Turkey

Tutkun, Hamdi, Gaziantep U, Medical Faculty, Dept of Psychiatry,
Gaziantep, Turkey

Savas, Haluk Asuman, Gaziantep U, Medical Faculty, Dept of Psychiatry,
Gaziantep, Turkey

Ozturk, Mucahit, Istanbul U, Istanbul Medical Faculty, Dept of Child &
Adolescent Psychiatry, Istanbul, Turkey

Alyanak, Behiye, Istanbul U, Istanbul Medical Faculty, Dept of Child &
Adolescent Psychiatry, Istanbul, Turkey

Kora, Meltem Erocal, Istanbul U, Istanbul Medical Faculty, Dept of Child
& Adolescent Psychiatry, Istanbul, Turkey
Address: Zoroglu, Suleyman Salih, Gaziantep U, Tip Fakultesi,
Cocuk ve Ergen Psikiyatrisi ABD, Kolejtepe, Hastanesi, Turkey, 27070,
zoroglus@hotmail.com
Source: Psychiatry & Clinical Neurosciences, Vol 57(1), Feb 2003. pp.
119-126.

Journal URL:
http://www.blackwell-science.com/~cgilib/jnlpage.asp?Journal=xpcn&File=x
pcn
Publisher: United Kingdom: Blackwell Publishing

Publisher URL: http://www.blackwellpublishing.com
ISSN: 1323-1316 (Print)

1440-1819 (Electronic)
Digital Object Identifier: 10.1046/j.1440-1819.2003.01088.x
Language: English
Keywords: suicide attempt; self mutilation; childhood abuse;
neglect; dissociation; self destructive behavior; adolescents; Turkey
Abstract: Examined (1) the frequency of childhood abuse and
neglect and its relationship with attempted suicide, self-mutilation and
dissociation; and (2) the potential impact of dissociation on
self-destructive behaviors of adolescents in Turkey. A questionnaire
consisting of items about abuse, neglect, self-mutilation and suicide
attempt and the Turkish Version of the Dissociative Experiences Scale
were given to 862 high school students (aged 14-17 yrs). The rates of
suicide attempt and self-mutilative behaviors were 10.1% and 21.4%,
respectively. Abused or neglected groups (34.3%) had 7.6-fold higher
suicide attempts and 2.7-fold higher self-mutilation behaviors. The
logistic regression model showed that each type of trauma and
dissociation contributed to suicide attempts and self-mutilation, but
dissociation was the most powerful. Suicidal and self-destructive
adolescents should precisely be evaluated for abuse, neglect and
dissociation in clinical practice.
  _____ 

Record: 7

Title: Action therapy with families and groups: Using creative arts
improvisation in clinical practice.
Author(s): Wiener, Daniel J., (Ed), Central Connecticut U, Dept of
Counseling & Family Therapy, New Britain, CT, US

Oxford, Linda K., (Ed), Harding U Graduate School of Religion,
Counseling Program, Memphis, TN, US
Source: Washington, DC, US: American Psychological Association, 2003.
ix, 299 pp. Publisher URL: http://www.apa.org/books
ISBN: 1-59147-012-9 (hardcover)
Language: English
Keywords: action therapy; families; groups; creative arts;
physical movement
Abstract: (from the cover) Introduces clinicians to innovative
therapeutic options that can be used with families and groups: action
methods or therapy approaches involving physical movement and expressive
art techniques. These methods offer clients and therapists new ways of
looking at problems and discovering solutions to these problems and are
thus especially appropriate to skills training; role development and
expansion; relationship enhancement; and short-term treatment with
groups, couples, and families. Contributors provide a brief overview of
featured action methods and illustrate the application of their
particular method to specific therapy cases, discussing the rationale
behind their clinical choices and how they handled any special
challenges or complications. Chapters illustrate family therapy that
focuses on dealing with grief and loss, family reorganization, and the
effects of trauma as well as group therapy approaches to the treatment
of addictive and compulsive disorders, self-mutilation, substance abuse,
autism, chronic mental illness, and career difficulties.
  _____ 

Record: 8

Title: The stigmata: The psychological and ethical message of the
posttraumatic sufferer.
Author(s): Albright, Matthew, Harvard Divinity School, Cambridge,
MA, US, malbright@hds.harvard.edu
Address: Albright, Matthew, 9 Pitman street, 1st Floor,
Somerville, MA, US, malbright@hds.harvard.edu
Source: Psychoanalysis & Contemporary Thought, Vol 25(3), Sum 2002. pp.
329-358.

Journal URL: http://www.iup.com/order.cfm?bookno=PC&action=info&J=J
Publisher: US: International Universities Press

Publisher URL: http://www.iup.com
ISSN: 0161-5289 (Print)
Language: English
Keywords: posttraumatic stress symptoms; stigmata; Christian
theology
Abstract: This paper analyzes both the psychoanalytic and
theological roots of the stigmata phenomenon using a specific case study
of an early twentieth-century stigmatic, Thérèse Neumann (1898-1962).
Using recent research on trauma, the stigmata will be analyzed
psychologically as posttraumatic stress symptoms expressed in
unconscious self-mutilation through abnormal autosuggestibility. Using
historical Christian theology, as well as Neumann's words and ideas that
influenced her, this paper illustrates how the stigmatic herself
understood her suffering. Comments on gender, power, and ethics will be
made regarding both the psychoanalytic and the religious view. These two
views will then be brought to bear on an understanding of posttraumatic
stress symptoms in which suffering may have moral and therapeutic value.
  _____ 

Record: 9

Title: The temporal ordering of childhood sexual abuse, eating
disturbances, and impulsive and self-destructive behaviors.
Author(s): Thompson, Kevin M., North Dakota State U, Dept of
Sociology, Fargo, ND, US

Wonderlich, Stephen A., U North Dakota School of Medicine & Health
Science, Dept of Neuroscience, Grand Forks, ND, US

Crosby, Ross D., U North Dakota School of Medicine & Health Science,
Dept of Neuroscience, Grand Forks, ND, US

Redlin, Jennifer A., North Dakota State U, Dept of Psychology, Fargo,
ND, US

Mitchell, James E., U North Dakota School of Medicine & Health Science,
Dept of Neuroscience, Grand Forks, ND, US
Address: Thompson, Kevin M., Dept of Sociology, North Dakota
State U, Minard Hall 402, Fargo, ND, US
Source: Advances in psychology research, Vol. 14. Shohov, Serge P. (Ed);
pp. 173-184. Hauppauge, NY, US: Nova Science Publishers, Inc, 2002. vi,
243 pp.
ISBN: 1-59033-393-4 (hardcover)
Language: English
Keywords: eating disturbances; self-destructive behaviors;
childhood sexual abuse; women; symptom onset; impulsive behavior
Abstract: (from the chapter) Examined the temporal ordering of
childhood sexual abuse (CSA) and eating disturbances in women;
determined whether the severity of CSA was associated with the onset of
eating disorder symptoms; and assessed the trajectory of CSA, eating
disturbances, and impulsive and self-destructive behaviors. 51 female
CSA victims (mean age 40.4 yrs) were recruited from clinical centers
specializing in trauma-related treatment, and newspaper advertisements.
Subjects self-reported on the timing of their CSA incident, eating
disturbances (extreme dieting, and/or binge eating), and impulsive and
self-destructive behaviors (alcohol intoxication, using drugs to get
high, shoplifting, suicide attempt, self-mutilation, regretted sexual
act). Results show that the timing of CSA and impulsive and
self-destructive behaviors were dependent on the number of eating
disorder symptoms reported. Dieting appeared not to be a gateway into
eating disorders following CSA. CSA severity was not associated with the
development of dieting, bingeing, or both behaviors. It is concluded
that CSA is at least a variable risk factor for eating disturbances and
impulsive and self-destructive behaviors.
  _____ 

Record: 10

Title: Identification with the aggressor: An interactive tactic or an
intrapsychic tomb? Commentary on paper by Jay Frankel.
Author(s): Bonomi, Carlo, U Florence, Inst di Psicoterapia
Analitica, Florence, Italy, bonomi@unifi.it
Source: Psychoanalytic Dialogues, Vol 12(1), 2002. pp. 153-158.

Journal URL: http://www.analyticpress.com/psychoanalytic_dialogues.html
Publisher: US: Analytic Press

Publisher URL: http://analyticpress.com
ISSN: 1048-1885 (Print)
Language: English
Keywords: therapeutic relationship; Ferenczi's concept; emotional
trauma; identification with an aggressor; everyday life
Abstract: Comments on the article by J. Frankel (see record
2002-00724-007) which discusses habitual identification with the
aggressor frequently occurring in people who have not suffered severe
trauma, which raises the possibility that certain events not generally
considered to constitute trauma are often experienced as traumatic.
Frankel suggests that emotional abandonment or isolation, and being
subject to a greater power, are such events. The author discusses this
topic in comparison with S. Ferenczi's idea. In Ferenczi's idea of
identification with an aggressor we can distinguish two sides. One is
what we might call an interactive tactic or a social strategy, which is
used in upsetting or unbalanced relations of power in order to forestall
lack of control, fear, and the like. This is the side that is explored
in great detail by Jay Frankel. The other side consists in a
intrapsychic change, which flows from severe trauma. The specific
effects of the latter are described by Ferenczi as
dissociation/fragmentation of the personality, sequestering of the
trauma, emotional abandonment, and isolation. Elsewhere, Ferenczi refers
to this as a form of psychic self-mutilation.
  _____ 

