Occurrence Of Suicide Research Articles

Seasonal Variation of Suicide in the City of São Paulo, Brazil, 1996–2010

In light of the few reports from intertropical latitudes and their conflicting results, we aimed to replicate and update the investigation of seasonal patterns of suicide occurrences in the city of São Paulo, Brazil. Data relating to male and female suicides were extracted from the Mortality Information Enhancement Program (PRO-AIM), the official health statistics of the municipality of São Paulo. Seasonality was assessed by studying distribution of suicides over time using cosinor analyses. There were 6,916 registered suicides (76.7% men), with an average of 39.0 ± 7.0 observed suicides per month. For the total sample and for both sexes, cosinor analysis estimated a significant seasonal pattern. For the total sample and for males suicide peaked in November (late spring) with a trough in May-June (late autumn). For females, the estimated peak occurred in January, and the trough in June-July. A seasonal pattern of suicides was found for both males and females, peaking in spring/summer and dipping in fall/winter. The scarcity of reports from intertropical latitudes warrants promoting more studies in this area.

Genetic and familial environmental effects on suicide--an adoption study of siblings.

BackgroundWhile there is clear evidence of familial influences on suicide, the origin of these is less certain. We have investigated genetic and familial environmental factors by studying the occurrence of suicide in biological and adoptive siblings of adoptees who died by suicide compared to siblings of surviving adoptees.MethodWe used the Danish Adoption Register and Danish population registers to compare 221 siblings of adoptees who died by suicide with the siblings of 1,903 adoptees who did not die by suicide. All adoptions in the Danish Adoption Register are non-familial, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses were conducted on incidence rates of suicide in biological and adoptive siblings given occurrence of suicide in the adoptees while also taking into account psychiatric disorders.ResultsThe risk of suicide in full siblings of adoptees who died by suicide before age 60 years was significantly higher than in full siblings of adoptees who had not died by suicide (incidence rate ratios (IRR) = 5.01; 95% confidence interval [CI] = 1.28 - 19.6). This increase persisted after adjustment for history of psychiatric admission of siblings (IRR = 4.19; 95% CI = 1.00 - 17.5).ConclusionsGenetic factors influence risk of suicide, probably independently of psychiatric disorder. This is relevant in provision of advice to families, including possible prevention of suicide.

High rate of suicide attempt and associated psychological traits in an isolated tribal population of North-East India

Background: Cases of suicide documented earlier all over the world reflect the presence of suicide behavior in primitive world at a higher rate compared to general urban population. The cause of such behavior is thought to be different among tribes and mental health was rarely presumed to be associated. In India, several ethnographic narratives described instances of suicides among several tribes, but evaluation of psychological traits were lacking. The present study on Idu Mishmi is an attempt to further validate earlier report of high rate of suicides among them and to evaluate psychological traits. MethodsInterview and administration of Patient Health Questionnaire (PHQ) on 218 individuals comprised the data. Bi-variate analyses and linear multiple regression were done to evaluate psychological traits in suicide behavior. ResultsIn the Idu Mishmi Population suicide attempt (14.22%) was higher than urban population in general (0.4–4.2%) and females were at higher risk. Depression (8.26%) was comparable with earlier reports, whereas anxiety syndrome (6.42%), alcohol abuse (36.24%) and eating disorder like Binge eating (6.42%), Bulimia nervosa (1.38%) were also recorded in the population. LimitationsAbsence of psychiatry clinic and mechanism of recording suicide occurrences in remote tribal area is the basic limitation of the study. ConclusionDepression and gender turned out to be significant determinants of suicide attempt in the studied population, whereas alcohol abuse was not a significant factor.

Suicide among Polish Officers during World War II in Oflag II–C Woldenberg

Although scholars have examined the occurrence of suicide in the concentration camps during World War Two, little has appeared on suicide in prisoner-of-war camps. The present note presents an attempt to document the occurrence of suicide in the Oflag II-C Woldenberg camp in what is now Western Poland, and estimates a suicide rate of between 22.4 to 38.4 per 100,000 per year in the roughly 6,600 prisoners.

