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Bantjes J, Mapaling C. "I'm Not Afraid of Dying Because I've Got Nothing to Lose": Young Men in South Africa Talk About Nonfatal Suicidal Behavior. Am J Mens Health 2021; 15:1557988321996154. [PMID: 33749356 PMCID: PMC7989143 DOI: 10.1177/1557988321996154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
First-person narratives of suicidal behavior may provide novel insights into how individuals with lived experience of suicide understand and narrate their behavior. Our aim was to explore the narratives of young men hospitalized following nonfatal suicidal behavior (NFSB), in order to understand how young suicidal men construct and understand their actions. Data were collected via narrative interviews with 14 men (aged 18–34 years) admitted to hospital following an act of NFSB in Cape Town, South Africa. Narrative analysis was used to analyze the data. Two dominant narratives emerged in which participants drew on tropes of the “great escape” and “heroic resistance,” performing elements of hegemonic masculinity in the way they narrated their experiences. Participants position themselves as rational heroic agents and present their suicidal behavior as goal-directed action to solve problems, assert control, and enact resistance. This dominant narrative is incongruent with the mainstream biomedical account of suicide as a symptom of psychopathology. The young men also articulated two counter-narratives, in which they deny responsibility for their actions and position themselves as defeated, overpowered, wary, and unheroic. The findings lend support to the idea that there is not only one narrative of young men’s suicide, and that competing and contradictory narratives can be found even within a dominant hyper-masculine account of suicidal behavior. Gender-sensitive suicide prevention strategies should not assume that all men share a common understanding of suicide. Suicide can be enacted as both a performance of masculinity and as a resistance to hegemonic gender roles.
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Affiliation(s)
- Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
| | - Curwyn Mapaling
- Faculty of Education, Nelson Mandela University, Port Elizabeth, South Africa
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Sweeney M, Tsapanou A, Stern Y. Regional cortical thickness and neuroticism across the lifespan. Psychiatry Res Neuroimaging 2019; 286:39-44. [PMID: 30878715 PMCID: PMC6697258 DOI: 10.1016/j.pscychresns.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 12/17/2022]
Abstract
Neuroticism is associated with greater reactivity to stress and lifetime psychopathology. In the present study we examined the association between neuroticism and regional and total cortical thickness (CT) across the lifespan, accounting for gender. We also assessed interactions among these factors. 450 subjects between 19 and 80 years were included. Participants completed the International Personality Item Pool and a structural MRI scan. Total CT and the mean values of CT in five regions of interest were examined. We also investigated the interaction effect among age, gender and neuroticism on CT. There was no significant association between neuroticism and regional/total CT. A significant interaction between neuroticism, age, and gender on the thickness of the anterior cingulate was found. Women high in neuroticism showed a thinner anterior cingulate cortex than women low in neuroticism, with increasing age. In contrast, men high in neuroticism had a thicker anterior cingulate cortex compared to men low in neuroticism, with increasing age. Overall, high neuroticism was associated with differential cortical thickness in the anterior cingulate among men and women with increasing age.
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Affiliation(s)
| | - Angeliki Tsapanou
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University College of Physicians and Surgeons, 630 W 168th Street, New York, NY 10032, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University College of Physicians and Surgeons, 630 W 168th Street, New York, NY 10032, USA.
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Calati R, Courtet P, Lopez-Castroman J. Refining Suicide Prevention: a Narrative Review on Advances in Psychotherapeutic Tools. Curr Psychiatry Rep 2018. [PMID: 29520726 DOI: 10.1007/s11920-018-0876-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Since psychotherapies for suicide prevention are receiving increasing attention, our purpose was to evaluate the related literature [meta-analyses and reviews on their effect on suicidal outcomes (A), perspective reviews concerning specific socio-demographic and clinical features (B), original studies with particular interest (C)] published over the last 3 years. RECENT FINDINGS (A) Across different diagnoses, particularly, efficacious psychotherapies were cognitive behavioral therapy-based ones and interventions directly addressing suicidal thoughts and behaviors during the treatment. When the focus was restricted to specific diagnoses, results were different: for example, in borderline patients, dialectical behavior therapy and psychodynamic psychotherapies were the only efficacious interventions. (B) Family therapies for adolescents and treatments for elderly depressed patients with disability/cognitive impairment should be further developed. (C) General long-term effects seem to be present, but specific interventions and treatment duration should be considered. Results indicated the presence of a number of promising interventions.