Record: 11

Title: The effects of dance/movement therapy on sexually abused
adolescent girls in residential treatment.
Author(s): Truppi, Ann Marie, Walden U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 62(4-B), Oct 2001. pp. 2081.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAI3010680
Language: English
Keywords: dance movement therapy; verbal therapy; sexual abuse;
adolescents; girls; residential treatment
Abstract: The purpose of this study was to determine the
difference in effects, if any, between two therapeutic interventions on
the self-concept, shame, and trauma symptoms of sexually abused
adolescent girls in residential placement. These interventions were (a)
a multimodal form of verbal therapy (WT) and (b) dance/movement therapy
(DMT). In addition to a low self-concept, increased levels of shame, and
the presence of symptoms related to trauma found in abused individuals,
the effects of sexual abuse on a young child can also result in many
psychological disturbances. Among these are a distorted body image,
dissociative reactions, low self-concept, behavior problems, eating
disorders, and self-mutilation, many of which can be lifelong and
emotionally disturbing. The five dependent variables in this study were
self-concept, shame, and issues related to trauma, specifically
dissociation, posttraumatic stress, and sexual concerns. In order to
test the null hypotheses that there would be no significant difference
in the dependent variables in this population despite the intervention
received, a multivariate analysis of variance was utilized. The five
variables were measured by the Piers-Harris Children's Self-Concept
Scale (CSCS), the Internalized Shame Scale (ISS), and the Trauma Symptom
Checklist for Children (TSCC), which were administered as pre- and
posttests. The MANOVA was run on the pretest and posttest data to
determine differences between the methods of therapy. Pillai's trace,
Wilks's lambda, Hotelling's trace, and Roy's largest root were used to
evaluate the multivariate hypothesis that the population means were
equal. In addition, Box's test was used to conclude that the covariance
matrices of the dependent variables were not different across groups.
Levene's test of the equality of error variances was also used. All
measures indicated that there were no significant differences between
DMT and MVT groups regarding the dependent variables before or after
treatment. Finally, the overall MANOVA showed no significant
differences; ANOVAs found no differences between the groups for each
dependent variable. No null hypotheses was rejected, and no significant
differences were found between DMT and MVT groups on measures of
self-concept, shame, sexual concerns, dissociation, and posttraumatic
stress. The small group size and insufficient length of treatment may
have contributed to the results.
  _____ 

Record: 12

Title: An examination of the relationship between childhood sexual
abuse, dissociation, and eating disorders.
Author(s): Bailey, Patricia Marie, West Virginia U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 62(2-B), Aug 2001. pp. 1065.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAI3004044
Language: English
Keywords: childhood sexual abuse; dissociation; eating disorders
Abstract: Researchers have documented a high percentage of eating
disordered individuals with a history of traumatic experiences such as
childhood sexual abuse (Abramson & Lucido, 1991; Oppenheimer, Howells,
Palmer, & Chaloner, 1985; Tice, Hall, Beresford, Quinones, & Hall,
1989). To what extent these adverse life events may contribute to the
onset, maintenance, and severity of maladaptive eating behaviors is
widely debated among researchers and clinicians. The present study
attempted to identify a spectrum of potentially traumatic life
experiences in eating disordered individuals and their relationship with
dissociation and eating pathology. Thirty-four female subjects meeting
DSM-IV criteria for Bulimia Nervosa (n = 13) or Eating Disorder Not
Otherwise Specified (n = 21) who were currently seeking treatment for
their eating disorder participated in the study. Measures included: the
Eating Disorders Inventory-2 (EDI-2), the Eating Disorders Inventory
Symptom Checklist (EDI-SC), the Early Trauma Interview and Inventory
(ETI), Trauma Symptom Checklist-40 (TSC-40), and the Dissociative
Experiences Scale-II (DES-II). Results indicated a high rate of early
childhood trauma, particularly sexual victimization (74%). No
significant differences were noted between the eating disorder groups in
the amount of overall trauma or dissociation, however, a trend was noted
for a greater amount and longer duration of sexual trauma for bulimic
individuals. Bulimic individuals reported an earlier onset of eating
problems and self-induced vomiting. When sexual abuse history was
considered, individuals with a history of incest reported greater levels
of trauma, family dysfunction, eating disturbance, and comorbid
pathology (e.g. substance abuse, sexual promiscuity, suicide attempts,
self-mutilation) compared to individuals with extrafamilial assault.
Results suggest that eating disorder pathology may develop in response
to a variety of early childhood experiences rather than to one discreet
category of abuse. It is likely that family dysfunction may also
contribute to the cumulative impact of early trauma.
  _____ 

Record: 13

Title: A witness breaks his silence: The meaning of a therapist's
response to an adolescent's self-destruction.
Author(s): Frankel, Jay, New York U, Postdoctoral Program in
Psychotherpy & Psychoanalysis, New York, NY, US
Source: American Journal of Psychoanalysis, Vol 61(1), Mar 2001. Special
issue: The traumatized adolescent: Theoretical and clinical
considerations. pp. 85-99.

Journal URL: http://www.wkap.nl/journalhome.htm/0002-9548
Publisher: Netherlands: Kluwer Academic Publishers

Publisher URL: http://www.wkap.nl
ISSN: 0002-9548 (Print)
Digital Object Identifier: 10.1023/A:1002709526548
Language: English
Keywords: adolescence; adolescent development; trauma; relational
configurations; witness; self mutilation
Abstract: Describes the case of a self-mutilating adolescent girl
(aged 15 yrs) and the author's dilemma, as her therapist, about telling
her parents about her self-abuse. The author uses two complementary,
mutually enhancing relational theories of trauma--S. Ferenczi's (1933)
and J. M. Davies and M. G. Frawley's (1994)--to help understand the
minefield he was in. Davies and Frawley describe certain relational
configurations that are typical of trauma victims. The author believes
that it is not only unavoidable but therapeutically vital for therapists
to participate in these configurations so they can know the patient's
experience in a personal way. It is also crucial that they be witnesses
who provide recognition for the patient's pain and, in so doing, relieve
the intolerable feeling of isolation that Ferenczi proposed was the most
basic trauma. In addition, the author discusses the observation that
some people who have not been previously traumatized in any gross way
manifest characteristics of trauma.
  _____ 

Record: 14

Title: Childhood sexual abuse, dissociation and adult self-destructive
behavior.
Author(s): Rodriguez-Srednicki, Ofelia, Montclair State U, Graduate
Training Program in School Psychology, Upper Montclair, NJ, US
Source: Journal of Child Sexual Abuse, Vol 10(3), 2001. pp. 75-90.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J070
Publisher: US: Haworth Press

Publisher URL: http://www.haworthpress.com
ISSN: 1053-8712 (Print)
Digital Object Identifier: 10.1300/J070v10n03_05
Language: English
Keywords: childhood sexual abuse; dissociation; adult
self-destructive behavior
Abstract: 175 female college students (aged 18-23 yrs) reporting a
history of childhood sexual abuse (CSA) and 266 not reporting a history
of childhood sexual abuse were compared on indices of 6 self-destructive
behaviors, including drug use, alcohol abuse, binge eating,
self-mutilation, risky sex, and suicidality. The samples were also
compared on 2 measures of dissociation, the Trauma Symptom Checklist
dissociation subscale and the Dissociative Experiences Scale. The CSA
group had significantly higher mean scores on all the indices of
self-destructive behavior except self-mutilation (where the mean
difference approached significance), and higher mean scores on both
measures of dissociation. One or both dissociation measures were related
significantly to each index of self-destructive behavior except binge
eating. Multiple regression mediation analyses provide support for the
hypothesis that dissociation mediates the relationships between CSA and
both drug use and alcohol abuse. Dissociation also explained significant
variability when added to the regressions of risky sex and suicidality
on CSA.
  _____ 

Record: 15

Title: Establishing safety with patients with dissociative identity
disorder.
Author(s): Brand, Bethany, Towson U, Towson, MD, US,
bbrand@towson.edu
Address: Brand, Bethany, Dept of Psychology, Towson U, 8000 York
Road, Towson, MD, US, bbrand@towson.edu
Source: Journal of Trauma & Dissociation, Vol 2(4), 2001. pp. 133-155.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229
Publisher: US: Haworth Press

Publisher URL: http://www.haworthpress.com
ISSN: 1529-9732 (Print)
Language: English
Keywords: self-mutilation; suicidality; dissociative identity
disorder; self-destructiveness
Abstract: Notes that the incidence of self-mutilation and
suicidality among patients with dissociative disorders is quite high. It
is necessary for clinicians working with this population to be adept at
dealing with safety problems. This article presents a sequence of basic
steps that can be used when helping dissociative patients establish
safety, a discussion of the functions of self-destructiveness, and an
overview of specific experiences and thinking patterns that contribute
to self-destructiveness among dissociative patients.
Conference: Annual Meeting of the ISSD, 1999, Miami, FL, US
Conference Notes: Parts of this paper were presented at the
aforementioned meeting.
  _____ 

Record: 16

Title: Self-mutilation in child and adolescent group home populations.
Author(s): Heinsz, Sandra Vallin, Walden U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 61(4-B), Oct 2000. pp. 2201.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAI9968781
Language: English
Keywords: behavioral characteristics & traumatic childhood
experiences & diagnostic labels, confirmed vs unconfirmed
self-mutilating vs nonmutilating adults & children from basic care group
homes
Abstract: The purpose of this study was to use mutiltiple sources
of data to devise a profile for identifying children at greater risk for
engaging in self-mutilative behaviors. The sample for this study
consisted of 57 children drawn from 18 basic care group homes from
throughout Georgia. Using descriptive and correlational research
methods, data were incorporated from the Child Behavior Checklist, the
Youth Self-Report, the Functional Assessment of Self-Mutilation, the
Social History/Demographic survey, agency behavior logs, and
psychological evaluations. By investigating the behavioral
characteristics, traumatic childhood experiences, and diagnostic labels
of child and adolescent group home populations, different profiles
emerged for confirmed self-mutilating, unconfirmed self-mutilating, and
nonmutilating groups of subjects. Overall, specific Youth Self-Report
scales indicating aggressive, delinquent, attentional, social, thought
disordered, anxious, or depressive problems significantly differentiated
between subject groups. Also, Functional Assessment of Self-Mutilation
data accurately corresponded with client records for 96% of confirmed
self-mutilating subjects. Childhood abuse or trauma signaled the need to
rule out self-injurious tendencies, as did histories of school
retention, Axis II diagnoses, multiple Axis I diagnoses, suicide attempt
histories, substance abuse histories, and early hospitalizations. In
addition to any Axis II diagnoses, specific diagnoses were identified
that could intimate self-mutilative tendencies in group home children.
Finally, a profile of the self-injurious acts perpetrated by confirmed
and unconfirmed self-mutilating group home youths indicated notable
between-group differences regarding the nature of self-injurious
behaviors. Implications of current findings are discussed from the
theoretical frameworks of attachment and object-relations theories.
  _____ 

Record: 17

Title: Inquiries into the regulation of disordered bodies: Selected
sick and twisted ethnographic fictions. (sick fiction, twisted fiction).

