Kevin's Watch

Study: 1 in 5 students practice self-injury
Some say they hurt to make emotional wounds visible

Monday, June 5, 2006; Posted: 10:40 a.m. EDT (14:40 GMT)
CHICAGO, Illinois (AP) -- Nearly 1 in 5 students at two Ivy League schools say they have purposely injured themselves by cutting, burning or other methods, a disturbing phenomenon that psychologists say they are hearing about more often.

For some young people, self-abuse is an extreme coping mechanism that seems to help relieve stress; for others it's a way to make deep emotional wounds more visible.

The results of the survey at Cornell and Princeton are similar to other estimates on this frightening behavior. Counselors say it's happening at colleges, high schools and middle schools across the country.

Separate research found more than 400 Web sites devoted to subject, including many that glorify self-injury. Some worry that many sites serve as an online subculture that fuels the behavior -- although whether there has been an increase in the practice or just more awareness is unclear.

Sarah Rodey, 20, a University of Illinois student who started cutting herself at age 16, said some online sites help socially isolated kids feel like they belong. One of her favorites includes graphic photographs that the site warns might be "triggering."

"I saw myself in some of those pictures, in the poems. And because I saw myself there, I wanted to connect to it better" by self-injuring, Rodey said.

The Web sites, recent books and media coverage are pulling back the curtain on the secretive practice and helping researchers better understand why some as young as grade-schoolers do it.

"You're trying to get people to know that you're hurting, and at the same time, it pushes them away" because the behavior is so distressing, said Rodey, who has been diagnosed with bipolar disorder.

The latest prevalence estimate comes from an analysis of responses from 2,875 randomly selected male and female undergraduates and graduate students at Cornell and Princeton who completed an Internet-based mental health survey.

Seventeen percent said they had purposely injured themselves; among those, 70 percent had done so multiple times. The estimate is comparable to previous reports on U.S. adolescents and young adults, but slightly higher than studies of high school students in Australia and the United Kingdom.

The study appears in this month's issue of Pediatrics, released Monday. Cornell psychologist Janis Whitlock, the study's main author, also led the Web site research, published in April in Developmental Psychology.

Among the Ivy League students who harmed themselves, about half said they'd experienced sexual, emotional or physical abuse that researchers think can trigger self-abuse.

Repeat self-abusers were more likely than non-injurers to be female and to have had eating disorders or suicidal tendencies, although self-injuring is usually not considered a suicide attempt.

Greg Eels, director of counseling and psychological services at Cornell, said the study's findings are not surprising. "We see it frequently and it seems to be an increasing phenomenon."

While Eels said the competitive, stressful college environment may be particularly intense at Ivy League schools, he thinks the results reflect a national problem.

Dr. Daniel Silverman, a study co-author and Princeton's director of health services, said the study has raised consciousness among his staff, who are now encouraged to routinely ask about self-abuse when faced with students "in acute distress."

"Unless we start talking about it and making it more acceptable for people to come forward, it will remain hidden," Silverman said.

Some self-injurers have no diagnosable illness but have not learned effective ways to cope with life stresses, said Victoria White Kress, an associate professor at Youngstown State University in Ohio. She consults with high schools and says demand for her services has risen in recent years.

Psychologists who work with middle and high schools "are overwhelmed with referrals for these kids," said psychologist Richard Lieberman, who coordinates a suicide prevention program for Los Angeles public schools.

He said one school recently reported several fourth-graders with burns on their arms, and another seeking help for "15 hysterical seventh-grade girls in the office and they all have cuts on their arms."

In those situations, Lieberman said there's usually one instigator whose behavior is copied by sympathetic but probably less troubled friends.

Rodey, a college sophomore, said cutting became part of her daily high school routine.

"It was part of waking up, getting dressed, the last look in the mirror and then the cut on the wrist. It got to be where I couldn't have a perfect day without it," Rodey said.

"If I was apprehensive about going to school, or I wasn't feeling great, I did that and I'd get a little rush," she said.

Whitlock is among researchers who believe that "rush" is feel-good hormones called endorphins produced in response to pain. But it is often followed by deep shame and the injuries sometimes require medical treatment.

Vicki Duffy, 37, runs a Morris County, New Jersey, support group and said when she was in her 20s, she had skin graft surgery on her arms after burning herself with cigarettes and a fire-starter. After psychological and drug treatment, she stopped the behavior 10 years ago.

Author of the 2004 book "No More Pain: Breaking the Silence of Self-Injury," Duffy recalled being stopped on the street by a 70-year-old woman who saw her scarred arms and said, "'I used to do that."'

Rodey said she stopped several months ago with the help of S.A.F.E. (Self-Abuse Finally Ends) Alternatives treatment program at a suburban Chicago hospital. Treatment includes behavior therapy and keeping a written log to track what triggers the behavior.

Rodey said she feels "healed" but not cured "because it's something I will struggle with the rest of my life. Whenever I get really stressed out, that's the first thing I think about."

Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Study: Strict parenting might lead to obese kids
Flexible rule-setting moms most likely to avoid chubby kids

Tuesday, June 6, 2006; Posted: 10:14 a.m. EDT (14:14 GMT)
CHICAGO, Illinois (AP) -- "Clean your plate or else!" and other authoritarian approaches to parenting might lead to overweight children, a new study finds.

Strict mothers were nearly five times more likely to raise tubby first-graders than mothers who treated their children with flexibility and respect while also setting clear rules.

But while the children of flexible rule-setting moms avoided obesity, the children of neglectful mothers and permissive mothers were twice as likely to get fat.

"The difference between the different parenting groups is pretty striking," said the study co-author, Dr. Kay Rhee of Boston University School of Medicine. The study of 872 families appears in the June issue of Pediatrics, released Monday.

