'Am I really the priority here?': help-seeking experiences of university students who self-harmed

BACKGROUND

Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university.

AIMS

This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support.

METHOD

Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework.

RESULTS

The analysis identified four themes: 'The initial university phase poses the greatest challenge', 'Perceived criteria for "valid" mental health problems', 'Evading external judgements, concerns and consequences' and 'The pivotal role of treatment options and flexibility in recovery'.

CONCLUSIONS

Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed 'valid', it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.

Dialogue with difference: Meta-representations in political dialogue and their role in constructing the ‘other’

When faced with the aftermath of a divisive political event, how do citizens make sense of the political opinions of those who voted differently to them? Drawing on the Social Representations Approach (SRA) and its emphasis on communication as a medium through which meaning making occurs, we utilize dialogical analysis of focus group data (N = 36) collected after the UK’s referendum on leaving the EU. We focus on how voters engage with the perspective of the other in an intragroup dialogue setting. In doing so, this paper aims to explore the role of meta-representations, or ‘what we think other people think’, in contexts of contested political issues. We show the value of considering how meta-representations function to delegitimize different political views and vote choices, and by implication serve an important role in socially representing the ‘other’, constructing and reproducing intergroup boundaries. This process is achieved through drawing on semantic barriers, communicative tools that play a crucial role in safeguarding one’s own beliefs from the threat of alterity.

Docking-based analysis and modeling of the activity of bile acids and their synthetic analogues on large conductance Ca2+ activated K channels in smooth muscle cells

OBJECTIVE

The objective of this study was to perform docking-based analysis of bile acid binding on the protein complex of channels and to derive neural network that predicts the influence of bile acids and their synthetic analogues on the activity of BK(Ca) channels in smooth muscle cells based on descriptors for bile acids and their synthetic analogues and on their already published activities using patch-clamp techniques.

MATERIALS AND METHODS

Ligands for molecular docking were optimized using computer routine for minimization of energy by using the force field MMFF94 via Chem3D 15.0 and ligands and protein channel complex were prepared in AutoDockTools 1.5.6. AutoDock Vina 4.0 software was used for blind docking; processing and verification of the obtained results was performed via Discovery Studio 4.0. Neural network was derived using descriptors for bile acids and their synthetic analogues and their already published activities on calcium-activated K+ channels in smooth muscle cells (ChemDraw Professional 15.0, Dragon 6 software).

RESULTS

Molecular docking was performed for: lithocholic acid, deoxycholic acid, 5β-cholanoic acid, 3β-hydroxi-5β-cholanoic acid, henodeoxycholic acid, ursocholic acid and α-muricholic acid. Neural network model Multiple layer perceptron is derived, having 0.9259 training performances and 0.3673 test performances, training error 0.0073 and test error 0,1607. Model was tested for henodeoxycholic, ursocholic and α-muricholic acid, and internal validation of the model is performed.

CONCLUSIONS

Molecular docking suggested that the pharmacophore for maximizing the activity of BK(Ca) channels in the steroid skeleton of bile acids is the C3 quasi-axial α-OH group and the C24 carboxyl function. Derived neural network model successfully predicted activities of tested bile acids on Ca2+ activated K+ channels in smooth muscle cells.

The nation in context: How intergroup relations shape the discursive construction of identity continuity and discontinuity

The perceived collective continuity (PCC) of a national identity serves as a crucial source of stability and self-esteem for group members. Recent work has explored the consequences of perceived continuity when the meaning of a nation's past is seen in a negative light, and the challenges this brings for the negotiation of a positive identity in the present, signalling the potential value of perceived discontinuity The current paper extends this literature by examining the role of intergroup relations in the construction of both collective continuities and discontinuities. Through analysing the discursive management of national identity in nine focus groups in a post-conflict context (Serbia, N = 67), we reveal how the tensions between continuity and discontinuity are embedded within a broader discussion of the nation's relationship with relevant national outgroups across its history. The findings contribute to theoretical knowledge on the interlinking of national identity and PCC by illustrating the ways in which intergroup relations of the past shape the extent to which continuity is seen as desirable or undesirable. We argue that despite the psychological merits of collective continuity, discontinuity can become attractive and useful when there is limited space to challenge how a nation's history is remembered and the valence given to the past. The paper concludes by offering an account of how social and political contexts can influence the nature, functions, and valence of PCC within national identities.

