Clinicopathologic features of fatal self-inflicted incised and stab wounds: a 20-year study

The files of the Forensic Science Center in Adelaide, South Australia, were examined for all cases listed as suicide in which death had been caused by the use of a sharp instrument during the 20-year period from January 1981 to December 2000. Fifty-one cases were identified, consisting of 35 men and 16 women. The age range was 23 to 83 years (mean 49 years) representing 1.6% of total suicides (513182). Fatal injuries included incised wounds to the arms in 51.4% of men (n = 1835) compared with 87.5% of women (n = 1416), incised and stab wounds to the neck in 40% of men (n = 1435) and 25% of women (n = 416), and stab wounds to the chest or abdomen in 28.6% of men (n = 1035) and 12.5% of women (n = 216). In 8 cases, multiple sites were involved. The use of sharp instruments in suicide was favored by older, rather than younger, individuals, with a tendency for women to incise their wrists. Hesitation marks were present in 23 cases (54%) and scarring of the wrists from previous suicide attempts in 5 cases. Although this study demonstrated a higher number of men than women committing suicide by using sharp objects, this method of suicide remains uncommon.     

Development and Validation of the Validity Indicator Profile

The Validity Indicator Profile (VIP; Frederick, 1997) is a two-alternative forced choice (2AFC) procedure intended to identify when the results of cognitive and neuropsychological testing may be invalid because of malingering or other problematic response styles. The test consists of 100 problems that assess nonverbal abstraction capacity and 78 word-definition problems. The VIP attempts to establish whether an individual's performance in an assessment battery should be considered representative of his or her true overall capacities (valid or invalid). Performances classified as valid are classified as compliant and reflect a high effort to respond correctly. Performances classified as invalid are subclassified as careless (low effort to respond correctly), irrelevant (low effort to respond incorrectly), or malingering (high effort to respond incorrectly). The VIP development sample included 944 nonclinical participants and 104 adults undergoing neuropsychological evaluation. The cross-validation sample consisted of 152 nonclinical participants, 61 brain-injured adults, 49 individuals considered to be at risk for malingering, and 100 randomly generated VIP protocols. The nonverbal subtest of the VIP demonstrated an overall classification rate of 79.8%, with 73.5% sensitivity and 85.7% specificity. The verbal subtest of the VIP demonstrated an overall classification rate of 75.5%, with 67.3% sensitivity and 83.1% specificity.Ross Crosby was at NCS Assessments, Minnetonka, Minnesota, during much of this project     

Overview of the Office of Research, Statistics, and International Policy functions

Research and statistics have been an integral part of social security program development and administration since the program's beginning. The Office of Research, Statistics, and International Policy (ORSIP) is responsible for developing and disseminating information on the effects of programs operated by the Social Security Administration (SSA) and the interactions among these programs, other tax and transfer programs, and economic, social, and demographic forces. This mission is carried out by collecting and tabulating statistics and by conducting policy research and legislative impact analyses. ORSIP also provides technical assistance to other SSA components. In this overview, each of those functions is outlined and major initiatives to carry out the office's primary objectives for fiscal year 1986 are described.     

Terror and triage: prioritizing access to mass smallpox vaccination

In response to the threat of a smallpox attack on the United States, the Centers for Disease Control and Prevention ("CDC") recommended the establishment of smallpox clinics designed to distribute a vaccine to the entire U.S. population in a ten day period. However, a number of potential obstacles raise questions about the feasibility of this plan. What is needed is a plan that applies principles of triage to smallpox vaccine distribution following a bioterrorism attack. Only in this way can those most vulnerable--the previously unvaccinated--be protected from a significantly increased risk due to delays that might arise in executing the CDC plan.     

No more kidding around: restructuring non-medical childhood immunization exemptions to ensure public health protection

Professor Silverman's article examines the complex challenges faced by U.S. policymakers attempting to balance the public health protections of mandatory childhood immunization programs with the legal, religious, philosophical, and practical concerns raised by permitting non-medical exemptions under the programs. The article begins with a discussion of the history of childhood immunization programs, and continues by describing the inconsistency of enforcement of state immunization laws and exemptions. The author analyzes recent cases from New York, Wyoming, and Arkansas, and discusses how these decisions both pose threats to these programs' public health protections, while also offering insight into potential problems for other state vaccination programs. Professor Silverman concludes by advocating that states adopt an "informed refusal" approach to vaccination exemption as a way of improving immunity protections, while respecting the autonomy rights of those who wish to opt out of the program.     

The Role of Parental and Peer Attachment in the Psychological Health and Self-Esteem of Adolescents

This paper presents the results of 3 studies examining the relationships of parental attachment, peer attachment, and self-esteem to adolescent psychological health. A model is presented in which parental attachment directly influences both psychological health and self-esteem and the influence of peer attachment on psychological health is totally mediated by self-esteem. Using structural equation modeling, Study 1 evaluates the model on a sample of 1998 Norwegian high school students (aged 12–19 years). With some modifications it is found to be a satisfactory fit. Study 2 replicates Study 1 using a sample of 358 Australian high school students (aged 15–18 years). A multisample analysis revealed no significant differences between the model for Studies 1 and 2. Study 3 was a further successful replication employing alternative measures of the constructs considered with a sample of 345 Australian high school students (aged 15–19 years). The major finding from all 3 studies is that the role of peer and parental attachment on psychological health is primarily meditated by self-esteem. Implications for research elucidating the links between attachment and specific aspects of self-esteem are discussed.