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Affiliation(s)
- Raffaella Calati
- INSERM U1061, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France. .,FondaMental Foundation, Créteil, France. .,Department of Emergency Psychiatry & Post-Acute Care, Lapeyronie Hospital, Montpellier University Hospital, Montpellier, France.
| | - Philippe Courtet
- INSERM U1061, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,FondaMental Foundation, Créteil, France.,Department of Emergency Psychiatry & Post-Acute Care, Lapeyronie Hospital, Montpellier University Hospital, Montpellier, France
| | - Jorge Lopez-Castroman
- INSERM U1061, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
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Abstract
Psychology, like society at large, continues to be baffled by the persistent belief that men and women differ in important psychological ways, in spite of countless studies that fail to demonstrate such differences or that capture them for only a brief moment. New approaches avoid the polarization of `male' and female' traits, emphasizing how and why these qualities change over the life span, across cultures and throughout history. To understand where the differences are, we must look to narrative, power, and the conditions of our lives.
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Affiliation(s)
- Carol Tavris
- 1847 Nichols Canyon, Los Angeles, California 90046, USA
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Physical distress and relationship problems: exploring the psychosocial and intrapsychic world of suicidal geriatric patients. Z Gerontol Geriatr 2015; 47:502-7. [PMID: 24202298 DOI: 10.1007/s00391-013-0563-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Suicide is a serious mental health problem in old age. Suicide ideation and life weariness are important psychopathological issues in geriatric medicine, although suicide ideation does not primarily depend on the severity of any physical disease. Despite these facts, insight into the internal psychological state of suicidal geriatric patients is still limited. MATERIAL AND METHODS This study examines intrapsychic and psychosocial issues in suicidal geriatric inpatients. A semistructured interview concerning suicide ideation in old age was used to interview 20 randomly chosen, acutely suicidal clinically geriatric inpatients aged 60 years and older. The control group comprised 20 nonsuicidal patients. RESULTS Hamilton Depression Scale 21 scores (HAMD 21; patient mean 17.3, control mean 6.1), suicidal ideation and psychiatric treatments differed significantly between the groups. In contrast to lifetime suicidal ideation, the discovery of a physical disease was the primary trigger for current suicidal ideation, followed by interactional conflicts. Patients would rather speak with family or friends than professionals about their suicidal ideation. CONCLUSION Suicidal ideation should be recognised as an important psychological problem in geriatric patients with interpersonal conflicts. Specific help and training for relatives is recommended.