Suicide and fatal single occupant motor vehicle collisions

Factors that influence choice of methods of suicide include availability of the material or device that is being used. Certain drivers utilise motor vehicles to deliberately self-harm, although ascertaining what percentage of these deaths were intentional is difficult. The files of Forensic Science South Australia in Adelaide, Australia were examined over a 5-year period from January 2005 to December 2009 for cases of fatal single occupant, single motor vehicle collisions involving impacts with trees, and for comparison, all cases of suicide. Tree impacts were selected as these represented the largest group of clearly defined single motor vehicle and solid object impacts. A total of 73 cases were identified, with those aged 17–24 years accounting for the highest proportion of deaths, compared with suicide victims who were predominately aged 25–39 years. Suicides showed little seasonal variation in incidence whereas more fatal collisions occurred in winter. A significant number of the drivers had ingested alcohol. The lack of a seasonal similarity in the occurrence of fatal collisions and suicides, and differences in the most common ages would be supportive of these groups being aetiologically different. Other factors in favour of these crashes not being intentional include intoxication and winter conditions.

Eco-evolutionary feedbacks, adaptive dynamics and evolutionary rescue theory

Adaptive dynamics theory has been devised to account for feedbacks between ecological and evolutionary processes. Doing so opens new dimensions to and raises new challenges about evolutionary rescue. Adaptive dynamics theory predicts that successive trait substitutions driven by eco-evolutionary feedbacks can gradually erode population size or growth rate, thus potentially raising the extinction risk. Even a single trait substitution can suffice to degrade population viability drastically at once and cause 'evolutionary suicide'. In a changing environment, a population may track a viable evolutionary attractor that leads to evolutionary suicide, a phenomenon called 'evolutionary trapping'. Evolutionary trapping and suicide are commonly observed in adaptive dynamics models in which the smooth variation of traits causes catastrophic changes in ecological state. In the face of trapping and suicide, evolutionary rescue requires that the population overcome evolutionary threats generated by the adaptive process itself. Evolutionary repellors play an important role in determining how variation in environmental conditions correlates with the occurrence of evolutionary trapping and suicide, and what evolutionary pathways rescue may follow. In contrast with standard predictions of evolutionary rescue theory, low genetic variation may attenuate the threat of evolutionary suicide and small population sizes may facilitate escape from evolutionary traps.

Internet suicide: Communities of affirmation and the lethality of communication

As a tool of instant information dissemination and social networking, the Internet has made possible the formation and affirmation of public identities based on personality traits that are usually characterized by clinicians as pathological. The wide variety of online communities of affirmation reveals new conditions for permissiveness and inclusiveness in expressions of these socially marginal and clinically pathologized identities. Much the same kind of discourse common to these online communities is evident in some suicide forums. Web sites with suicide as their central raison d'être, taken together, encompass a wide range of ideas and commitments, including many that provide collective affirmation outside of (and often with hostility toward) professional intervention. The paradox of a potentially life-affirming effect of such forums runs counter to a stark dualism between online therapy versus "prochoice" forums and, by extension, to simple models of the influence of ideas on the lethality of suicide. Different forums either intensify or mitigate self-destructive tendencies in ways that are significant for understanding the place of communication in the occurrence of suicide and for therapeutic practice.

Effect of subthalamic deep brain stimulation on non-motor fluctuations in Parkinson’s disease

The non-motor consequences of subthalamic stimulation are largely questioned. Cognition, motivation, anxiety, depression and even occurrence of suicides have been considered as a potential consequence of the surgical intervention. Non-motor fluctuations are present in all the patients with motor fluctuations and may sometimes be even more invalidating. Interestingly, subthalamic deep brain stimulation alleviates non-motor fluctuations allowing strikingly successful effects on sensory, dysautonomic and cognitive fluctuations while psychic fluctuations respond less consistently to this treatment. Nevertheless, severe mood fluctuations, oscillating from Off dysphoria to ON hypomania, are frequently associated with addictive behaviors and improve dramatically after subthalamic stimulation. This may be a further argument to support the indication of surgery for these patients.

Thresholds of Meaning: Passage, Ritual, and Liminality in Contemporary French Narrative (review)