Understanding the psychological appeal of populism

Psychology can play an important role in expanding our understanding of the demand-side of populism by revealing its underlying relational logic. Social psychological perspectives on populism are beginning to show how: 1) the division between us ('the good people') and them ('the corrupt elites'/'foreign others') taps into core intergroup dynamics, 2) economic and cultural processes are construed in terms of basic status concerns, and 3) collective emotions become mobilised through political communication. Taking these insights into consideration, we reflect on psychology's contribution to the study of populism thus far, and chart out an ambitious role for it at the heart of this interdisciplinary field.

Uses of the Past: History as a Resource for the Present

Collective memory has become an increasingly important topic in social and human sciences over the past thirty years. Beyond the interest for how we understand history, collective memory research has explored how the past has been used to defend certain understandings of the world (for instance nationalist ideologies), political actions (as in the case of intractable conflicts), or collective identities (particularly when they are seen as reflecting the historical 'essence' of a national group). That is, how the history is used as a resource for the present. However, theoretical conceptualisations have more directly focused on how collective memory is produced, and less so on how it is mobilised for the present. In this paper, we propose to review the main conceptualisation of collective memory in psychology - as social thinking, as social identity, and as sense-making - and how they more or less implicitly understand the relations between past and present. In a final section, we argue that representations of history have mainly been seen, in collective memory research, as a source of meaning for the present or as a way to position oneself in the current social field. In conclusion, we propose a third way of understanding the relations between past and present, considering collective memory to be both transformative of the present and prospective for the future.

Who are we and where are we Going: from Past Myths to Present Politics

Social groups, and the social identities which people develop as part of them, are often experienced as stable and continuous over time. Thus, countries experiencing rapid socio-political change often face the challenge of re-constructing the meaning of the social group to adapt to the demands of the present, while simultaneously making this re-construction appear as a natural progression of 'our' historical journey. In the present paper, I ask the question of how, in times of socio-political change, the past is used in the present, and the implications this has for how individuals represent their nation's future. Drawing on Serbia and its political movement towards EU integration, the present article illustrates how developed and legitimized historical narratives, linked to the myth of origin of a nation, become utilized to frame present challenges. In doing so, it allows for uncertainties in the present to become anchored in established historical narratives, which in turn have consequences for which political actions are deemed acceptable and legitimate for the future.

Diagnostic value of biohumoral markers of necrosis and inflammation in patients with right ventricular myocardial infarction

INTRODUCTION/AIM

Patients with right ventricular myocardial infarction (RVMI) and patients with left ventricular myocardial infarction (LVMI) of the anterior wall with ST-elevation (STEMI), due to the profundity and volume of the necrosis, tend to have a more severe and more complicated clinical outcome as well as a higher mortality level compared to patients with myocardial infarction of inferoposterior localization in the left ventricle (IPILK), without the right ventricle being overtaken. C-Reactive protein (CRP) is a sensitive and reliable indicator of acute inflammation and is in good correlation with creatin kinasis (CK) or the enzymes which indicate necrosis markers in acute myocardial infarction (AIM). Because of this, a common biohumoral answer is of greater importance and more reliable both diagnostically and prognostically; it signifies a more severe and more complicated clinical outcome, especially on the rupture of the myocardium. The main goal of this study was to compare the maximum values of enzymes and CRP in patients with RVMI and LVMI who had first STEMI and who were in the acute phase treated with percutaneous transluminal coronary angioplasty (PTCA).