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Boyd A, Van de Velde S, Vilagut G, de Graaf R, O'Neill S, Florescu S, Alonso J, Kovess-Masfety V. Gender differences in mental disorders and suicidality in Europe: results from a large cross-sectional population-based study. J Affect Disord 2015; 173:245-54. [PMID: 25462424 DOI: 10.1016/j.jad.2014.11.002] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 10/31/2014] [Accepted: 11/01/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION When evaluating gender differences in mental disorders and suicidality, specifically between European countries, studies are sparse and frequently hindered by methodological issues, such as the limited items evaluated and inconsistent sampling designs. METHODS In ten European countries participating in the World Mental Health Survey Initiative, lifetime internalizing and externalizing disorders and suicidality were assessed among 37,289 respondents. Disorders were classified using DMS-IV criteria. Odds ratios (OR) for gender differences were calculated using logistic regression, while trends across age-groups were tested via gender × age interaction. RESULTS Within countries, prevalence of any lifetime internalizing disorder ranged from 10.8% to 44.5% among women and 5.9% to 26.5% among men, with women having consistently higher odds than men (OR range: 1.52-2.73). Prevalence of any lifetime externalizing disorders ranged from 0.2% to 6.6% among women and 2.2% to 22.4% among men, with women having consistently lower odds than men (OR range: 0.05-0.35). Any lifetime suicide attempt was found in 0.8-5.4% of women and 0.3-2.4% of men, showing inconsistent relative gender-differences across countries (OR range: 0.77-4.72). Significant effects in gender OR across age-groups were not observed for any internalizing disorder or suicide attempt, yet were present for any externalizing disorder in France (p = 0.01), the Netherlands (p = 0.05), and Spain (p = 0.02). LIMITATIONS Mental disorders were assessed with the CIDI 3.0 and not psychiatric evaluations. Suicidality does not fully represent more important clinical events, such as suicide mortality. CONCLUSIONS Consistent across European countries, internalizing disorders are more common among women and externalizing disorders among men, whereas gender differences in suicidality varied.
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Affiliation(s)
- Anders Boyd
- Ecole des Hautes Etudes en Santé Publique (EHESP) and EA4057 Paris Descartes University, Paris, France; INSERM UMR_S1136, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Sarah Van de Velde
- Ecole des Hautes Etudes en Santé Publique (EHESP) and EA4057 Paris Descartes University, Paris, France; Ghent University, Ghent, and Research Foundation-Flanders, Brussels, Belgium
| | - Gemma Vilagut
- Health Services Research Unit IMIM-Hospital del Mar Medical Research Institute, Barcelona, and CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Siobhan O'Neill
- Bamford Centre for Mental Health and Well-Being, University of Ulster, Londonderry, Northern Ireland
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Jordi Alonso
- Health Services Research Unit IMIM-Hospital del Mar Medical Research Institute, Barcelona, and CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Vivane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP) and EA4057 Paris Descartes University, Paris, France.
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Lester D. The Cultural Meaning of Suicide: What Does That Mean? OMEGA-JOURNAL OF DEATH AND DYING 2012; 64:83-94. [DOI: 10.2190/om.64.1.f] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Scholars sometimes stress that it is important to know the individual meaning of suicide and the cultural meaning of suicide, but the meaning of these terms remains unclear. The present article discusses this problem and suggests that the individual meaning of suicide is best based on the motives for suicide, while the cultural meaning of suicide is best rooted in the lay theories of suicide in which the members of cultures and subcultures believe.
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Cleary A. Suicidal action, emotional expression, and the performance of masculinities. Soc Sci Med 2012; 74:498-505. [DOI: 10.1016/j.socscimed.2011.08.002] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 08/04/2011] [Accepted: 08/08/2011] [Indexed: 02/07/2023]
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da Silva Cais CF, Stefanello S, Fabrício Mauro ML, Vaz Scavacini de Freitas G, Botega NJ. Factors Associated with Repeated Suicide Attempts. CRISIS 2009; 30:73-8. [DOI: 10.1027/0227-5910.30.2.73] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: This study compares sociodemographic and clinical characteristics of 102 first-time hospital-treated suicide attempters (first-evers) with a group of 101 repeat suicide attempters (repeaters) consecutively admitted to a general hospital in Brazil, during the intake phase of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Aims: To compare sociodemographic and clinical characteristics of first-time hospital-treated suicide attempters (first-evers) with a group of repeat suicide attempters (repeaters). Methods: A standardized interview and psychometric scales were administered to all patients. Results: Repetition was associated with being of female sex (OR = 2.7; 95% confidence interval (CI) = 1.2–6.2), a housewife (OR = 3.8; 95% CI = 1.2–11.8), and having a score above median on the Beck Depression Inventory (OR = 5.2; 95% CI = 1.7–15.6). Conclusions: The findings suggest that repeaters, namely, depressed housewives who have attempted suicide previously, need specific treatment strategies in order to avoid future suicide attempts.