Author(s): Meiners, Erica Ruth, Simon Fraser U., Canada
Source: Dissertation Abstracts International Section A: Humanities &
Social Sciences, Vol 60(7-A), Feb 2000. pp. 2556.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4209 (Print)
Order Number: AEHNQ37732
Language: English
Keywords: economic & social & political factors & ethnography
relevant to organization of disordered bodies, humans
Abstract: This dissertation explores how disordered bodies are
organized. 'Disordered' refers predominantly to addictions and/or
self-mutilating practices that are delineated as mental disorders within
the current Diagnostic Statistical Manual of Mental Disorders (DSM). In
addition it covers related practices popularized as 'disorders' by the
North American recovery movement. Through an exploration of some
historical, socio-cultural, and economic contexts to the recovery
movement and the DSM, and through close readings of textual examples of
disordered bodies, this dissertation argues that the disordered body is
co-produced by economic, social, and political factors. Folded into this
theoretical inquiry on the tools and forces that are at play are
'ethnographic fictions,' emphasizing how ethnography can function to
re-present and reify, or possibly resist, disordering bodies.
Synthesizing concepts from medical anthropology,
queer/feminist/anti-racist theorists, critical ethnography, and/or
educational and literary theorists, this dissertation works to be inter-
or counter-disciplinary. This dissertation is divided into three
overlapping parts. (1) Re/covering Bodies, addresses some ideological
and economic factors at work behind the DSM that organize the narration
of bodies in pain or, bodies that do not fit within a prescribed social
order. Offering a post-fordist analysis, a framework useful to
understand the impacts of economic forces in configuring social orders,
this section also emphasizes the necessity of examining discourse. (2)
Putting Out in the Field, represents an ethnography as it unravels the
work of an ethnographer. While exploring aspects of an organization that
seeks to do support work with disordered bodies, it questions practices
of ethnography, specifically highlighting the role of participant
observation in ethnography, the writing of fieldnotes, the
construction(s) of data, and the (re)constructions of whiteness and
other identity markers (in the field). (3) Fleshwork contradicts and
complements the preceding work. Emphasizing interpretation and
translation, issues already exposed as partial, situated, and fragmented
within ethnographic research, this section places texts and/or fiction
as a site for ethnographic fieldwork to examine how desire(s) might
travel and be expressed in disordered bodies. This section also shifts
to look at trauma studies, a subtext throughout this dissertation, to
highlight issues of communication and representation possibly relevant
for ethnographers.
  _____ 

Record: 18

Title: History of childhood sexual or physical abuse in Japanese
patients with eating disorders: Relationship with dissociation and
impulsive behaviours.
Author(s): Nagata, Toshihiko, Osaka City U Medical School, Dept of
Neuropsychiatry, Osaka, Japan

Kiriike, N.

Iketani, T.

Kawarada, Y.

Tanaka, H.
Source: Psychological Medicine, Vol 29(4), Jul 1999. pp. 935-942.

Journal URL: http://uk.cambridge.org/journals/psm/
Publisher: US: Cambridge Univ Press

Publisher URL: http://www.cup.org
ISSN: 0033-2917 (Print)
Digital Object Identifier: 10.1017/S0033291799008557
Language: English
Keywords: prevalence of traumatic events, Japanese females with
anorexia nervosa binge eating/purging type or bulimia nervosa purging
type
Abstract: Investigated the prevalence of traumatic events in
Japanese patients with eating disorders, and examined the relationship
between such traumatic events and clinical features. Ss consisted of 33
patients with anorexia nervosa restricting type (RAN), 40 patients with
anorexia nervosa binge eating/purging type (AN-BP), 63 patients with
bulimia nervosa purging type (BN) and 99 healthy controls. All were
female and diagnoses were based on Diagnostic and Statistical Manual of
Mental Disorders-IV (DSM-IV). The Physical and Sexual Abuse
Questionnaire, Eating Disorder Inventory, and Dissociation Experience
Scale (DES) were administered to all of the Ss. Paradoxically, victims
of minor sexual abuse committed by Chikan (a Japanese word indicating a
person who commits minor sexual crimes) were more prevalent among
controls than among patients with RAN, AN-BP or BN. However, physical
punishment histories tended to be more prevalent among patients with
AN-BP or BN than among RAN or controls. Only AN-BP and BN patients with
physical punishment histories had twofold higher scores for DES and
significantly more frequent histories of self-mutilation (67% vs 33%)
compared with patients without such histories.
  _____ 

Record: 19

Title: Antisocial personality disorder, affect dysregulation and
childhood abuse among incarcerated women.
Author(s): Zlotnick, C., Brown U, Dept of Psychiatry & Human
Behavior, Providence, RI, US
Source: Journal of Personality Disorders, Vol 13(1), Spr 1999. pp.
90-95.

Journal URL:
http://www.guilford.com/cartscript.cgi?page=periodicals/jnpd.htm&cart_id
=547216.21319
Publisher: US: Guilford Publications

Publisher URL: http://www.guilford.com
ISSN: 0885-579X (Print)
Language: English
Keywords: role of affect dysregulation & childhood abuse in
antisocial personality disorder, incarcerated adult females
Abstract: The aim of this study was to examine the role of affect
dysregulation and childhood abuse in antisocial personality disorder
(ASPD), using a sample of incarcerated women. Subjects for this study
were 85 incarcerated women who were administered structured interviews
to assess for ASPD, borderline personality disorder (BPD), posttraumatic
stress disorder (PTSD), childhood trauma, and affect dysregulation.
Using a series of logistic regressions, this study found that a greater
degree of affect dysregulation--in particular, poor anger
modulation--was significantly related to ASPD, controlling for BPD and
PTSD in women prisoners. After controlling for BPD, recent self
mutilation was not significantly related to ASPD. Likewise, a history of
childhood abuse was not significantly associated with ASPD.
  _____ 

Record: 20

Title: Age at sexual abuse onset and its effects on long-term
symptomatology.
Author(s): Vig, Alisa, Pacific Graduate School of Psychology, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 59(7-B), Jan 1999. pp. 3741.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9839245
Language: English
Keywords: age at sexual abuse onset, maladaptive behavior &
dysfunctional schemas & long-term symptomatology, adults
Abstract: Psychological symptoms, maladaptive behaviors and
schemas are much more common among adults who were sexually abused as
children than among those with no such childhood history (Briere &
Runtz, 1993; Browne & Finkelhor, 1986; Herman, 1992a, 1992b). Previous
studies conducted with this population have led researchers and
clinicians to conclude that sexual abuse significantly affects long-term
mental health (Browne & Finkelhor, 1986; Briere & Runtz, 1993). Although
developmental theories support such assumptions, the research of sexual
abuse from a developmental perspective has not been fully addressed.
This study focused on the associations between the age at the first
onset of sexual abuse and maladaptive behavior, dysfunctional schemas,
and long-term symptomatology from a developmental perspective. Pearson
Product Moment Correlation Coefficients (r) and regression analyses were
used to measure the relationships between the age at the first onset of
sexual abuse and the criterion variables. Overall, findings indicate
that earlier age of onset of sexual abuse was positively associated with
several maladaptive behaviors and several psychology symptoms. Age of
abuse onset was not related to the four schemas assessed. Earlier onset
of abuse was significantly related to higher levels of self-mutilation
behavior, somatic symptoms, depressive symptoms and overall
pervasiveness and severity of symptomatology. Earlier onset of sexual
abuse showed non significant but negative relationship to dissociative
symptoms, interpersonal sensitivity, and sexual difficulties. These
results may indicate that people who were abused earlier in life are
more prone to experience specific symptoms during adulthood than those
with later abuse onset. The strong association between the age of the
abuse and self-mutilation, somatic, and depressive symptoms, as well as
the general index of distress, may indicate that these areas are more
vulnerable to elicitation with earlier abuse onset. These findings
actually support the more general idea that was stated by Cicchetti
(1986): the earlier the disruption in child development, the more
psychological difficulties would be presented. Hence, when the injury
happens early on in life, the victim is more prone to continued sequelae
of the trauma. Disruption that occurs at earlier ages can affect the
development of functioning in any subsequent stage of development.
  _____ 

Record: 21

Title: Perceived abuse and neglect as risk factors for suicidal
behavior in adolescent inpatients.
Author(s): Lipschitz, Deoborah S., Connecticut Veterans' Affairs
Medical Ctr, National Center for PTSD, Psychiatric Service, West Haven,
CT, US

Winegar, Robert K.

Nicolaou, Andreas L.

Hartnick, Elizabeth

Wolfson, Michele

Southwick, Steven M.
Source: Journal of Nervous & Mental Disease, Vol 187(1), Jan 1999. pp.
32-39.

Journal URL: http://www.jonmd.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com/
ISSN: 0022-3018 (Print)
Digital Object Identifier: 10.1097/00005053-199901000-00006
Language: English
Keywords: history of sexual or physical or emotional abuse &/or
neglect, risk of suicide attempts or ideation or self-mutilation,
psychiatrically hospitalized 12-18 yr olds
Abstract: The aim of this study was to assess relative risk of
histories of different types of abuse (sexual, physical, and emotional)
and neglect (physical and emotional) for suicidal behavior (attempts,
ideation, and self-mutilation) in psychiatrically hospitalized
adolescents. Seventy-one adolescent inpatients (34 boys, 37 girls)
completed self-report measures of abuse and neglect, current suicidal
ideation, and lifetime suicide and self-mutilation attempts. The
prevalence of sexual and physical abuse was 37.5% and 43.7%,
respectively, with 31.3% and 61% of youngsters reporting emotional and
physical neglect. Fifty-one percent of youngsters had made suicide
attempts, and 39% had self-mutilated. Suicide attempters were
significantly more likely to be female, Latino, to report sexual,
physical, and emotional abuse, and to endorse emotional neglect. In
multivariate analyses, female gender, sexual abuse, and emotional
neglect remained significant predictors of self-mutilation and suicidal
ideation. Female gender and sexual abuse remained significant predictors
of suicide attempts.
Conference: 149th Annual Meeting of the American Psychiatric
Association, 1996, New York, US
Conference Notes: This paper was presented in part at the 149th
Annual Meeting of the American Psychiatric Association, May 4-8 1996,
New York, NY.
  _____ 

Record: 22

Title: Self-mutilation in clinical and general population samples:
Prevalence, correlates, and functions.
Author(s): Briere, John, U Southern California, School of Medicine,
Dept of Psychiatry & Behavioral Sciences, Los Angeles, CA, US

