Suicide by Shotgun in Southeastern Minnesota

Suicide by shotgun is a common method of suicide with high regional variation. We sought to describe their distinct, challenging features and provide demographic and risk characteristics. We reviewed 228 gunshot wounds autopsied at Mayo Clinic from 1994 to 2014; of these, 75 (32.9%) were shotgun wounds. All were suicides and contact range. Ages ranged from 14 to 92 years old; of these, 97% were men. The majority involved the head (70.9%), were intraoral (48.2%), and had upward (73.2%) and backward (73.2%) directionality. Next most common was the chest (21.5%), with backward (94.1%) and downward (64.7%) directionality. Four involved multiple wounds. Wadding was recovered in 16 (21.3%) cases. Six (8.0%) had a survival period. Most (66.7%) took place at home. Seventy‐one percent had a known psychiatric history; 32.4% had positive toxicology. Although contact range shotgun wounds cause severe destruction, entrance wound and other characteristic are identifiable with thorough scene, autopsy, and radiographic documentation.     

Forensic Features of Lethal Late‐Presenting Diaphragmatic Hernias

Diaphragmatic defects are a relatively common and benign finding in adults which may be congenital or secondarily acquired. The case files at Forensic Sciences South Australia were reviewed over a 10‐year period from July 2005 to June 2015 for all adult (>17 years) cases in which diaphragmatic hernias were identified at postmortem examination that had either caused or contributed to death. Five cases were found: age range 49–90 years (average 67.2 years); male:female ratio 2:3. Herniated organs included the stomach (N = 3), small (N = 3) and large intestines (N = 2). Mechanisms of death involved lung compression with respiratory failure and/or mediastinal shift, and vascular compromise with gastric or intestinal infarction and/or perforation. Diaphragmatic hernias may not be identified until the time of autopsy and may be quite complex entities to evaluate due to a lack of clinical history and to difficulties in determining their origin and possible contributions to mechanisms of death.     

Gender Arguments and Paradigmatic Challenges within Intimate Partner Violence Research: A Call for a more Inclusive Paradigm of Understanding Regarding Physical Partner Violence Perpetration

This paper suggests that the epistemology surrounding intimate partner violence (IPV) is flawed due to two areas in particular: 1) an overreliance on quantitative methodologies that lack the detailed and contextual information required for complex understandings of IPV and 2) the minimization of alternative theoretical perspectives on the meaning of gender. Although an ecological perspective to understanding IPV has been advocated by the World Health Organization as a useful theoretical framework from which to understand IPV (Krug et al. 2002), few empirical studies have tested this complex perspective. We suggest that broader research approaches may prove useful in shedding light on non-conventional IPV experiences, potentially broadening our understanding of this complex phenomenon.     

Relationship to Perpetrator and Posttraumatic Symptomatology Among Sexual Abuse Survivors

This study investigated the association of several dimensions of relationship to perpetrator of childhood sexual abuse to posttraumatic symptomatology in adulthood. A structured clinical interview, the Impact of Event Scale, and the TSC-40 were administered to 67 women survivors seeking psychotherapy. The t-tests for significant differences indicated that subjects whose perpetrators were not caretakers experienced higher levels of posttraumatic symptomatology (PTS) in adulthood than those abused by caretakers. No significant differences were found in traumatic symptomatology between those whose perpetrators were family members and those whose perpetrators were not or between those abused by someone in the home and those abused by someone outside the household. Implications for future research and clinical practice are explored.     

The Philosophy of the Gift and the Psychology of Advocacy: Critical Reflections on Forensic Mental Health Intervention

This article examines mental health advocacy,exploring the philosophy of the gift and thepsychology of forensic intervention. Byselectively, though strategically, reviewing the workof Hobbes, Emerson, and Nietzsche,we argue that egoism, charity, and pity displace altruistic, selfless gift-giving. To furtherlegitimize our analysis, we consider Derrida's semiotic deconstructionism and Lacan's psychoanalytic semiotics. Derrida points outhow gift-giving is an aporetic reality; that is,it represents an (im)possibility. Lacandemonstrates how the mirror stage of development givesrise to the self-other ego, in which the subjectis always and already divided. We subsequentlyexplain, therefore, how the gift of mental healthadvocacy must necessarily proceed, in part, from self-interests (i.e., egoism), making the virtuousact of mental health advocacy an (im)possibility.