Reviewed by: Thresholds of Meaning: Passage, Ritual, and Liminality in Contemporary French Narrative Rebecca Loescher (bio) Jean H. Duffy . Thresholds of Meaning: Passage, Ritual, and Liminality in Contemporary French Narrative. Liverpool: Liverpool UP, 2011. In Thresholds of Meaning, Jean H. Duffy proposes an original and insightful reading of contemporary French narrative, challenging some critics' recent accusations of a "current 'crisis' or even decline of the French novel" (1). Citing the difficulty of delineating a cohesive taxonomy of twentieth-century literary groups, rather than insist on a formal continuity, she seeks to highlight the thematic affinities that exist both among contemporary French authors and between this new generation and their nouveau roman predecessors. In effect, Duffy chooses to focus on the works of Pierre Bergounioux, François [End Page 969] Bon, Marie Darrieussecq, Hélène Lenoir, Laurent Mauvignier, and Jean Rouaud, in which one "particular thematic nexus" appears, that of a "shared preoccupation" with the "processes of meaning-production," both in textual content and linguistic form (18). Although the focus of her study is not of a comparative nature (the attention she draws to the similarities between these works and the nouveau roman takes place largely within the notes), Duffy contends that this mise en scène of the "processes by which man extracts meaning from and imposes meaning on his experience" is of "fundamental importance" to both generations of writers (17). Furthermore, she underscores the role of passage ("those changes of place, state, occupation, social position and age" 18) and of the ritual activities associated with liminality in these operations of meaning production, for they continually pit the individual against his or her larger social group and its communicative and behavioral codes. Accordingly, Duffy frequently but perceptively turns to social theories pertaining to the negotiation of meaning inherent in ritual, liminality, and rites of passage, particularly the works of Arnold van Gannep, Victor Turner, and Ronald Grimes. In the first chapter of her study, Duffy focuses on passage and liminality during moments of life crisis in Darrieussecq's Le Mal de mer, Lenoir's Le Répit, and Mauvignier's Appendre à finir, where "illness or injury is inextricably bound up with the account of marital breakdown" (32). She posits that these three texts constitute various forms of the "illness narrative," a notion recently developed by medical research referring to the salubrious creation of "new meanings" and of a "new cohesive self" for the ill, as well as supportive networks, via the interruption of normal routines and relations and the "impairment of [the subject's] [ . . . ] sense of identity" (30). In addition to illustrating the physical and marital in-between states, each text examined "engage[s] with a range of ritual activities" which structure the total experience (32). It is only from within the marginal position of illness or injury that each of the novels' protagonists is able to face and contend with their respective conjugal relationships, accomplishing the ritualistic activities (such as passing through thresholds—in both concrete and abstract terms—and partaking in or preparing festive meals) that both structure that experience and allow for eventual release from the liminal state. The second chapter of Duffy's inquiry centers on the destabilization of "traditional frames of reference" and "sense of identity" following the occurrence of suicide within the social circles that figure in Bon's L'Enterrement, Mauvignier's Loin d'eux, and Bergounioux's La Maison rose (20). Following a long history of social, religious, and legal interdictions and taboos, Duffy argues that acts of suicide continue to be "seen as a threat to social cohesion," striking at the "heart of the notion of social solidarity" (75), and, accordingly, represent for each of the novels' protagonists more an "abortion of the normal passage from youth to maturity" than a "family calamity" (76). Because these texts expose the "issue of suicide primarily through the impact it has on a given community" Duffy focalizes chiefly on the intersubjective, communicative, [End Page 970] and ritualistic management of the transgression by each group of proches, relying notably on Erving Goffman's notion of facework and David Le Breton's development on formalized uses of silence (77). In effect, the thwarted passage to...

Injury Prevention and Care : An Important Public Health Agenda for Health, Survival and Safety of Children

Injuries affect the lives of thousands of young people and their families each year in India. With the gradual decline of communicable and nutritional diseases, injuries will be a leading cause of mortality, morbidity and disabilities and the success achieved so far in child health and survival is in jeopardy. Available data indicate that among children less than 18 y, 10-15 % of deaths, 20-30 % of hospital registrations and 20 % of disabilities are due to injuries. Based on available data, it is estimated that injuries result in death of nearly 1, 00,000 children every year in India and hospitalisations among 2 million children. Road Traffic Injuries (RTI's), drowning, falls, burns and poisoning are leading injury causes in India. Drowning and burns are major causes of mortality in less than 5 y, while RTIs, falls and poisoning are leading causes in 5-18 y. A shift in the occurrence of suicides to younger age groups of 15-20 y is a matter of serious concern in recent years. More number of males, those in rural areas, and majority of poor income households are affected due to injuries.Child injuries are predictable and preventable. Children have limitations of size, development, vision, hearing and risk perceptions as compared to adults and hence are more susceptible and vulnerable to injuries. Thus, it is important to make products and home - road and school environments safer along with greater supervision by parents and care givers. The key approaches include vehicle and product safety, environmental modification, legislation and enforcement, education and skills development along with availability of quality trauma care. Child injury prevention and care requires good quality data, building human and financial resources, strengthening policies and programmes based on evidence and integrated implementation of countermeasures along with monitoring and evaluation. Child injury prevention and control is crucial and should be an integral part of child health and survival.