Gil, Eliana
Source: American Journal of Orthopsychiatry, Vol 68(4), Oct 1998. pp.
609-620.
Publisher: US: American Orthopsychiatric Association, Inc.
ISSN: 0002-9432 (Print)
Language: English
Keywords: prevalence of & role of childhood & adult traumas in
self mutilation, 18-90 yr olds
Abstract: Self-mutilation, examined in samples of the general
population, clinical groups, and self-identified self-mutilators, was
reported by 4% of the general and 21 % of the clinical sample, and was
equally prevalent among males and females. Results suggest that such
behavior is used to decrease dissociation, emotional distress, and
posttraumatic symptoms. Childhood sexual abuse was associated with
self-mutilation in both clinical and nonclinical samples.
  _____ 

Record: 23

Title: The possibility of love: A psychological study of adolescent
girls' suicidal acts and self-mutilation.
Author(s): Machoian, Lisa, Harvard U, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 59(4-B), Oct 1998. pp. 1886.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9830063
Language: English
Keywords: The possibility of love: A psychological study of
adolescent girls' suicidal acts and self-mutilation
Abstract: This research explores adolescent girls' suicidal acts
and self-mutilation through psychological case studies. These behaviors
tend to begin in early adolescence; girls' suicidal acts peak at ages 13
and 14 (Velez & Cohen, 1988). This thesis addresses the question, why at
this age? The literature on girls' and women's psychological development
theoretically guides this inquiry (Brown & Gilligan, 1992). Past
research reports that suicidal adolescent girls often have histories of
trauma, and experience family violence, discord, and disruption
(Spirito, Brown, Overholser, & Fritz, 1989). Given this history, why do
girls' suicidal acts begin at adolescence and peak at ages 13 and 14? To
discover what girls know about why they inflict harm upon themselves, I
interviewed four white girls, ages 13 through 17. I used intensive
clinical interviews because the information I was seeking required the
establishment of a trusting relationship and an in-depth psychological
approach. I used the voice-centered relational method for data analysis,
the "Listener's Guide," to interpret the narratives because it is
sensitive to the layering and multi-voiced nature of psychological
processes (Brown, et al., 1988). Findings indicate that the increase and
peak in girls' suicidal acts, and the onset of cutting, in early
adolescence signify a desperate, complex, developmental peaking of hope
for love and relationship. Girls' suicidal acts and cutting constituted
strategic relational moves, a way of testing the hope that somebody does
care. A major discovery was the girls' observation and straightforward
description of the fact that people who did not listen to their words,
did listen and take them seriously when they hurt themselves. The girls
clearly articulated their astute awareness that violence is an effective
"language" in that people notice and respond to violent acts. As girls
discovered the efficacy of speaking through violence, they were called
"manipulative." In effect, they had learned how to "manipulate" in that
they succeeded in gaining a response from those who had ignored their
more direct expressions of hurt. If this was the intention of their
suicidal act, they "succeeded" rather than failed--at least initially.
Implications for clinical care, education, and future research are
discussed
  _____ 

Record: 24

Title: Self-mutilating survivors of childhood sexual abuse: A treatment
program.
Author(s): Newman, Shana Jemeela, Miami Inst. of Psychology of the
Caribbean Ctr. For Advanced Studies, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 59(2-B), Aug 1998. pp. 0861.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9825591
Language: English
Keywords: Self-mutilating survivors of childhood sexual abuse: A
treatment program
Abstract: Self-mutilation has been a topic of research interest
since the early 1930's. The etiology of self-mutilation and the variety
of behaviors which are considered self-destructive are complex. The
purpose of this dissertation was to create a goal oriented treatment
program sensitive to the past trauma, present stressors, and future
coping strategies of sexual abuse survivors who self-mutilate. This
program is unique in its use of behavioral and cognitive treatment
modalities while addressing the needs of this specific population. The
target population of this paper are females who report a history of
sexual abuse prior to age 18 years old who self-mutilate.
Self-mutilation is defined by Walsh and Rosen (1988) type III category.
Type III behaviors are generally unacceptable in all social groups,
except a few like minded peers, and includes wrist and body cutting;
self-inflicted burns; self-tattooing; and wound excoriation. Koop's
(1988) definition of child sexual abuse will be used. A treatment
program called Management of Self-Mutilation (MSM) was designed to be
implemented in a community mental health facility and is considered a
day treatment program. Clients can be referred from community agencies,
inpatient facilities, private practitioners, and through self-referrals.
The program meets the guidelines established by Medicaid to encourage
federal reimbursement. MSM has drawn its theoretical bases from
cognitive/behavioral models (Beck, 1976), and empowerment and affect
management theories (Donaldson & Cordes-Green, 1994; Miller, 1994). The
program consists of a five day per week schedule composed of therapy
groups and activities, e.g., symptom management, social skills training,
relaxation training, and psychoeducational instruction (Vinogradov &
Yalom, 1989). Each group and activity in the treatment program targets
behaviors and beliefs with a focus on the member's coping style and
self-mutilation behaviors. These groups focus on investigating
antecedent trauma, and work with the affective defenses (Donaldson &
Cordes-Green, 1994). The Trauma Symptom Inventory (TSI), Beck Depression
Inventory (BDI), and The Daily Record of Dysfunctional Thoughts, as well
as observed and self-report of self-mutilation are used for pre and post
measures to evaluate initial assessment, treatment, and treatment
outcome. (Abstract shortened by UMI.)
  _____ 

Record: 25

Title: Self-mutilating behavior of sexually abused female adults in
Turkey.
Author(s): Baral, Isin, U Istanbul, Medical Faculty, Istanbul,
Turkey

Kora, Kaan

Yüksel, Sahika

Sezgin, Ufuk
Source: Journal of Interpersonal Violence, Vol 13(4), Aug 1998. pp.
427-437.

Journal URL: http://www.sagepub.com
Publisher: US: Sage Publications

Publisher URL: http://www.sagepublications.com/
ISSN: 0886-2605 (Print)
Language: English
Keywords: self mutilating behavior, 16-37 yr old female survivors
of childhood sexual abuse
Abstract: The study included 42 female adult patients. All the
patients had been sexually abused by family members. The participants
were grouped into 2 groups: those with self-mutilating behavior (SMB)
and those without such behavior. They were evaluated for history of
physical and sexual trauma, suicide attempts, eating habits, and SMB.
The ratio of SMB in the sample was 33.3%. Findings suggest that SMB and
sexual abuse are closely related to eating disorders, particularly
anorexia. The relationship between SMB and suicide attempts was
significant. Childhood abuse, especially sexual abuse, is a largely
ignored psychosocial problem in Turkey. SMB and sexual abuse are highly
correlated, and therefore SMB might be considered as an important signal
for the presence of sexual abuse.
  _____ 

Record: 26

Title: Neuropsychological characteristics of self-mutilating and other
subgroups of borderline women.
Author(s): Schmieder, Linda Marie, The Fielding Inst, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 58(8-B), Feb 1998. pp. 4471.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9806416
Language: English
Keywords: Neuropsychological characteristics of self-mutilating
and other subgroups of borderline women
Abstract: Recent research has associated neuropsychological
deficits with borderline personality disorder and with self-mutilation.
These latest findings, along with the hypothesized early neural
development, suggest that borderlines who experience preverbal trauma
are more likely to act out their distress nonverbally, such as
self-mutilation. In addition, there may be subgroups, distinguishable by
neuropsychological characteristics, within the borderline continuum.
This research examined the relationship between borderline pathology,
self-mutilation, and neuropsychological deficits. Adult borderline women
(n=28), self-mutilating adult borderline women (n=24), and a control
group composed of participants who had similar clinical symptoms but did
not qualify, either by intensity or range of symptoms, for the diagnosis
of borderline (n=21), were assessed on 11 neuropsychological measures.
The hypotheses were: (1) the borderline groups would exhibit greater
neuropsychological dysfunction than the control group, (2) the
borderline self-mutilating group would exhibit greater
neuropsychological dysfunction than borderline non-mutilating group, and
(3) the degree of neuropsychological dysfunction would reflect the
functioning level of the individual. Results revealed that the
self-mutilating group did not evidence more neuropsychological
dysfunction than the borderline non-mutilating group, but the combined
borderline group (self-mutilators and non-mutilators) did evidence
statistically significantly more neuropsychological deficits than the
control group. Further analysis of the groups, redefined by high,
medium, and low functioning level, revealed that the low functioning
group demonstrated statistically significantly more neuropsychological
deficits, followed by the medium functioning group, and then by the high
functioning group. The discussion chapter addressed the clinical
implications of subgroups of borderline pathology that can be identified
in a clinical setting. The theoretical implications, based on an
integration of developmental object relations theory and
neuropsychology, suggest that the impact of neuropsychological deficits
from an early age would result in difficulties in affect regulation and
a predictable pattern of symptoms, the severity of which is associated
with the severity in neuropsychological dysfunction, that we identify as
borderline personality disorder.
  _____ 

Record: 27

Title: Correlation between autonomy-behavior and current theories of
neuropathic pain.
Author(s): Kauppila, Timo, U Helsinki, Inst of Biomedicine, Dept of
Physiology, Helsinki, Finland
Source: Neuroscience & Biobehavioral Reviews, Vol 23(1), 1998. pp.
111-129.