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Affiliation(s)
- Carlos Filinto da Silva Cais
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | - Sabrina Stefanello
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | - Marisa Lúcia Fabrício Mauro
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Neury José Botega
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
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Klein H, Elifson KW, Sterk CE. Predictors of suicidal ideation among "at risk" cocaine-using African American women. Suicide Life Threat Behav 2006; 36:336-48. [PMID: 16805662 DOI: 10.1521/suli.2006.36.3.336] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The focus of this study was to identify factors that differentiate women drug abusers who had experienced suicidal ideation from those who did not. Face-to-face interviews were conducted with 221 cocaine-using women in Atlanta, GA, 88 (39.8%) of whom reported thinking about committing suicide at least once during the 90 days prior to interview and 133 (60.2%) of whom did not. Multivariate logistic regression was used to identify predictors of suicidal ideation, and post hoc goodness-of-fit tests were conducted to assess the robustness of final models derived. Model 1 excluded all psychosocial functioning measures and Model 2 included these items. Both models showed that suicidal ideation was more common among women who were unemployed, had been abused sexually, engaged in sexual relations to cope with stresses, or had less helpful relatives. In addition, Model 1 revealed a heightened risk for women experiencing financial problems and those who had a previous mental health diagnosis, whereas Model 2 showed an elevated risk among women who experienced anxiety and those who had lower levels of self-esteem. These findings suggest the need for prevention and intervention programs that target at-risk women, and for such programs to include an emphasis on suicidal ideation in addition to focusing on risk factors that are addressed more commonly.
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Affiliation(s)
- Hugh Klein
- Rollins School of Public Health, Emory University, USA.
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11
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Abstract
BACKGROUND Gender is one aspect of an individual's identity that has been widely debated and discussed in relation to many different aspects of social life. The literature review explores how gender stereotypes affect women and their experience of mental illness. The aim is to demonstrate how a feminist perspective provides a useful lens through which women's experience of mental illness can be viewed. METHODS The papers were identified by a computerized search of the CINAHL, Medline, BIDS ISI and Mental Health Nursing Collection databases and a hand search. All papers were screened and subjected to critical review. RESULTS A theoretical framework was developed that reflected two key themes to emerge from the feminist literature on women and mental illness, namely psychiatry as a method of socially controlling women and the medicalization of women's unhappiness. In addition the complexities and contradictions in the feminist arguments are highlighted. CONCLUSION The paper concludes by considering the implications of the issues raised for nursing practice by drawing attention to the current debates on the need to focus on gender relations rather than just on women's issues.
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Affiliation(s)
- N Wright
- Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
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12
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Affiliation(s)
- Silvia Sara Canetto
- Silvia Sara Canetto is associate professor of Psychology at Colorado State University, Fort Collins, CO, USA
| | - Isaac Sakinofsky
- Isaac Sakinofsky is professor of psychiatry and public health sciences at the University of Toronto, and head of the High Risk Consultation Clinic and Suicide Studies Program at the Clarke Institute of Psychiatry, Toronto, Canada
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Lewis RJ, Atkinson J, Shovlin J. Gender Differences in Attributions about Suicide and Alcohol Use. OMEGA-JOURNAL OF DEATH AND DYING 1995. [DOI: 10.2190/nbwg-hpp6-ar8n-rupt] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This research examined attributions that female and male college students made about an individual who committed suicide. The gender of the victim and whether alcohol use was involved were systematically varied. Results indicated that female and male respondents see the issues involved in suicide differently. Female respondents appear to place more emphasis on contextual clues such as alcohol use and gender of the actor. In addition, both female and male respondents tended to associate alcohol use and suicide for male actors but not for female actors. These results are discussed in terms of stereotypes that may be held for females and males vis-a-vis emotional expression and alcohol use. The use of population base rates in attributions about suicide and alcohol use is also considered. Directions for future research are also presented.