Suicide Deaths and Nonfatal Hospital Admissions for Deliberate Self-Harm in the United States

Background: No one knows whether the temporality of nonfatal deliberate self-harm in the United States mirrors the temporality of suicide deaths. Aims: To analyze day- and month-specific variation in population rates for suicide fatalities and, separately, for hospital admissions for nonfatal deliberate self-harm. Methods: For 12 states, we extracted vital statistics data on all suicides (n = 11,429) and hospital discharge data on all nonfatal deliberate self-harm admissions (n = 60,870) occurring in 1997. We used multinomial logistic regression to analyze the significance of day-to-day and month-to-month variations in the occurrence of suicides and nonfatal deliberate self-harm admissions. Results: Both fatal and nonfatal events had a 6%–10% excess occurrence on Monday and Tuesday and were 5%–13% less likely to occur on Saturdays (p < .05). Males were more likely than females to act on Wednesdays and Saturdays. Nonfatal admission rates were 6% above the average in April and May (p < .05). In contrast, suicide rates were 6% above the average in February and March and 8% below it in November (p < .05). Conclusions: Suicides and nonfatal hospital admissions for deliberate self-harm have peaks and troughs on the same days in the United States. In contrast, the monthly patterns for these fatal and nonfatal events are not congruent.

Sleep, Serotonin, and Suicide

The author hypothesizes that sleep loss associated with a decrease in serotonergic activity plays a significant role in attempted suicide. Recent research has emphasized the role of the economic recession on the occurrence of suicide, but with no attention paid to possible biological aspects. In this brief review, the association between sleep, the serotonergic system, and suicide is initially introduced. Then, with consideration of recent research, a hypothesis regarding the oc- currence of suicide is proposed. Finally, based on that hypothesis, three factors possibly germane to reducing suicides (sufficient sleep duration, activation of the serotonergic system, and activation of the prefrontal cortex) are discussed.

How can we Pinpoint Genetic Involvement in Antidepressant-Induced Suicide?

During the early 1990s, emergence of patients’ suicide receiving antidepressant, especially in children was reported [1]. By enter into this millennium, the US and European regulatory agencies began implementing verification programs to assess the influence on suicidal behavior from the use of antidepressants such as SSRIs [2-4], drug’s safety in patients has renewed as a criteria indispensable for approving or withdrawing a new drug. Just following this dilemma, we hypothesized that human’s genetic makeup might affect the occurrence of suicide in patients receiving antidepressants [5]. Now many reports support the argument that human’s genetic makeup also decides antidepressant-induced suicide [6,7]. The question is how to pinpoint genetic involvement in antidepressant-induced suicide. There are many controversial in solving this technical problem.

대학생의 자기통제력, 스트레스, 외로움 및 자살시도의 상관관계

본 연구의 목적은 대학생의 자기통제력, 스트레스, 외로움 및 자살시도의 상관관계를 알아보고 자살시도 예방을 위한 기초자료를 제공하고자 시도되었다. 본 연구의 대상자는 1,253명의 대학생이다. 수집된 자료는 SPSS 17.0 Program으로 기술통계, <TEX>$x^2$</TEX>-test, t-test, Pearson correlation coefficient, Stepwise multiple regression으로 통계 처리 하였다. 자살시도를 한 정도는 대학생의 13.6%로 나타났고, 자기통제, 인터넷 중독, 스트레스, 자기 효능감, 불안, 외로움의 점수는 각각 69.9점, 42.5점, 86.4점, 48.2점, 46.2점, 40.1점 이었다. 자살시도는 성별, 종교, 부모 생존, 가족의 경제적 상태, 주거형태, 교우관계, 운동, 음주, 외로움, 상태불안, 스트레스, 자기통제력 그리고 인터넷 중독에 따라 유의한 차이가 있었다. 자살시도의 영향요인은 부모생존, 인터넷 중독, 성별, 운동 그리고 외로움으로 나타났고, 변수의 설명력은 5.5%를 차지하였다. 본 연구는 대학생에 대한 자살예방 프로그램과 조기 선별검사를 실시하여 대학생의 자살시도의 예방을 제안 한다. 향후 대학생의 자살시도에 영향을 미치는 다양한 변인들을 규명하는 후속연구가 필요하다. The purpose of this study was to investigate the relationship self-control, stress, loneliness among University Students, to provide the basic data for prevention of suicide occurrence. Methods: The subjects of this study were 1,253 university students. The collected data was analyzed using descriptive statistics, <TEX>$x^2$</TEX>-test, t-test, Pearson correlation coefficient and stepwise multiple regression with SPSS 17.0 Program. Results: The degree of the suicide attempt was 13.6%. The reported scores for self-control, internet addiction, stress, self-efficacy, anxiety, loneliness were 69.9, 42.5, 86.4, 48.2, 46.2, 40.1, respectively. The degree of suicide attempt was significantly different according gender, religion, parents status, family economic status, living, friendship, exercise, alcohol drinking, loneliness, state anxiety, stress, self-control, and internet addiction. The influential factors affecting suicide attempt were parents status, internet addiction, gender, exercise, and loneliness, which explained about 5.5% of the variance. Conclusions: These result suggest that earlier screening and suicide prevention programs for university students will be helpful in preventing suicide attempt. Future studies need to be pursued to find various variances for suicide attempt for university students.