Journal URL: http://www.elsevier.com/inca/publications/store/8/3/1/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0149-7634 (Print)
Digital Object Identifier: 10.1016/S0149-7634(98)00038-4
Language: English
Keywords: rat-based autotomy vs other models of experimental
traumatic mononeuropathy & application to mechanisms of neuropathic pain
in humans
Abstract: The past 10 years have brought several new experimental
models with which to study chronic neuropathic pain in animals.
Consequently, our knowledge about the mechanisms subserving neuropathic
pain in humans has improved. However, the 1st animal model used for
studying this type of chronic pain, the rat-based autotomy-model, can
still be considered a useful tool for pain studies. The original model
was based on the observation that peripheral nerve trauma causing
axotomy frequently resulted in self-mutilation of the denervated part in
the rat, a behavior called autotomy. The present review assesses some of
the similarities and differences between the autotomy-model and more
recent models of experimental traumatic mononeuropathy. In addition, it
considers some of the similarities between the results obtained in
clinical studies and in autotomy studies. Topics discussed include:
putative mechanisms of autotomy, putative peripheral mechanisms of
autotomy, putative spinal mechanisms of neuropathic pain and autotomy,
and putative supraspinal mechanisms of neuropathic pain and autotomy.
  _____ 

Record: 28

Title: Trauma, dissociation, impulsivity, and self-mutilation among
substance abuse patients.
Author(s): Zlotnick, Caron, Brown U, Dept of Psychiatry & Human
Behavior, Providence, RI, US

Shea, Tracie

Recupero, Pat

Bidadi, Kahil

Pearlstein, Teri

Brown, Pamela
Source: American Journal of Orthopsychiatry, Vol 67(4), Oct 1997. pp.
650-654.
Publisher: US: American Orthopsychiatric Association, Inc.
ISSN: 0002-9432 (Print)
Language: English
Keywords: traumatic stressors, dissociation & impulsivity &
self-mutilation, 16-69 yr old substance abusing or dependent psychiatric
inpatients
Abstract: Explored the relationship between traumatic stressors
and the trauma-related features of dissociation, impulsivity, and
self-mutilation, a complex of symptoms hypothesized to be a reaction to
intense affect. Among 85 substance abusing or dependent inpatients (aged
16-69 yrs), it was found that those with histories of distressing
traumatic events reported more self-mutilative acts, higher levels of
dissociation, and a greater degree of impulsivity than did patients
without such histories. Implications of the findings for research and
clinical practice are discussed.
  _____ 

Record: 29

Title: Self-medication, traumatic reenactment, and somatic expression
in bulimic and self-mutilating behavior.
Author(s): Farber, Sharon Klayman, Yeshiva U, Albert Einstein Coll
of Medicine, Bronx, NY, US
Source: Clinical Social Work Journal, Vol 25(1), Spr 1997. pp. 87-106.

Journal URL: http://www.wkap.nl/journalhome.htm/0091-1674
Publisher: Netherlands: Kluwer Academic Publishers

Publisher URL: http://www.wkap.nl
ISSN: 0091-1674 (Print)
Language: English
Keywords: psychosomatic processes & psychic functions & symptom
substitution in & assessment & engagement & countertransference of
patients with binge-purge & self-mutilating behavior, conference
presentation
Abstract: A psychoanalytic framework provided direction for the
author's research on the association between binge-purging (bulimic) and
self-mutilating behaviors. The similarities in the multiple functions
and psychosomatic processes served by these behaviors are presented, as
well as the phenomenon of symptom substitution. Both behaviors tend to
be practiced by those with severe personality and dissociative disorders
and posttraumatic stress disorder. Both serve ego-compensatory needs in
the absence of the adequate ability to regulate and modulate emotions,
moods, and tensions. They may serve as compensatory attempts to
differentiate self and object, define and differentiate body boundaries,
master severe childhood trauma by means of psychophysiological addictive
reenactments, and to express emotion. The implications of these
behaviors for assessment, engagement, and countertransference are
discussed.
  _____ 

Record: 30

Title: Developmental factors and ego state changes in female delicate
self-cutters.
Author(s): Weimer, Susan Elizabeth, Smith Coll School For Social
Work, US
Source: Dissertation Abstracts International Section A: Humanities &
Social Sciences, Vol 57(9-A), Mar 1997. pp. 4136.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4209 (Print)
Order Number: AAM9704568
Language: English
Keywords: Developmental factors and ego state changes in female
delicate self-cutters (self mutilation, trauma, girls, women,
development)
Abstract: The author constructed a paradigm which identified
multiple factors, abstracted from prior literature, associated with the
delicate self-cutting symptom. She investigated the presence of
developmental interferences (physical abuse, sexual abuse, and
invasive/intrusive medical procedures), and the quality of object ties
by means of a face-to-face, one-time rated interview with a clinical,
convenience sample of 12 female subjects, ages 15 to 46. She also
microanalyzed a cutting episode with each subject in order to explore
affective and ego state changes associated with a cutting episode.
Subjects also completed the Tennessee Self-Concept Scale, and a Semantic
Differential on concepts of self and body before, during and after a
cutting episode, and on concepts of mother, father, and friends. The
most significant findings indicated that these subjects had extremely
low self-regard; they evaluated their significant objects more
positively than they did themselves; and they supported some of the
discrete affective and ego state changes associated with a cutting
episode. Although significant, the presence of developmental
interferences was not universal.
  _____ 

Record: 31

Title: Realities lost and found: Trauma, dissociation, and somatic
memories in a survivor of childhood sexual abuse.
Author(s): Droga, Janet T., Inst for the Psychoanalytic Study of
Subjectivity, New York, NY, US
Source: Psychoanalytic Inquiry, Vol 17(2), 1997. pp. 173-191.

Journal URL: http://www.analyticpress.com/psychoanalytic_inquiry.html
Publisher: US: Analytic Press

Publisher URL: http://analyticpress.com
ISSN: 0735-1690 (Print)
Language: English
Keywords: trauma & dissociation & somatic memories, female
survivor of childhood sexual abuse, case report, conference presentation

Abstract: Focuses on the process of recovering memories of
childhood sexual abuse in the course of treatment and particularly on
the genesis, function, and role in the healing process of the somatic
manifestations that are prevalently encountered. The author explores the
phenomenon of somatic memories, that is, memories that are anchored in
bodily sensations, considering both developmental aspects and
implications for psychoanalytic treatment. The relation of somatic
memories to the intersubjective context of trauma and the sense of
reality of the traumatic events is considered. The case of a woman in
her late twenties whose memories of extensive childhood sexual abuse
emerged during analysis, initially in the form of self-mutilation,
dreams, and bodily sensations is described. The S originally sought
treatment because of stress in her job and anxiety about actively
undermining her graduate school/work as she had done in the past. Issues
of abuse and possible sexual abuse in the S's past emerged because of
the extent of the S's symptomatology, a dream of being anally sodomized
by her father, strong anger toward her father, and her responses to
change, specially the change of the doorknobs in the therapist's office.
  _____ 

Record: 32

Title: Assessing psychological variables contributing to the severity
of Deliberate Self Harm as related to the self medication hypothesis.
Author(s): Hart, Janell Rosemary, U California, Los Angeles, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 57(6-B), Dec 1996. pp. 4029.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9632846
Language: English
Keywords: history of family self injury in chilhood & age of onset
& early trauma & lifestyles & parental nurturance, severity of
Deliberate Self Harm, self-mutilators vs alcoholics vs cocaine addicts
Abstract: Difficulties in the identification of self-mutilators
who fall under the category of Deliberate Self Harm have impaired the
assessment and subsequent treatment of this group. Therefore, more
information about the characteristics of this group is necessary to
isolate variables contributing to Deliberate Self Harm (D S H). The
addictive nature of this behavior suggests a connection between this
group and other addictive populations. Therefore, a sample of 60
self-injurers, who met the characteristics of this DSH population,
surveyed as to the extent and severity of their self harm behavior, were
compared with a group of 60 alcoholics and 60 cocaine addicts. All three
sample groups were surveyed as to their related addictions, addictive
lifestyles, and perceptions of parental nurturance. Because of the
difficulty in obtaining self-injury subjects, electronic survey methods
were used. In part, similar levels of early trauma, incidence of
episodic violence and lack of parental nurturance identified the DSH
population. A moderate positive correlation was found between history of
family self injury during childhood and age of onset (r=.32, p<.001). A
low correlation was found between history of death in the family during
childhood and onset of DSH symptoms (r=.26, p<.001). A significant
positive correlation was also found between incidence of early trauma,
and the severity of DSH symptoms (r=.32, p<.001). As predicted, DSH
group showed the same types of self-care vulnerabilities as the other
addiction groups. An analysis of variance found a significant difference
between scores on the Computerized Lifestyle Assessment (CLA) in the
Alcohol group and in the DSH group, (F(2,179) = 38.5, p <), and a
significant difference between scores in the Alcohol group and scores in
the Cocaine group (F(2,179) = 24.5, p <), indicating that there were
more similarities in self care capacity among the DSH and the Cocaine Groups.
  _____ 

Record: 33

Title: Eating disturbance and incest.
Author(s): Wonderlich, Stephen, U North Dakota, Dept of
Neuroscience, Grand Forks, ND, US

Donaldson, Mary Ann

Carson, David K.

Staton, Dennis

et al.
Source: Journal of Interpersonal Violence, Vol 11(2), Jun 1996. pp.
195-207.

Journal URL: http://www.sagepub.com
Publisher: US: Sage Publications

Publisher URL: http://www.sagepublications.com/
ISSN: 0886-2605 (Print)
Language: English
Keywords: development of bulimic behavior, 20-57 yr old female
incest victims
Abstract: This study examines the relationship between reported
history of incest and the subsequent development of bulimic behavior. A
total of 38 women receiving treatment for reported incest abuse were
compared with 27 control subjects who were also in treatment but who
denied histories of sexual abuse. The results revealed that incest
victims were significantly more likely to binge, vomit, experience a
loss of control over eating and report body dissatisfaction than control
subjects. Incest victims also more frequently showed comorbidity with
other maladaptive behaviors, such as alcohol abuse, suicidal gestures,
self-mutilation, and cigarette smoking. These results suggest that
incest may increase the risk for the development of bulimic behavior and
that these eating problems may be a part of a larger pattern of
dysfunctional efforts to regulate trauma-related emotional distress.
  _____ 

Record: 34

Title: A psychoanalytically informed understanding of the association
between binge-purge behavior and self-mutilating behavior: A study
comparing binge-purgers who self-mutilate severely with binge-purgers
who self-mutilate mildly or not at all.
Author(s): Farber, Sharon Klayman, New York U, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 56(10-B), Apr 1996. pp. 5794.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9603317
Language: English
Keywords: binge eating & purging, bulimics with vs without
self-mutilation disorder
Abstract: The relationship between binge-purging and
self-mutilation was studied. Although originally planning to compare and
contrast self-mutilating with non-mutilating bulimics, the design had to
be revised because surprisingly, 89 of 99 subjects reported current
self-mutilation. Compared to mildly or non-mutilating binge-purgers,
severely mutilating bulimics reported significantly severer purging
behavior, dissociation, suicidality, physical illness, traumatic/abusive
childhood/adolescent experiences, childhood/adolescent self-injury and
disturbed eating, body image problems, and experiencing the purge as the
apex of the bulimic episode. The findings suggest that severe
self-mutilation and purging are indicators of severe childhood and
adolescent abuse/trauma. Binge-purge chronicity significantly (p <0) and
severe purging less significantly, were found to be predictive of the
development of severe self-mutilation. Severe purging and
self-mutilation seem to be used to defend against and adapt to the
sequelae of body-focused trauma. Additional findings have implications
for illuminating self-medication, addiction, laxative abuse,
sadomasochism, psychosomatics, symptom substitution, suicidality, body
piercing and tattooing.
  _____ 