METHODS

During a six-year period (2000-05), in the Clinic for Urgent Internal Medicine at the Military Medical Academy, a total of 74 patients included in a prospective study were divided into two groups. The first group consisted of patients with RMI 19 (25.67%), and the second group of patients with LMI 55 (74.33%). The patients in both groups received a percutaneous coronary intervention (PCI), if they had been admitted in the first 4 hrs from the beginning of the chest pain, and if there were no contraindications. All the others received thrombolitic therapy, and a "rescue" PCI if needed, in the next 24-48 hours. The risk factors, clinical outcome, necrosis and inflammation biomarkers (enzymes and CRP), coronary status, restenosis of stent, and intra-hospital mortality rate in the first month, as well as a long term prognosis over a period of one year, were analysed.

RESULTS

The average age of the patients in the group with RVMI 19 (7 m + 12 f) was 66.1 +/- 11y, and in the group with LVMI 55 (45 m + 10 f) 59.6 +/-13y, with a statistical trend which indicated that the patients with RVMI were older (66.1 +/- 11y vs. 59.6 +/- 13y, p < 0.061) and that women dominated (63.1% vs. 18.8%, p < 0.001). No statistical differences were found between the two groups of patients concerning the length and the appearance of the chest pain before admission to the hospital and the beginning of the PCI treatment, as well as risk factors such as smoking, cholesterol or diabetes. Of the total of 74 patients with the first STEMI as a primary manifestation of a coronary disease, we performed a primary PCI on 58 (78.37%), and a "rescue" PCI on 16 (21.63%) after the thrombolitic therapy during the 24-48h after admission. We had no cases of death either during the primary or the delayed PCI, or in the next 24h following the intervention. During the hospital phase of treatment, in the group with RMI the causes of death were the rupture of the free wall of the right ventricle (1), acute pancreatitis (1), ARDS and hypostatic pneumonia (1), cerebrovascular insult (1). During the following year, one more patient died due to reinfarction of the anterior localization. In the group with LMI, during the hospital phase of treatment 5 (9.09%) patients died: reinfarction (2), rupture of the left ventricle (1), respiratory insufficiency and severe hypostatic pneumonia (1), cerebrovascular insult (1). During the following year, 4 more patients died, sudden death (2), ischemic dilatative cardiomyopathy (2). The total mortality rate over a one-year period of observation in the group with LMI was 9 (16.3%), and in the group with RMI 5 (26.3%). Radionuclide ventriculography (RNV) was performed in the acute phase of myocardial infarction from 7-14 days after PCI and after 6 months in both groups as an independent indicator of the ejection fraction (EF) of both ventricles. The given results show that a statistically proven significant difference exists in the recovery of the right ventricle in acute phase RMI (49.1 +/- 7.9 vs. 35.4 +/- 10, p< 0.001), as well as after 6 months (49.2 +/- 9.7 vs. 38.3 +/- 11.2, p < 0.010) in patients with RMI.

CONCLUSION

Primary PCI should be done whenever it is possible with all patients who have a great volume and depth of necrosis, especially if that is the first manifestation of a coronary disease and the first acute STEMI, as were all of our patients in both groups. Our results show that older patients with RMI, and dominantly women, have a more severe and more complicated clinical outcome in the acute phase of RMI compared to patients with LMI of the anterior wall. In the longer prognosis of this case, they have a quicker and a more complete recovery of the right ventricle due to which they have a better immediate and long term prognosis, but demand careful overseeing and energetic treatment in the acute phase of the myocardial infarction, especially considering that their treatment is often specific compared to patients with an infarction of the left ventricle.

In vivo modulation of the splenocyte yield and composition by female sex steroid hormones

