Suicide and Self-Injury, Continued

(Ross, S., & Heath, N. (2003). Two models of adolescent self-mutilation. Suicide and Life-Threatening Behavior, 33, 277-286. )

The gist: "Two models, the hostility and anxiety reduction models, were simultaneously tested in order to determine whether SM in adolescence was characterized by greater feelings of anxiety and hostility" (Ross & Heath, p.1, 2003).

• even after further reading, I still feel unclear regarding the anxiety reduction model and the hostility model - I need to keep working at it
  
• beginning understanding: anxiety reduction model relates to feeling overwhelmed, a need for release and for feelings to stop -- hostility model relates to an inability to express hurt/anger/pain and as such, individual cuts 'to feel'
• state variable - more anxious as a direct result of SI behavior
  
• trait variable - more anxious to begin with, SI somewhat secondary
• seriously, I'm just not connecting with this article and I can't see the relevance of the research - Why is this an assigned article over countless others? - I'll have to come back to it, I suppose

Hurry, J. (2000). Deliberate self-harm in children and adolescents. International review of psychiatry, 12, 31-36.

The gist: This is a British article discussing deliberate self-harm in children and adolescents. In this instance, deliberate self-harm seems to refer to both self-injury as well as parasuicide. Given the year, this article is rather dated in many respects, but I think it serves as an interesting comparison to research, definitions, and practice here in the United States.

• my understanding of parasuicide is as follows: parasuicide refers to repetative, near-lethal behavior that exists without the explicit intend of suicide - driving too fast, dangerous work without the right equipment, binge substance abuse, etc.
• in my mind, parasuicide is not the same thing as self-injury
• parasuicide, deliberate self-harm, uncompleted suicide, attempted suicide - these are sometimes used interchangeably, but don't necessarily mean the same thing - why such messy operationalization?
  
• similar patterns in reporting to child abuse and neglect (i.e. severe underreporting)
• impulsive vs. compulsive behaviors - DSM-IV classifications
  
• the UK seems to lump in SI with everything else. Why?
• N. (Australian) suggests that the Commonwealth tends to lag behind the states by about a year in regard to such things - also made a fine point questioning whether this lumping relates, in part, to differences in health insurance policies - private vs. socialized and so on
• factoring in age and cognitive development
  
• "Adolescents can understand the concept of death cognitively. However, it is not clear that they internalize the end of their own lives, particularly younger adolescents. It would not be uncommon for students even as old as 16 to view death as magical, temporary, and reversible" (Lieberman, Poland, & Cassel, in press)