Rory C. O'Connor

Self-harm and suicide in adolescents

Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs.

Subjective experience and the attentional lapse: Task engagement and disengagement during sustained attention

Three experiments investigated the relationship between subjective experience and attentional lapses during sustained attention. These experiments employed two measures of subjective experience (thought probes and questionnaires) to examine how differences in awareness correspond to variations in both task performance (reaction time and errors) and psycho-physiological measures (heart rate and galvanic skin response). This series of experiments examine these phenomena during the Sustained Attention to Response Task (SART, Robertson, Manly, Adrade, Baddeley, & Yiend, 1997). The results suggest we can dissociate between two components of subjective experience during sustained attention: (A) task unrelated thought which corresponds to an absent minded disengagement from the task and (B) a pre-occupation with ones task performance that seems to be best conceptualised as a strategic attempt to deploy attentional resources in response to a perception of environmental demands which exceed ones ability to perform the task. The implications of these findings for our understanding of how awareness is maintained on task relevant material during periods of sustained attention are discussed.

The psychology of suicidal behaviour

The causes of suicidal behaviour are not fully understood; however, this behaviour clearly results from the complex interaction of many factors. Although many risk factors have been identified, they mostly do not account for why people try to end their lives. In this Review, we describe key recent developments in theoretical, clinical, and empirical psychological science about the emergence of suicidal thoughts and behaviours, and emphasise the central importance of psychological factors. Personality and individual differences, cognitive factors, social aspects, and negative life events are key contributors to suicidal behaviour. Most people struggling with suicidal thoughts and behaviours do not receive treatment. Some evidence suggests that different forms of cognitive and behavioural therapies can reduce the risk of suicide reattempt, but hardly any evidence about factors that protect against suicide is available. The development of innovative psychological and psychosocial treatments needs urgent attention.

Self-harm in adolescents: self-report survey in schools in Scotland

BACKGROUND The suicide rate in Scotland is twice as high as that in England. However, the prevalence of self-harm is unknown. AIMS To determine the prevalence of self-harm in adolescents in Scotland and the factors associated with it. METHOD A total of 2008 pupils aged 15-16 years completed an anonymous lifestyle and coping survey. Information was obtained on demographic characteristics, lifestyle, life events and problems, social influences, psychological variables and self-harm. RESULTS Self-harm was reported by 13.8% of the respondents. The majority (71%) of those who had self-harmed had done so in the past 12 months and girls were approximately 3.4 times more likely to report self-harm than boys. In multivariate analyses, smoking, bullying, worries about sexual orientation, self-harm by family and anxiety were associated with self-harm in both genders. In addition, drug use, physical abuse, serious boy/girlfriend problems, self-harm by friends and low levels of optimism were also associated with self-harm in girls. CONCLUSIONS Despite markedly different national suicide rates, the prevalence of self-harm in Scotland is similar to that in England with girls at least three times more likely to report self-harm than boys. The findings suggest a role for emotional literacy programmes in schools and highlight the importance of promoting positive mental health among adolescents.

Mind-wandering and dysphoria.

Mind-wandering shares a number of important similarities with thinking in depression. This experiment examines whether mind-wandering provides a useful marker of cognition in dysphoria during a word learning task. Dysphoria was associated with more accessible mind-wandering when attempting to encode verbal items. In addition, in the dysphoric population, periods when the mind wandered led to greater decoupling from task-relevant processing as indexed by slower response times, and greater physiological arousal, as indexed by faster heart rates. In the general population, periods of mind-wandering when attempting to encode information were associated with poor retrieval and high skin conductance. Finally, the extent to which mind-wandering was associated with poor retrieval was associated with an individuals’ latency to retrieve specific autobiographical memories from outside the laboratory. These results provide strong evidence for the utility of mind-wandering as a marker for depressive thinking and suggest a number of important implications for therapy for depression.

Perceived Discrimination and Psychological Distress: The Role of Personal and Ethnic Self-Esteem

The present study aimed to draw on 2 theoretical models to examine the relationship between perceived ethnic discrimination and psychological distress in a sample of ethnic minority young people (N=154). Analysis provided no support for the hypothesis derived from the self-esteem theory of depression that self-esteem (personal and ethnic) moderates the discrimination-distress relationship. There was, however, partial support for a mediating role of self-esteem, as predicted by the transactional model of stress and coping. This mediational relationship was moderated by gender, such that both forms of self-esteem exerted a mediating role among men but not women. The authors consider the implications of their findings for theory and future research examining the consequences of discrimination on psychological well-being.

Predicting hopelessness and psychological distress: The role of perfectionism and coping

This study investigated an integrative model involving the relationship between perfectionism (P. L. Hewitt & G. L. Flett, 1991) and coping (C. S. Carver, A F. Scheier. & J. K. Weintraub, 1989) to predict changes in hopelessness and general psychological distress among college students. Results indicated that changes in psychological well-being (4-5 weeks later) were predicted by socially prescribed perfectionism, and, as theorized, avoidance coping moderated the link between perfectionism and psychological well-being beyond initial levels of distress. Support was also found for the adaptive effects of cognitive reconstruction coping and other-oriented perfectionism, whereas, under certain conditions, self-oriented perfectionism was shown to be maladaptive. These findings offer support for the proposed model. Implications for intervention and suggestions for future research are discussed.

The Integrated Motivational‐Volitional Model of Suicidal Behavior

This chapter describes the Integrated Motivational‐Volitional (IMV) model of suicidal behavior, which accounts for the complex interplay between biology, psychology, and social factors in the etiology and course of suicidal behavior. The IMV model builds on the empirical and conceptual evidence from other models and perspectives and is able to make differential predictions in respect of suicidal ideation/intent and behavior. Although the development of the IMV model was influenced by a number of different models, the main drivers were the Theory of Planned Behavior, the diathesis–stress hypothesis, and the arrested flight model of suicidal behavior. As suicidology has been dominated by the search for risk factors since its inception, greater emphasis should also be given to the further identification and promotion of protective factors. Indeed, the IMV model identifies three stages along the motivational‐volitional pathway for potential intervention, not to mention numerous opportunities to ameliorate risk in the premotivational phase.

Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy?

Non-suicidal self-injury (NSSI) is a term that is becoming popular especially in North America and it has been proposed as a new diagnosis in DSM-5. In this paper we consider what self-harm research can tell us about the concept of NSSI and examine the potential pitfalls of introducing NSSI into clinical practice.

The Relations between Perfectionism and Suicidality: A Systematic Review

Since the 1980s, there has been a 300 percent increase in the number of published papers on perfectionism. Given the inconsistent findings in the literature, this systematic review examines, for the first time, the nature of the relationship between perfectionism and suicidality. To this end, the three main psychological and medical databases (PsychInfo 1887-May 2006, Medline 1966-May 2006 and Web of Knowledge 1981-May 2006) were searched. Twenty nine papers of perfectionism and suicidality were found. There is considerable evidence that selfcritical evaluative concerns perfectionism (i.e., socially prescribed perfectionism, self-criticism, concern about mistakes, and doubts about action) is correlated with suicidality. The methodological implications for future research are examined. In addition, the clinical implications for treatment and how these findings relate to the current conceptual debate on the nature of perfectionism are discussed.