The study was designed to shed more light on the controversial role of the two main ovarian steroid hormones (i.e. estradiol and progesterone) in shaping the size and phenotypic characteristics of the splenic lymphocyte pool. For this purpose ovariectomized adult rats (OVX) were treated for 14 subsequent days with either estradiol or progesterone (to attain physiological concentrations of the hormones). Afterwards, the splenocyte yield, and overall number of splenocytes bearing TCR alpha beta receptor, CD4 and CD8 coreceptor were evaluated. Fourteen-day-long ovarian hormone deprivation produced an increase in the splenic weight and splenocyte yield (on the account of a rise in the number of TCR alpha beta- cells), although the number of TCR alpha beta+ cells was reduced as a result of a decrease in the size of the CD4+ cell subpopulation. Replacement of either estradiol or progesterone prevented the increase in splenic weight and reduced the splenocyte yield to values significantly lower than that in sham-OVX rats. Both the treatments completely abolished the effect of ovariectomy on the size of TCR alpha beta- cell population, but had differential effects on that of TCR alpha beta+ cell population; estradiol did not affect its size, while progesterone caused a reduction on the account of a decrease in the numbers of both CD4+ and CD8+ cells. The results suggest that: a) estradiol and progesterone have similar effects on the size of the splenic B cell population and that replacement of either estradiol or progesterone can prevent the effects of ovariectomy on the size of this population and b) estradiol does not affect while progesterone reduces the size of splenic T cell population. Thus, replacement of none of them is able to compensate the removal of gonads.

In vivo modulation of the distribution of thymocyte subsets by female sex steroid hormones

This study examined the effects of the principal ovarian steroids, 17 beta-estradiol (E) and progesterone (P), on the thymic structure and on the intrathymic development of T-cells. Adult female rats were ovariectomized (OVX) and treated for 14 days with physiological doses of either E or P; controls received an equivalent volume of vehicle. Ovariectomy produced a marked increase (vs. sham-operated controls) in thymus weight, which was associated with an increase in the volume and cellularity of both the medulla and cortex. Treatment of OVX rats with E reduced the thymic weight to value, which was significantly lower than that of sham-operated controls decreasing the volume of cortex below level in sham-OVX rats, and reversing the effect of ovariectomy on the volume of medulla. P only prevented the increases in thymus weight and cortical volume induced by OVX. However, unlike E, it had no discernable effect on the medullary volume. E treatment reduced the cellularity of the cortex and medulla to values, which were lower than those of sham-OVX rats, while P only reversed the effects of OVX on the cellularity of both the compartments. Ovariectomy also had a profound effect on the thymocyte profile, increasing the proportion of CD4+8+TCR alpha beta- cells and producing a corresponding decrease in the relative proportions of all TCR alpha beta high cell subsets. The decrease in the latter was opposed by treatment with E or P. However, the sensitivity of the less mature cells (except CD4-8-TCR alpha beta-, the percentage of which was reduced by both hormones) to the two hormones differed. E reduced the relative proportion of CD4-8+TCR alpha beta-, CD4-8+TCR alpha beta low and CD4+8+TCR alpha beta- cells, while P increased the percentage of CD4-8+TCR alpha beta low cells. The results suggest that E and P affect both the lymphoid and nonlymphoid compartments of the thymus, and that while P increases the volume of the nonlymphoid component of the medulla, E has the opposite effect. The finding that ovariectomy decreased while E and P increased the relative proportion of the most mature thymocytes, which include CD4-8-TCR alpha beta high cells that are believed to harbour potentially autoreactive cell clones, is particularly interesting and may relate to the high propensity of autoimmune diseases in females.

Lipid peroxidation intensity and lipid status parameters in the estimation of the severity of ischemic heart disease

Atherosclerotic changes on the coronary arteries are the basis of the ischemic heart disease. It is assumed that the initial changes in this process occur as a consequence of the lipid peroxidation in the vessel wall. We estimated this process through the level of malondialdehyde (MDA) in the serum of 86 patients in whom selective coronary angiography was done for the suspected ischemic heart disease. According to the number of the stenotic coronary arteries (stenosis greater than 50%), we divided the patients into four groups: the control group with normal coronary angiography finding, simple, double or triple vessel coronary disease. In all the patients we also estimated the other parameters of the lipid status (cholesterol, triglycerides, LDL, HDL, Apo-AI, Apo B) and atherogenic indices Apo-AI/Apo B, LDL/HDL and HDL/total cholesterol. No significant changes were observed in the lipid parameters between the control and experimental group. However, mean MDA level in the whole experimental group was 3.89 mumol/L, 3.93 mumol/L in triple vessel coronary disease, 3.83 mumol/L in double vessel and 3.92 mumol/L in single vessel disease group. The difference between all the experimental and the control group was highly significant (p < 0.001). We concluded that the level of MDA--lipid peroxidation index had the better correlation with the disease status than the other parameters of lipid status and the sensitive atherogenic indices.

