RESUMO
Derma abuse or self-inflicted epidermal damage is introduced here for the first time to describe a number of blood-letting behaviours, it is associated with low lethality and the absence of suicidal attempts. Derma-abuse encompasses a number of behaviours replete with synonyms and acronyms. Researchers for the most part have described a medley of behaviours that have been categorized as life threatening and equated with suicidal intent. The purpose of this study is two-fold: First, to present and discuss vignettes of four young adolescents and second to study the dynamics and characteristics of six derma abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period with an emphasis on the dynamics of behaviour and treatment. Our findings suggest that patients involved in derma-abuse are generally non suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psychodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans-generational, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction. A novel form of DGT is introduced for the treatment of these patients. The changing attitudes of adolescents in today's culture as they freely engage in risky behaviors present a major mental health crisis to service providers both in developing and developed countries.
Assuntos
Adolescente , Humanos , Suicídio , Tentativa de Suicídio , Trinidad e Tobago , Região do CaribeRESUMO
Alcoholics Anonymous is well established in Trinidad and serves as an indispensable modality in the rehabilitation of alcoholics. This study seeks to investigate socio-demographic characteristics and gender differences of members attending AA groups in Trinidad. Data was collected along the following variables: age, gender, ethnicity, religion, age of onset of alcohol use, psychiatric diagnosis and intentions for seeking treatment. A descriptive study of 107 members attending AA groups in Trinidad was studied and analyzed utilizing a demographic questionnaire and the Michigan Alcohol Screening Test (MAST). The statistical package for the Social Sciences (SPSS, version 16) was used to conduct all statistical analyses. The age of the sample ranged from 22 to 78 with a mean of 48.01. Males dominated the sample, accounting for 68% (n=73), while females were 32% (n=34). In terms of ethnicity, East Indians accounted for 62% (n=65) of the sample, Africans 14% (n=15), Mixed 16% (n=17) and Other 7% (n=7). Religious constitution was dominated by Hindus 36% (n=38), Roman Catholics 21% 9n=22), other 14% (n=15), Presbyterian 10% (n=11), Pentecostal 9% (n=10), Muslim 5% (n=6) and Anglican 4% (n=5). Results utilizing the t-test showed that mean scores for males versus females differed significantly from each other (t (1,105) =2.11, p=0.036) with males having a higher score on the MAST compared to females. Overall 14% of individuals indicated to having a co-morbid psychiatric disorder of which 10.5% were depression. There was no significant difference between genders. The composition and structure of AA groups in Trinidad is fashioned on a male gender bias. There is a need to address specific gender issues in the treatment of female alcoholics.