Record: 35

Title: Self-mutilation and childhood trauma.
Author(s): Feder, Susanna, Adelphi U, the Inst of Advanced
Psychological Studies, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 56(8-B), Feb 1996. pp. 4580.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9541028
Language: English
Keywords: development of scale to assess frequency & severity of
self-mutilation & history of childhood trauma, borderline women
inpatients
Abstract: This study involved the development of scale that was
used to rank the frequency and severity of self-mutilation in a sample
of borderline inpatients. The scale was used to explore the relationship
between the frequency and severity of self-mutilation and the history of
childhood trauma. Self-mutilation in a sample of borderline inpatients
was examined and its relationship to childhood trauma (sexual abuse,
physical abuse, verbal abuse and loss) as measured by the Retrospective
Assessment of Traumatic Experience (RATE) and the Traumatic Stress scale
(PAI 16) of the Personality Assessment Inventory (PAI) was tested. The
subjects for the study were 86 women hospitalized at The New York
Hospital-Cornell Medical Center, Westchester Division who had agreed to
participate in an ongoing study of borderline disorders. This study was
restricted to women, as women are most likely to be diagnosed with BPD
(Herman, 1992; Kriesman & Strauss, 1989; Weston et al., 1990), and more
likely than men to engage in self-mutilating acts (Waites, 1993; Walsh &
Rosen, 1988). The major finding of this study was that the
self-perception of trauma as measured by the PAI Traumatic Stress scale
was significantly associated with both increased number of episodes of
cutting and more severe cutting as measured by a history of stitches.
Current depression was found to be significantly associated with both
frequency and severity of cutting. History of psychosis was found to be
more associated with severity of cutting. Difficulties in interpersonal
relationships were found to be more associated with more frequent
cutting episodes. No association was found with impulsivity. Cutting as
a symbolic and transitional experience was discussed. The adaptive
nature of self-mutilation was explored in light of the patient's
alexithymia and inability to self-soothe. Treatment implications were
explored with a focus on the importance of the therapist's ability to
contain the patient's intense affective states.
  _____ 

Record: 36

Title: Ethical and legal considerations with self mutilating and lethal
clients.
Author(s): Vesper, Joyce H.
Source: American Journal of Forensic Psychology, Vol 14(4), 1996. pp.
25-38.
Publisher: US: American College of Forensic Psychology

Publisher URL: http://www.forensicpsychology.org
ISSN: 0733-1290 (Print)
Language: English
Keywords: ethical & legal & treatment considerations in working
with self mutilating & lethal patients, psychotherapists
Abstract: Self inflicted violence is a form of coping with the
pain left over from years of trauma and abuse. To the survivor, self
mutilation is a technique developed to avoid suicide or homicide. To the
clinician, it is a symptom of a major mental illness. Hence treaters
attempt to control the mechanism. In reality, self mutilation is a
symptom of a deeper psychological problem that is related to the family
or history of abuse. Therefore as historical information is uncovered,
self inflicted violence escalates. The treating therapist is faced with
both an ethical and legal dilemma of whether to proceed with treatment
and risk further self mutilation, suicide and homicide attempts or stop
the exploratory work to keep the client alive and/or protect potential
harm to third parties.
  _____ 

Record: 37

Title: Violences de l'adolescent et angoisse de démembrement.
Translated Title: Adolescent violence and dismemberment anxiety.
Author(s): Nevjinsky, Fern, U Rouen, Rouen, France
Source: Psychologie Clinique et Projective, Vol 2(1), 1996. pp. 93-112.
Publisher: French Guiana: Dunod

Publisher URL: http://www.dunod.com/pages/home
ISSN: 1265-5449 (Print)
Language: French
Keywords: serious crisis & occurrence of violent acts &
dismemberment anxiety, 13-16 yr olds, 6-7 yr study
Abstract: Discusses the signs that may be linked to the occurrence
of violent acts during adolescence based on a 6-7 yr longitudinal study
of 40 13-16 yr olds attending regular schools. Interpretation of the
obtained data suggests that adolescents who have gone through serious
crises may experience (1) melancholy during massive narcissistic
regression and (2) dismemberment anxiety as a result of instinctual
disentanglement and the failure to establish a primary erogenous
masochistic core.
Conference: Society on the Rorschach and French-Language Projective
Methods: Violence inflicted, violence sustained, 1994, Paris, France
  _____ 

Record: 38

Title: Challenging self-harm through transformation of the trauma
story.
Author(s): Miller, Dusty, Antioch/New England Graduate School, Dept
of Clinical Psychology, Keene, NH, US
Source: Sexual Addiction & Compulsivity, Vol 3(3), 1996. Special issue:
Special Issue on reenactment, trauma, and compulsive behavior. pp.
213-227.
Publisher: United Kingdom: Taylor & Francis

Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1072-0162 (Print)

1521-0715 (Electronic)
Language: English
Keywords: childhood trauma, self-injuring behavior, teenagers &
adults
Abstract: Self-injuring behavior in teenagers and adults is highly
correlated with histories of childhood trauma. These symptoms, including
self-mutilation, eating disorders, substance abuse, excessive cosmetic
surgeries, and compulsive exposure to danger, can be understood as
physical and psychological reenactments of trauma-based relationships
with the abuser(s) and the nonprotecting bystanders. Using an integrated
three-stage treatment model, Trauma Reenactment Syndrome (TRS) can be
approached through a narrative focus on the logic and relational
functions of the self-harming behavior. Assessment and treatment
guidelines are described.
  _____ 

Record: 39

Title: The complexity of adaptation to trauma: Self-regulation,
stimulus discrimination, and characterological development.
Author(s): van der Kolk, Bessel A., Human Resources Inst Hosp,
Trauma Ctr, Brookline, MA, US
Source: Traumatic stress: The effects of overwhelming experience on
mind, body, and society. van der Kolk, Bessel A. (Ed); McFarlane,
Alexander C. (Ed); et al; pp. 182-213. New York, NY, US: Guilford Press,
1996. xxv, 596 pp.
ISBN: 1-57230-088-4 (hardcover)
Language: English
Keywords: secure attachment & regulation & adaptation of affective
states & self & personality development, individuals exposed to trauma
Abstract: (from the chapter) [discusses] the role of secure
attachments in protecting individuals against being traumatized /
describes how trauma leads to a variety of problems with the regulation
of affective states, such as anger, anxiety, and sexuality / how affect
dysregulation makes people vulnerable to engage in a variety of
pathological attempts at self-regulation such as self-mutilation, eating
disorders, and substance abuse / how extreme arousal is accompanied by
(a) dissociation and (b) the loss of capacity to put feelings into words
/ how failure to establish a sense of safety and security leads to
characterological adaptations that include problems with self-efficacy,
shame, and self-hatred, as well as problems in working through
interpersonal conflicts / concludes with a brief description of
deliberations concerning the definition of complex trauma in Diagnostic
and Statistical Manual of Mental Disorders-IV (DSM-IV) and ICD as well
as treatment implications
  _____ 

Record: 40

Title: "Symbolic or not-so-symbolic wounds: The behavioral ecology of
human scarification": Erratum.
Author(s): Ludvico, Lisa R., Pennsylvania State U, Dept of
Anthropology, University Park, US

Kurland, J. A.
Source: Ethology & Sociobiology, Vol 16(5), Sep 1995. pp. 348.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/0/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0162-3095 (Print)
Language: English
Keywords: behavioral ecology of scarification or tattooing, test
of cultural anthropological vs sexual selection hypotheses, erratum
Abstract: Reports an error in the original article by L. R.
Ludvico and J. A. Kurland (Ethology & Sociobiology, 1995 [Mar], Vol
16[2], 155-172). A correction is made to the last complete sentence in
the journal abstract. (The following abstract of this article originally
appeared in PA, Vol 83:04619.) Examined 2 proximate cultural
anthropological and 2 sexual-selection hypotheses from behavioral
ecology in relation to human scarification or tattooing. Scarification,
deliberate and often painful modification, was analyzed from the
perspective of 4 competing hypotheses: rite of passage, hardening/trauma
procedure, nonadaptive sexually selected character, or adaptive
pathogen-driven sexually selected character. The 4 hypotheses were
tested using the Standard Cross Cultural Sample with scarification
identified as a general piercing and as a more-specialized
wound-mediated modification. Adaptive sexual-selection was supported
only in North America, and rite of passage was supported in the
worldwide sample as well as in 3 of the geographic subsamples: Africa,
Insular Pacific, and South America. There was evidence that
scarification and polygyny were associated. Results suggest that a
global pattern remains elusive.
  _____ 

Record: 41

Title: Symbolic or not-so-symbolic wounds: The behavioral ecology of
human scarification.
Author(s): Ludvico, Lisa R., Pennsylvania State U, Dept of
Anthropology, University Park, US

Kurland, J. A.
Source: Ethology & Sociobiology, Vol 16(2), Mar 1995. pp. 155-172.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/0/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0162-3095 (Print)
Language: English
Keywords: behavioral ecology of scarification or tattooing, test
of cultural anthropological vs sexual selection hypotheses
Abstract: Examined 2 proximate cultural anthropological and 2
sexual-selection hypotheses from behavioral ecology in relation to human
scarification or tattooing. Scarification, deliberate and often painful
modification, was analyzed from the perspective of 4 competing
hypotheses: rite of passage, hardening/trauma procedure, nonadaptive
sexually selected character, or adaptive pathogen-driven sexually
selected character. The 4 hypotheses were tested using the Standard
Cross Cultural Sample with scarification identified as a general
piercing and as a more-specialized wound-mediated modification. Adaptive
sexual-selection was supported only in North America, and rite of
passage was supported in the worldwide sample as well as in 3 of the
geographic subsamples: Africa, Insular Pacific, and South America. There
was evidence that scarification and polygyny were associated. Results
suggest that a global pattern remains elusive.
  _____ 

Record: 42

Title: Activation of !a-sub-2-adrenergic receptors decreases nerve
trauma-induced afferent barrage but not autotomy.
Author(s): Taira, T., U Helsinki, Inst of Biomedicine, Finland

Tanila, H.

Jyväsjärvi, E.