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Canetto SS, Feldman LB. Covert and Overt Dependence in Suicidal Women and Their Male Partners. OMEGA-JOURNAL OF DEATH AND DYING 1995. [DOI: 10.2190/q21e-br2n-qkya-gvmn] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dependence has traditionally been associated with suicidal behavior, especially in women. According to recent psychodynamic formulations, overt expression of dependence is influenced by covert mental representations and context-interactional variables. This study explored the covert mental representations and the interactional context of dependence in suicidal women and their male nonsuicidal partners. On the basis of theory, we hypothesized that suicidal women and their partners would have similar covert dependent needs, but opposite styles of dealing with these needs. The suicidal women would express these needs directly through overt dependent behavior while their partners would manifest their dependent needs indirectly through reinforcing dependent behavior in suicidal women. As predicted by theory, suicidal women and their partners were found to be similar in terms of covert dependence and different with regard to overt behavior—male partners tending to foster dependence in suicidal women. Contrary to prediction, most suicidal women did not directly express excessive dependence.
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Abstract
The success of traditional suicide prevention efforts is evaluated and found wanting. Some encouraging recent developments are noted, and it is suggested that suicidologists might also profitably consider the strategies used by professionals dealing with other public health and social problems, such as drug abuse and delinquency.
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Affiliation(s)
- D Lester
- Center for the Study of Suicide, Blackwood, NJ
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Nemeth J, Swaim RC, Katona E, Oetting ER. Substance use among Hungarian students. THE INTERNATIONAL JOURNAL OF THE ADDICTIONS 1994; 29:1443-67. [PMID: 7829279 DOI: 10.3109/10826089409048718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
There is very little empirical data on drug and alcohol use among Hungarian adolescents. The purpose of this pilot project was to develop instrumentation and methods that could be used to assess legal and illegal substance use among Hungarian adolescents. A Hungarian translation of The American Drug and Alcohol Survey was developed and adapted to the unique circumstances of Hungarian patterns of use. This survey was tested with 234 students, 135 females and 99 males, from Grades 8 and 11 enrolled in public schools, in Györ, Hungary during 1991-1992. The students reported little or no substance use other than use of alcohol and tobacco. Older students were more likely than younger students to be involved with alcohol and cigarettes. Females and males were equally likely to try alcohol, but males were more likely to have been drunk than females. Despite the low reported use of substances other than alcohol and tobacco, students demonstrated attitudes toward drug use that may place them "at risk" for future use.
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Affiliation(s)
- J Nemeth
- Department of Psychology, Colorado State University, Fort Collins 80523
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Gleason NA. College women and alcohol: a relational perspective. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 1994; 42:279-289. [PMID: 8046167 DOI: 10.1080/07448481.1994.9936360] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Little attention has been paid to college women's drinking, partly because women drink less than college men do, partly because they are less likely to get into trouble with the authorities, and partly because women have only recently been understood to develop differently and to have different needs from those of men. Recent theories stress the importance of relationships in women's development, identity, and self-esteem and failures in mutuality and intimacy as contributing to subjective pain and dysfunction. These theoretical formulations suggest a new understanding for women's use of alcohol, one that emphasizes drinking as a way of being with others, of seeking acceptance from peers, and of numbing the pain that comes from relationships that do not work. Women are at greater risk of being abused when drinking, and women who have been sexually or physically abused are at greater risk for abusing alcohol.
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Affiliation(s)
- N A Gleason
- Stone Center for Developmental Services and Studies, Wellesley College, Massachusetts
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Abstract
Attempted suicides occur primarily among women, while completed suicides occur primarily among men. Risk factors for both attempted and completed suicides include mental and addictive disorders, disrupted family environments, and precipitating events. This article presents an overview of findings on gender differences from epidemiologic studies of completed and attempted suicides, with a focus on suicide attempts among women, and discusses possible reasons for gender differences in suicidal behaviors.
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Affiliation(s)
- E K Mościcki
- Prevention Research Branch, National Institute of Mental Health, Rockville, MD 20857
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