Pituitary adenomas secreting large amounts of prolactin may give false low values in immunoradiometric assays. The hook effect

Immunoradiometric assay (IRMA) for serum prolactin (PRL) measurement can give falsely low values, leading to unnecessary surgery in patients with prolactinomas. We studied clinical and biochemical features of patients with pituitary macroprolactinomas in whom plasma PRL levels had been underestimated due to the so-called "high dose PRL hook effect". This phenomenon was observed in four (14.2%) out of 28 patients with pituitary macroadenomas (13 macroadenomas) and 15 non-functioning macroadenomas) reffer during one-year period. Undiluted median (range) PRL levels were 11.3 (3.0-48.7), 983.9 (194.4-1959.4), and 96.9 (66.6-147.7) micrograms/l in patients with non-functioning macroadenomas, macroprolactinomas and the hook effect adenomas, respectively. In all patients assay was performed after serum dilution, and only in patients with the hook effect the median PRL levels increased significantly to 5795.0 (2097.2-12722.2) micrograms/l. The mean age at diagnosis was 38 +/- 6.5, 45 +/- 6, and 53 +/- 3 yr, for the patients with the hook effect, macroprolactinoma and non-functioning adenoma, respectively. Males were predominant (75%) in the hook effect adenoma group. Patients with the hook effect macroprolactinomas were all treated successfully with dopamine agonists, and all patients had significant shrinkage of the tumor mass (more than 50% shrinkage). In conclusion, this study suggests that patients with high dose PRL hook effect are generally younger, more frequently males with very large pituitary adenomas (grade III-IV according to Hardy). It is necessary, whenever performing IRMA for serum prolactin measurement, to dilute samples routinely (1:1 and 1:10 dilutions) in every patient with pituitary tumor.

Differential effects of gonadectomy on the thymocyte phenotypic profile in male and female rats

As an organ responsible for generation of T-cell repertoire the thymus occupies a central position in establishment of mature immune response. To assess the potential role of the gonadal steroids in development and maintenance of immunological sexual dimorphism, the effects of gonadectomy pre- and postpuberty on the thymocyte profile of male and female rats were examined. Rats aged 30 days or 75 days were gonadectomized; 30 days later the thymic cellularity was estimated and the expression of the cell surface antigens (CD4 and CD8) and the T-cell receptor (TCR) alpha beta was analyzed by flow cytometry. Regardless of age at surgery, the thymus weight and total thymocyte yield were greater in sham-operated males than females; this sexual dimorphism in thymic cellularity persisted after gonadectomy. Sexual dimorphism in the composition of thymocyte subsets was also evident in sham-operated rats, with males expressing a higher percentage of CD4-8- cells, and remained after gonadectomy of adult rats. In male rats, gonadectomy at day 75 increased the percentage of CD4+8- single-positive and TCR alpha beta + cells. In contrast, in females, ovariectomy decreased the percentages of CD4+8- single-positive, CD4-CD8- double-negative, and TCR alpha beta + cells and increased the percentage of CD4+CD8+ double-positive cells. In the immature rats gonadectomy increased the percentages of CD4+CD8- single-positive and TCR alpha beta + thymocytes and decreased the percentages of double-positive and double-negative cells in males, while in the female it increased the percentage of CD4+8- single-positive thymocytes. Gonadectomy at that age abolished the sexual dimorphism in the expression of accessory molecules (i.e., CD4/CD8), but facilitated gender-specific expression of TCR alpha beta. In conclusion, the results suggest that the gonadal steroids are more important for the development than for the maintenance of the sexual dimorphism in the thymocyte composition.