Pertovaara, A.

et al.
Source: Brain Research Bulletin, Vol 36(6), 1995. pp. 563-567.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/2/5/4/5/6/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0361-9230 (Print)
Language: English
Keywords: systemic medetomidine, nerve trauma induced autotomy vs
pain behavior vs afferent electrical responses, male rats
Abstract: Studied the effect of pretraumatic systemic
administration of medetomidine (ME) on denervation-induced neuropathic
pain behavior in rats. Peroneal responses evoked by electrical
stimulation of a tibial nerve were recorded in 42 male rats; phrenic
movements induced by hemostatic tail clamp were also measured. ME was
found to potentiate analgesia and to decrease respiratory rate during
pentobarbital anesthesia. ME did not, however, decrease autotomy. It is
suggested that, in this model of deafferentation-induced pain,
depression of the trauma-induced afferent barrage did not automatically
induce preemptive analgesia.
  _____ 

Record: 43

Title: An existential-phenomenological investigation of the experience
of self-cutting in subjects with multiple personality disorder.
Author(s): Robinson, Faith A., California Inst of Integral Studies,
US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 55(7-B), Jan 1995. pp. 3025.
Publisher: US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN: 0419-4217 (Print)
Order Number: AAM9429049
Language: English
Keywords: An existential-phenomenological investigation of the
experience of self-cutting in subjects with multiple personality
disorder (personality disorders)
Abstract: This phenomenological study examines the experience of
self-cutting in eleven females identified as having multiple personality
disorder (MPD) in an attempt to find and describe the essential
structure of the self-cutting experience in this dissociative
population. Subjects who were referred by their therapists provided
detailed, written protocols describing a single, non-suicidal
self-cutting experience. Supporting verbal dialogue was collected in
follow-up interviews. Protocols were analyzed by rigorous,
phenomenological methodology. Analysis revealed 32 constituents of the
experience of self-cutting for these eleven women. These constituents
are described in psychologically-relevant detail and reduced to a brief
summary of the essential structure of the experience. Each protocol is
described in a one-page, context-oriented description. Results show the
need to find relief from an intense state of distress and the use of
cutting as a means of expression of one's internal states. The data
reflect two sub-groups of cutters: ritual abuse survivors and non-ritual
abuse survivors. The dialogues provide data pertaining to multiplicity,
self-cutting, internal conflicts, therapeutic relationships, childhood
traumas, and ritual abuse.
  _____ 

Record: 44

Title: Impulsivity and aggression.
Author(s): Hollander, Eric, (Ed), City U New York, Mt Sinai School
of Medicine, Seaver Ctr for the Research & Treatment of Autism, New
York, NY, US

Stein, Dan J., (Ed)
Source: Oxford, England: John Wiley & Sons, 1995. x, 372 pp.
ISBN: 0-471-95328-8 (hardcover)
Language: English
Keywords: diagnostic & epidemiologic & evolutionary &
neurobiological & neuropsychological & legal issues in impulsivity &
aggression & related disorders
Abstract: (from the cover) Impulsivity and aggression have
undergone considerable research scrutiny in recent years and will
comprise a major research topic in psychiatry over the next decade.

Specifically addressing diagnostic, epidemiologic, evolutionary,
neurobiological, neuropsychological and legal issues, this . . . text
brings together a large array of diverse data to provide a unique,
comprehensive and up-to-date account of this subject. Specific impulse
control disorders, personality disorders, and related disorders such as
self-mutilation, bulimia, substance abuse and neurological trauma are
discussed. Treatment strategies--particularly psychopharmacology, new
agents undergoing trials and psychological approaches--are reviewed.

This text will have a wide audience including researchers and clinicians
in psychiatry, psychology, psychopharmacology and mental health care, as
well as those in the fields of social and health policy.
  _____ 

Record: 45

Title: Alcohol consumption in trauma patients with injuries due to
suicide attempts and automutilation.
Author(s): Kingma, Johannes, University Hosp Groningen, Dept of
Traumatology, Netherlands
Source: Psychological Reports, Vol 75(3, Pt 1), Dec 1994. pp. 1337-1338.
Publisher: US: Psychological Reports

Publisher URL: http://www.ammonsscientific.com/
ISSN: 0033-2941 (Print)
Language: English
Keywords: alcohol consumption & injuries due to suicide &
automutilation, male vs female trauma patients, Netherlands
Abstract: Investigated the association of alcohol consumption and
gender across the life span of 2,124 trauma patients treated at a
university hospital for suicide attempt or automutilation over the 24-yr
period between 1970 and 1993. 71% of the victims were male and 80% were
in the 10-39 yr age range. 20.3% of trauma victims had consumed alcohol;
the highest percentage of alcohol consumption was observed among Ss in
the 30-39 yr age range. Most frequent alcohol consumption occurred among
Ss aged 20-39 yrs, and included 75% of Ss who had used alcohol before
their suicide attempt or automutilation. The main risk group for these 2
types of self-inflicted injuries was victims aged 20-39 yrs.
  _____ 

Record: 46

Title: "Quo vademus?"--New directions in borderline personality
disorder research.
Series Title: Progress in psychiatry, No; 45
Author(s): Cowdry, Rex William, National Inst of Mental Health,
Rockville, MD, US
Source: Biological and neurobehavioral studies of borderline personality
disorder. Silk, Kenneth R. (Ed); pp. 209-225. Washington, DC, US:
American Psychiatric Association, 1994. xxix, 256 pp.
ISBN: 0-88048-480-2 (hardcover)
Language: English
Keywords: biological & neurobehavioral approaches in borderline
personality disorder research
Abstract: (from the introduction) reviews [recent] studies and
reflects on the future course of biological and neurobehavioral research
in BPD [borderline personality disorder]

(from the chapter) approaches to BPD through analogy to Axis I disorders
/ new borders for borderline personality disorder [panic and anxiety
disorders; trauma, posttraumatic stress disorder (PTSD), and multiple
personality disorder; behavioral and cognitive dyscontrol] / the rise of
dimensional approaches and their possible biological underpinnings
[impulsivity, affective instability, CNS dysfunction, self-mutilation,
psychosis]
  _____ 

Record: 47

Title: Women who hurt themselves: A book of hope and understanding.
Author(s): Miller, Dusty, Smith Coll, School for Social Work,
Northampton, MA, US
Source: New York, NY, US: Basic Books, Inc, 1994. viii, 280 pp.
ISBN: 0-465-09220-9 (hardcover)
Language: English
Keywords: 3-stage therapeutic program, females with trauma
reenactment syndrome of self inflicted violence due to childhood abuse
or violation or neglect
Abstract: (from the jacket) Here at last is a book that provides
help for the thousands of women who secretly inflict violence on
themselves. This . . . book is the first to focus on women who harm
themselves through self-mutilation, compulsive cosmetic surgeries,
eating disorders, and other forms of chronic injury to the body.

[The author] argues that the hallmark of their condition is a childhood
history of failure to receive adequate protection. Trauma Reenactment
Syndrome [TRS], as the author calls it, is a cluster of behaviors and
problematic relationship patterns common to women who were abused,
violated, and neglected as children.

This book presents for the first time Dusty Miller's successful
three-stage therapeutic program.

(from the publicity materials) [The book] provides TRS sufferers with
understanding and offers therapists new ideas for treatment.
  _____ 

Record: 48

Title: "I Never Promised You a Rose Garden": Compulsive
self-mutilation.
Series Title: Clinical practice series, No; 28
Author(s): Murray, Barbara J., Suncoast Medical Clinics, Private
Practice, St Petersburg, FL, US
Source: Rediscovering childhood trauma: Historical casebook and clinical
applications. Goodwin, Jean M. (Ed); pp. 191-199. Washington, DC, US:
American Psychiatric Association, 1993. xxv, 215 pp.
ISBN: 0-88048-460-8 (hardcover)
Language: English
Keywords: studies two historic cases for information on
self-mutilation due to child abuse
Abstract: (from the chapter) illustrate the diagnostic problems in
two cases of self-mutilating behaviors accompanied by dissociation / the
first case "Deborah" is drawn from the 1964 autobiographical novel "I
Never Promised You a Rose Garden," which describes a girl [aged 16]
diagnosed as "schizophrenic" and treated by Frieda Fromm-Reichmann in
the late 1940s and early 1950s (Greenberg 1964/1981) / the person in the
second case, "Ann," [aged 22] whose case is presented here because of
its remarkable similarities to the first, was treated in a rural
community mental health center in the 1980s.

the long process described in "Rose Garden" of protective care and
intensive interpretation seems still to map the treatment of choice in
such cases
  _____ 

Record: 49

Title: Depersonalisation und Selbstbeschädigung.
Translated Title: Depersonalization and self-harming behavior.
Author(s): Eckhardt, Annegret, Johannes Gutenberg-U Mainz, Klinik
für Psychosomatische Medizin und Psychotherapie, Germany

Hoffmann, Sven O.
Source: Zeitschrift für Psychosomatische Medizin und Psychoanalyse, Vol
39(3), 1993. pp. 284-306.
Publisher: Germany: Vandenhoeck & Ruprecht

Publisher URL: http://www.vandenhoeck-ruprecht.de/
ISSN: 0340-5613 (Print)
Language: German
Keywords: psychodynamic processes in depersonalization phenomena,
patients with deliberate self harming behavior or factitious disorders
Abstract: Notes that patients with deliberate self-harm syndrome
and with factitious disorders often report depresonalization phenomena,
during which the Ss have a diminished sensitivity to pain. The
self-mutilating act can temporarily stop the feelings of
depersonalization, returning the patient to an awareness of having a
body, even if the latter is defined by its limitations. Connections
between depersonalization and self-mutilation are discussed, along with
other aspects of self-harming behaviors such as self-punishment,
self-directed aggression, identification with aggressor, and
re-enactment of early childhood traumas. Depersonalization is understood
as a defense mechanism. A clinical example is included. (English
abstract)
  _____ 

Record: 50

Title: Sexual abuse and the problem of embodiment.
Author(s): Young, Leslie, Boston U, MA, US
Source: Child Abuse & Neglect, Vol 16(1), 1992. pp. 89-100.