Prevalence and correlates of suicidal ideation in SLE inpatients: Chinese experience

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs. Because of double damages of body and mind, SLE patients are in a potential risk of suicide. Many factors may contribute to the occurrence of suicide in SLE: socioeconomic factors, medical factors, mental health, family support and coping style. This study aims to investigate the prevalence and correlates of suicidal ideation in SLE inpatients in China in order to determine whether they had risk of suicide, and if so, what factors should be paid more attention to prevent suicide in wards. A total of 285 SLE patients were interviewed with questionnaires on suicidal ideation and socio-demographic characteristics, Beck Depression Inventory (BDI), Family APGAR and Trait Coping Style Questionnaire (TCSQ). Disease activity was assessed with SLE Disease Activity Index. The other medical information was collected from the patients' medical records. In total, 34.4% of SLE patients had current suicidal ideation. Significant individual risk factors for current suicidal ideation in SLE patients included having religious belief, heavy self-reported financial burdens, long duration of SLE, low level of family functioning and negative coping style. And in the presence of these risk factors, being separated, divorced or widowed, having premorbid suicidal ideation and depression were independent predictors of suicidal ideation. In summary, the rate of suicidal ideation in SLE patients in China is higher than that in other countries. Factors that contribute to risk of suicidal ideation include social and cultural domains and physical and psychological health. Although the association of suicidal ideation to religions and medical factors is still to be investigated, these findings may give some references to suicide prevention efforts for SLE patients in China.

Deliberate self-harm in rural and urban regions: A comparative study of prevalence and patient characteristics

In countries like the UK, people living in urban regions are more likely to suffer poor physical and mental health than rural populations, and to have increased rates of psychiatric disorder. Urban/rural differences in suicidal behaviour have most frequently focussed on variations in the occurrence of suicide. We have investigated rates of deliberate self-harm (DSH) in urban and rural districts of Oxfordshire, England, and compared characteristics of DSH patients resident in these two areas. Information was collected on 6833 DSH episodes by 4054 persons aged 15 years and over presenting to the local general hospital between 2001 and 2005. We found that urban DSH rates were substantially higher than rural rates amongst both males and females aged between 15 and 64 years. This relationship was sustained even when socio-economic deprivation and social fragmentation were taken into account. There was little difference between urban and rural rates for patients aged 65 years and over. Urban DSH patients were more likely to be younger, non-white in ethnic origin, unemployed, living alone, to have a criminal record, to have previously engaged in DSH, and to report problems with housing. Rural DSH patients were more likely to suffer from physical illness, and to have higher suicide intent scores. Results of studies such as this can help identify where resources for preventive initiatives should be primarily directed and also what types of individuals may be at most risk in different areas. However, since variation by area will in part be due to differences at the individual level, further research utilising multi-level modelling techniques would be useful.