Mothers and children in Lawrence, Kansas, were among those in 10 U.S. cities who participated in the study.

Rhee speculated that parents who show respect and warmth within a framework of rules may help their children learn to make good decisions about food and exercise. Or it could be that strict parents create a stressful household where overeating becomes a comfort and escape, she said.

Other studies have shown the flexible parenting style, also called authoritative, has other good results for children such as higher achievement in school and lower incidence of depression, said John Lavigne, chief psychologist at Children's Memorial Hospital in Chicago.

Lavigne, who was not involved in the new study, said most parents can learn a different way of handling their children.

"Some parents might have difficulty changing their style. But a lot of other parents are very amenable to change, if they only have the right kind of advice," Lavigne said.

Not enough fathers participated in the study to measure their effects on children's weight, Rhee said. And since more than 80 percent of the study participants were white, the findings may not be applicable to other racial groups, she said.

The study also did not take into account the weight status of the mothers, so the researchers couldn't rule out that a mother's weight might influence both her parenting and her children's weight. However, a previous study showed that parenting style is not linked to weight status, Rhee said.

To determine parenting style for the new study, researchers surveyed the mothers and observed them interacting with their children when the kids were 4 years old. The children's body mass indexes were measured later when the children were in first grade.

Seventeen percent of the children of strict disciplinarians were overweight compared to 9.9 percent of the children of neglectful parents, 9.8 percent of the children of permissive parents and 3.9 percent of the children of flexible rule-setters.

"Children need adults to set some limits and as the child matures they need to learn responsibility and self-regulation gradually," said Dr. Nancy Krebs, co-chair of the task force on obesity for the American Academy of Pediatrics, who also was not involved in the new study.

The researchers studied mothers and children in Little Rock, Arkansas; Irvine, California; Lawrence, Kansas; Boston, Massachusetts; Philadelphia, Pennsylvania; Pittsburgh, Pennsylvania; Charlottesville, Virginia; Morgantown, North Carolina; Seattle, Washington, and Madison, Wisconsin.

In homes where parents are firm but flexible, "the rules can be bent a little or modified a little to accommodate the situation. But ultimately there are rules," Rhee said. "You still maintain the rule that the child has to have a vegetable at dinner, but the child gets to pick which one and how much of it they eat."

Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

'Complicated grief' suggested as separate diagnosis
Prolonged, intense sadness is different, doctors say

Wednesday, June 21, 2006; Posted: 10:56 a.m. EDT (14:56 GMT)
NEW YORK (Reuters) -- It's normal to feel sadness and grief with the passing of a loved one, but an intense and persistent yearning for the person who died, difficulties "moving on" with life after a period of time, and a sense that life and the future are meaningless and purposelessness, are signs of "complicated grief," warns a group of Dutch doctors.

"Although some of these symptoms also occur in people with normal (as opposed to complicated) grief, in people with complicated grief these symptoms are very intense and persist for at least 6 months to the point of functional impairment," Dr. Paul A. Boelen, a psychologist and psychotherapist from Utrecht University in The Netherlands told Reuters.

In other words, he said, "people with complicated grief are basically stuck in a state of chronic grieving."

Complicated grief is a fairly new concept, Boelen said. It is not currently included in the Diagnostic and Statistical Manual of Mental Disorders, the official diagnostic system from the American Psychiatric Association. However, Boelen predicted it would be in included in the next edition of the DSM.

"That is because, among other things, there is now very much evidence that complicated grief is a very debilitating mental health condition, that is distinct from more familiar depressive and anxious symptoms and syndromes, and that poses people at risk for considerable and persistent health impairments," Boelen said.

He and his colleagues present a model of complicated grief in the current issue of Clinical Psychology: Science and Practice. They hope their conceptualization of the condition will help facilitate research on this new concept.

Who is most at risk for complicated grief? General bereavement research has indicated that people confronted with deaths that are violent (resulting from suicide, homicide, accidents) and that are untimely (loss of child) have greater risks of getting stuck in the process of mourning than people confronted with other losses, according to Boelen.

"Moreover, personality styles such as insecure attachment and high neuroticism have been found to be risk factors," he said. Negative thinking and particular types of avoidance behaviors (i.e., suppressing thoughts and emotions about the loss, and failing to adapt ones everyday life) also put people at risk for CG.

Boelen and colleagues have developed a cognitive-behavioral treatment approach, which aims to get the individual to process the loss, identify and change problematic beliefs and interpretations about the loss. This strategy has proven to be "very successful," Boelen said.

Copyright 2006 Reuters. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Two doctors Billy Cohn and Bud Frazier from the Texas Heart Institute successfully replaced a dying man’s heart with a device—proving that it is possible for your body to be kept alive without a heart, or a pulse.

[...]

The turbine-like device, that are simple whirling rotors, developed by the doctors does not beat like a heart, rather provides a ‘continuous flow’ like a garden hose.

After the doctors experimented on one of the calves, Abigail, Doctor Cohn told NPR: "If you listened to her chest with a stethoscope, you wouldn't hear a heartbeat. If you examined her arteries, there's no pulse. If you hooked her up to an EKG, she'd be flat-lined."

Craig Lewis was a 55-year-old, dying from amyloidosis, which causes a build-up of abnormal proteins. The proteins clog the organs so much that they stop working, according to NPR.

But after the operation, with the ‘machine’ as his heart's replacement, Lewis’ blood continued to spin and move through his body.

However, when doctors put a stethoscope to his chest, no heartbeat or pulse can be heard (only a ‘humming’ sound)—which “by all criteria that we conventionally use to analyze patients”, Doctor Cohn said, he is dead.

This is proof that “human physiology can be supported without a pulse”.