Journal URL: http://www.elsevier.com/inca/publications/store/5/8/6/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0145-2134 (Print)
Language: English
Keywords: embodiment & personal identity formation & associated
psychiatric disorders, sexually abused children & adults
Abstract: Explores trauma, sexual abuse (SA), and some of the
potential resulting long-term effects in terms of the problem of
embodiment and the formation of personal identity and psychological
integrity. The author examines the effect of severe SA on an
individual's, particularly a child's, sense of living in his/her body
and living in the world. First, trauma and dissociation are analyzed and
linked to the development and maintenance of a "posttraumatic" sense of
personal identity. Then, disorders associated with sexual abuse
(dissociation, multiple personality disorder, eating disorders,
somatization disorder, self-mutilation, suicide, suicide attempts) are
examined in terms of their phenomenological coherence and relation to
the problem of embodiment. This conceptual framework may be of use to
those assessing and treating the survivors of SA. (French & Spanish
abstracts)
  _____ 
  _____ 

Record: 1

Title: Dissociative experiences and eating disorders.
Author(s): Goldner, Elliot M.

Cockhill, Leslie A.

Bakan, Rita

Birmingham, C. Laird
Source: American Journal of Psychiatry, Vol 148(9), Sep 1991. pp.
1274-1275.

Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Language: English
Keywords: dissociation to childhood sexual abuse & other
experiences, adult female with eating disorders, commentary
Abstract: Compared the scores of 25 women with eating disorders
(EDs) and 25 age-matched female controls who completed a dissociative
experiences scale. As in a similar study by M. A. Demitrack et al (see
record 1991-04944-001), ED Ss reported a significantly higher rate of
self-mutilation, shoplifting, and dissociation to childhood sexual
abuse. Data support the view that patients with EDs have been subjected
to traumas that may place them at risk for dissociative psychopathology.
  _____ 

Record: 2

Title: A terrible, swift sword: Christ-imagery in therapy.
Author(s): Bixler, William G.
Source: Journal of Psychology & Christianity, Vol 4(2), Sum 1985. pp.
37-41.
Publisher: US: Christian Assn for Psychological Studies

Publisher URL: http://www.caps.net
ISSN: 0733-4273 (Print)
Language: English
Keywords: Christ imagery in psychotherapy, traumatic memory of
incest & resultant self mutilation, 23 yr old female
Abstract: Describes the case of a 23-yr-old female for whom Christ
imagery was used to help her deal with a traumatic memory. Suggestions
as to why such a technique works and cautions about its use are
provided.
  _____ 

Record: 3

Title: ECT for major depression in a patient with acute brain trauma.
 

Author(s): Ruedrich, Stephen L., U Nebraska Medical Ctr, Nebraska
Psychiatric Inst, Omaha

Chu, Chung-chou

Moore, Stan L.
Source: American Journal of Psychiatry, Vol 140(7), Jul 1983. pp.
928-929.

Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Language: English
Keywords: ECT, 21 yr old depressed female with cerebral cortical
laceration due to self inflicted gunshot wound
Abstract: Describes the case of a 21-yr-old woman with depression
and cerebral cortical laceration caused by a self-inflicted gunshot
wound. Because of continued self-mutilation and suicidal ideation, S was
later institutionalized. She received ECT 3 wks after wounding herself
and had no untoward effects. Relative contraindications to ECT based on
head injury and posttraumatic seizures are discussed. (10 ref)
  _____ 

Record: 4

Title: Self-amputation and restitution: Comment.
Author(s): Goldwyn, Robert M., Harvard Medical School, Boston
Source: General Hospital Psychiatry, Vol 5(1), Apr 1983. pp. 29-30.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/1/
Publisher: Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN: 0163-8343 (Print)
Language: English
Keywords: self amputation & restitution, comment on article by G.
W. DeMuth et al
Abstract: In a comment on the case reports of self-amputation and
restitution presented by G. W. DeMuth et al (see record 1983-33307-001),
the present author notes the enormous efforts and skill required and
provided by the psychiatric, surgical, and nursing staffs to cope with
these patients. It is stressed that these patients did not inflict
whole-body trauma (i.e., commit suicide), but from the present author's
experiences, future attempts are likely to be made. It is suggested that
long-term follow-up of such patients may determine whether there are
subsequent efforts to repeat the trauma or to commit suicide. The
knowledge so gained may help to improve aftercare to ensure better
results. (1 ref)
  _____ 

Record: 5

Title: Self-mutilation in children and adolescents.
Author(s): Simpson, Cynthia A., U Kansas, Lawrence

Porter, Garry L.
Source: Bulletin of the Menninger Clinic, Vol 45(5), Sep 1981. pp.
428-438.

Journal URL:
http://www.guilford.com/cartscript.cgi?page=periodicals/jnme.htm&cart_id
=547216.21319
Publisher: US: Guilford Publications

Publisher URL: http://www.guilford.com
ISSN: 0025-9284 (Print)
Language: English
Keywords: type of mutilation & alcohol or drug abuse & weight &
history of physical & sexual abuse & neglect, 5-19 yr old self
mutilators
Abstract: Collected data on 20 5-19 yr old self-mutilators from
Ss' hospital records, which included summaries prepared by attending
physicians, group therapists, and psychiatric nurses. Many of the Ss had
previous psychiatric hospitalizations, some of which included
self-mutilating behavior. Specifically, data were gathered on the
following variables: age, type of mutilation, alcohol or drug abuse,
weight, physical abuse, sexual abuse, and the sense of abandonment felt
by the S. Hospital records on some of the variables were incomplete and,
as a result, only age, type of mutilation, and weight were accurately
documented. Findings show that there was an unusual disruption in the
early attachment process in that many Ss were abandoned by one or both
parents in early childhood. Results also show that many Ss compulsively
ate, abused alcohol and drugs, and sliced, burned, or pulled hair from
their bodies. Most Ss had been physically abused by family members and
many also had been sexually violated. It is suggested that
self-mutilation may be a plausible and effective, if somewhat
sensational, defense that is designed to handle stress by reducing
painful emotional trauma. (9 ref)
  _____ 

Record: 6

Title: Adoleszenzkrisen und soziale Integration im frühen
Erwachsenenalter.
Translated Title: Crises in adolescence and social integration in
early adulthood.
Author(s): Verhofstadt-Deneve, Leni, State U of Ghent, Belgium
Source: Praxis der Kinderpsychologie und Kinderpsychiatrie, Vol 29(8),
Nov-Dec 1980. pp. 278-285.
Publisher: Germany: Vandenhoeck & Ruprecht

Publisher URL: http://www.vandenhoeck-ruprecht.de/
ISSN: 0032-7034 (Print)
Language: German
Keywords: emotional conflicts & psychosocial complications during
early adulthood, institutionalized delinquent adolescents
Abstract: Results from 104 institutionalized delinquent
adolescents confirm the hypothesis that crisis and contradiction can be
regarded as motivating forces in psychosocial development. Ss who
experienced a large number of emotional conflicts (e.g.,
self-mutilation, suicide attempts) were less afflicted by psychosocial
complications during early adulthood than were controls. (English
abstract) (36 ref)
  _____ 

Record: 7

Title: Self-mutilative behavior in the Cornelia de Lange syndrome.
Author(s): Bryson, Yvonne, U. California, San Diego

Sakati, Nadia

Nyhan, William L.

Fish, Charles H.
Source: American Journal of Mental Deficiency, Vol. 76(3), Nov 1971. pp.
319-324.
Publisher: US: American Assn on Mental Retardation

Publisher URL: http://www.aamr.org/index.shtml
ISSN: 0002-9351 (Print)
Language: English
Keywords: compulsive self-mutilative behavior, patients with
Cornelia de Lange syndrome
Abstract: Describes 3 female and 1 male adolescent patients with
the Cornelia de Lange syndrome (Type II) in whom compulsive
self-mutilation was a major feature. Each patient had a stereotyped
pattern of abusive behavior in which there was repeated trauma to the
same area. Together with data from 2 additional patients, results
indicate that self-mutilation may represent a distinctive feature of
this disorder. A relationship between organic disease and the expression
of human behavior is suggested.
  _____ 

Record: 8

Translated Title: On the psychotherapy of a self-mutilation
patient: Essay on the psychoanalytic significance of digital
self-mutilation.
Author(s): Montagnier, Marie-Therese
Source: Revista de Psicoanalisis, Vol. 34(4), Jul 1970. pp. 697-708.
Publisher: Argentina: Asociacion Psicoanalitica Argentina

Publisher URL: http://www.apa.org.ar
ISSN: 0034-8740 (Print)
Language: French
Keywords: psychotherapy, self-mutilation, 16 yr. old boy,
discussion of psychoanalytic significance
Abstract: Describes the case of a 16-yr-old boy who had been
placed since early childhood in a home for retarded children and, at the
age of 13, was placed in a psychiatric hospital with a diagnosis of
profound imbecility. Analysis revealed (a) fixation at the level of
archaic oral fantasies of reciprocal devouring, indicating primitive
traumas; (b) gumming or the absence of a structured anal period which
did not allow progress in mentalizing the pleasure of fece retention,
control, and creation; and (c) existence on an immediate Oedipal level
which was destructive to both self and object. In the course of
analysis, great improvement was noted.
  _____ 

Record: 9

Title: The prisoner of society: Psychiatric syndromes in captive
society.
Author(s): Scott, George D.
Source: Correctional Psychologist, Vol. 3(7), Jan 1969. pp. 3-5.
Publisher: US: Florida State University
Language: English
Keywords: psychiatric syndromes in prison society
Abstract: Presents short descriptions of a variety of psychiatric
syndromes (related to penitentiary terminology): (a) the initial
admission trauma, "admission fog," is characterized as seclusiveness,
conversational disinterest, bland obedience, and physical lethargy; (b)
"coasting," an acceptance of the status quo of prison life produces
self-imposed and protective isolation from outside; (c) "gate
fever-short time jitters," refers to the separation anxiety pending
return to society; (d) "lock-up request-crisis request" is a prison
phenomenon where the inmate no longer can control of impending hostility
and needs isolation to reestablish self-control; (e) "isolation
sickness" is the psychological reaction to deprivation of accustomed
sensory input; (f) "stir crazy" is a reaction to confinement and is a
regression to childish, silly, petulant behavior; (g) "slashing
syndrome" a form of self-mutilation designed for attention-getting
value; (h) "phantom female" syndrome refers to pseudoheterosexual
attachment for a female surrogate in a fellow inmate; and (i)
"homosexual panic" refers to the anxiety reaction to the inmate's
reaction to his own strong homosexual desires.
 

Bulletin Board | Advertise with Us | Calendar | FAQ’S