African‐American Women and Suicide: A Review and Critique of the Literature

AbstractThis paper reviews the literature on African‐American women’s suicide rates. This topic is often neglected due to African‐American women’s low rates of suicide occurrence. This review seeks to answer the call for increased scientific inquiry on matters related to African‐American women and suicide. The author begins by identifying complex dynamics surrounding African‐American women’s unique social position in order to establish a better understanding of how socio‐cultural influences are addressed in the literature in relation to the suicide paradox. Both theoretical and empirical studies are thoroughly assessed in order to identify the risk and protective factors exclusive to African‐American women. The literature concludes that a history of mental disorders, particularly depression, a history of physical and emotional abuse, and a history of alcohol and substance abuse have all proven significant in increasing the risk of suicidal behavior among African‐American women. Untreated depression continues to be the leading cause of suicide among African‐American women. Contrarily, the literature identifies religious/spiritual beliefs, strong social ties, low rates of suicide acceptability, and unique coping strategies developed as a result of longstanding oppressive conditions as primary reasons for African‐American women’s exceptionally low suicide rates.

SUICIDE IN TAIWAN'S SOCIETY

Taiwan is a modern industrialized megalopolis clinging to the fringes of the ancient Chinese culture. This tiny island has evolved from agricultural backwater status to global technological giant over the last few decades. Despite the economic prosperity and democratic reforms, social problems involving suicide additionally emerged, and suicide became one of the top ten major causes of death since 1982. In this paper, we have presented data on the occurrence of suicide in Taiwan between 1986 and 2007. We have explored the socio-cultural, religious and economic elements associated with suicide in Taiwan's society. We have also outlined certain measures to minimize the occurrence of suicide in Taiwan in the near future.

The impact of media reporting of suicide on actual suicides in Taiwan, 2002–05

ObjectivesTo assess changes in the intensity of suicide news reporting in Taiwan's local newspapers after the arrival of a daily tabloid-type newspaper, Apple Daily (AD), and evaluate the impact of...

Correlates of Cutting Behavior among Sexual Minority Youths and Young Adults

Using secondary analyses of data from a sample of 265 sexual minority youths, the authors examined correlates of to determine whether patterns are similar to those found in studies of with community samples of predominately heterosexual youths. The sample consisted of youths who received services at an urban social service agency serving the sexual minority community; youths from the region attending social events, who located the survey through the Internet, or who were referred from other youth-serving agencies; and youths from out of state who found the survey through the Internet or were referred by youth-serving agencies. Prevalence of was higher than that found in community-based samples of similar age groups. However, similar patterns of risk were found with regard to peer victimization, homelessness, suicidality, and depression. Female and transgender respondents were more likely to have engaged in than were male respondents. No significant race-based differences emerged. Both age and having knowledge of a supportive adult were associated with decreased likelihood of cutting. Additional findings link higher levels of outness, higher occurrence of suicidality among social network, and higher rates of smoking to increased likelihood of cutting. Implications for practice and future research are discussed. KEY WORDS: cutting; gay; lesbian; nonsuicidal self-injury; transgender ********** Historically, nonsuicidal research has focused on adult populations, on populations that experience developmental disabilities or psychoses, or on clinical samples (Brodsky, Cloitre, & Dulit, 1995).Although rates of have been increasing over the past few decades among the adolescent population (Brener, Krug, & Simon, 2000; Briere & Gil, 1998), it is only more recently that attention has turned to examining NSSI among this population (Prinstein, 2008). This study seeks to contribute to the knowledge about NSSI through analyses of secondary data in a number of ways. First, it examines the prevalence of among a nonclinical sample of sexual minority youths and young adults, a population of young people about which very little is known with regard to NSSI. Second, it examines correlates that predict to determine whether the emergent patterns mirror patterns found in NSSI research with other youths and young adult populations. Third, it examines a number of variables not currently explored in other literature with youths and adolescent populations. Finally, it examines what youths and young adults in the sample report as helping them resist urges to cut. NOMENCLATURE The language and definitions used in the literature to indicate intentional create confusion. A number of terms, including self-inflicted injury (Crowell et al., 2008; Welch, Linehan, Sylvers, Chittams, & Rizvi, 2008) and (Crawford, Geraghty, Street, & Simonoff, 2003), have been used to refer to a range of behaviors that encompass with and without suicidal intention. Research that has focused more specifically on with nonsuicidal intent has used terms such as self-injury (Simeon & Favazza, 2001),self-mutilation (Babiker & Arnold, 1997), and self-injurious behavior (Whitlock, Eckenrode, & Silverman, 2006; Whitlock & Knox, 2007). In this article, we use the term nonsuicidal (NSSI) (Armey & Crowther, 2008; Nock & Mendes, 2008) to indicate that occurs without the intent to die, and we use the term deliberate self-harm (DSH) to indicate that encompasses both NSSI and with suicidal intent. When the is even more narrowly defined, we use the specific term for that behavior, such as cutting or burning. …