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Biomedical subjects

Israel Orbach

Publications and source records attributed to Israel Orbach.

13 recordsLinked to original sources
PubMed2006

Self-object differentiation in suicidal adolescents.

BACKGROUND: Although problems in the differentiation between self and object are commonly encountered in clinical work with suicidal adolescents, empirical validation of this phenomenon is limited in the literature. The aim of this study was to use empirical methods to examine the differentiation between self and parental representations in suicidal inpatient adolescents. METHODS: Ninety-six adolescents participated in the study: 32 suicidal inpatients, 32 nonsuicidal inpatients, and 32 healthy controls. The 3 groups were matched for sex, age, and education. All participants completed scales on self-object differentiation and suicidal tendencies. RESULTS: Suicidal adolescents were found to be significantly different from both nonsuicidal psychiatric and healthy controls in negative self and parental descriptions (P < .001) but did not differ from the other groups when describing positive traits. Moreover, suicidal adolescents described themselves as being significantly less differentiated from both their father (P < .001) and mother (P < .01) in negative traits but not in positive traits, when compared to the 2 other groups. CONCLUSIONS: Suicidal adolescents have difficulties differentiating the negative aspects of the self from the negative aspects of their parents. These results emphasize the importance of object relations theory in understanding suicidal tendencies in adolescents. A model combining negative symbiosis and suicidal tendencies offers several therapeutic intervention strategies.

Adolescent↗
PubMed2006

Negative bodily self in suicide attempters.

In the present study we investigated the relationship between suicidal behavior and aspects of bodily perception and parental care. Measures of bodily perception included measures of tactile sensitivity, body attitudes, and body experiences. Measures of parental care included parental bonding, negative and positive touch, and early maltreatment. One hundred and two adolescents (suicidal and nonsuicidal inpatients, and a control group) participated in the study. It was hypothesized that suicidal adolescents would (1) have higher tactile sensation thresholds, and more negative body attitudes and experiences; and (2) report less parental care, lower positive and higher negative parental touch, and higher parental maltreatment. It was also hypothesized that bodily sensitivity would mediate the relationship between suicidal tendencies and perceived negative early care. These hypotheses were confirmed. The role of a negative bodily self in suicidal behavior is proposed and discussed.

Adolescent↗
PubMed2004

Terror suicide: how is it possible?

How it is possible for people who apparently do not suffer from distress or pathology to commit violent, cruel suicides? Based on the distinction between causes for suicide and facilitators of suicide, I contend that terror suicide is based largely on processes that facilitate suicide rather than on personal distress. Under this premise, terror suicides are examined in terms of enthusiastic determination to achieve a goal, ideological rage, glorification of the post self, heavenly rewards, materialistic benefits for families, induced dissociative processes, and linguistic mediation. Also described are the processes and preparations by which the idea of terror suicide and its facilitators are induced. Further, a theoretically inferred profile of the suicide attacker is also suggested.

Journal Article↗
PubMed2003

Pain perception in recovered bulimia nervosa patients.

OBJECTIVE: Decreased pain sensitivity is found in individuals who are ill with bulimia nervosa (BN). The purpose of this study is to determine whether altered pain perception persists after recovery from bulimia nervosa (RBN). METHODS: Eleven women who were recovered from BN for more than 1 year were compared with 15 healthy volunteer women. The participants received two pain evaluations--thermal pain stimulation (TPS), which evaluates threshold and tolerance to heat, and the submaximal effort tourniquet test (SETT), which assesses threshold and tolerance to ischemic pain induced by inflation of a blood pressure cuff. RESULTS: Compared with the controls, the RBN women showed elevated pain threshold as measured with the SETT and a tendency to elevated pain threshold on the TPS. DISCUSSION: Decreased pain sensitivity persists after recovery from BN and may reflect altered modulatory function in this illness.

Adult↗
PubMed2003

Comparison of the suicidal behavior of adolescent inpatients with borderline personality disorder and major depression.

The objective of the study was to examine the hypothesis that some forms of suicidal behavior among adolescents are related to helplessness and depression, whereas others are related to anger and impulsivity. Sixty-five adolescents were studied. Thirty-three had borderline personality disorder (BPD), of whom 17 had made a recent suicide attempt. Thirty-two had major depressive disorder (MDD), of whom 16 had made a recent suicide attempt. Assessments were made with the Child Suicide Potential Scale, the Beck Depression Inventory, the Beck Hopelessness Scale, the Multidimensional Anger Inventory, the Overt Aggression Scale, the Impulsiveness-Control Scale, and the Suicide Intent Scale. Adolescents with BPD had more anger, aggression, and impulsiveness than those with MDD, but similar levels of depression and hopelessness. Suicidal versus nonsuicidal adolescents were more depressed, hopeless, and aggressive, but not more angry or impulsive. There were no significant differences in impulsiveness for the MDD suicidal group versus the MDD nonsuicidal group, but the suicidal BPD adolescents were significantly more impulsive than the nonsuicidal BPD adolescents. In the subjects with BPD, impulsiveness and aggression correlated significantly and positively with suicidal behavior. In the subjects with MDD, no such correlations were seen. In both diagnostic groups, depression and hopelessness correlated positively and significantly with suicidal behavior. Anger did not correlate with suicidal behavior in either of the groups. The suicidal subjects with MDD had significantly higher suicidal intent scores than the suicidal adolescents with BPD. We conclude that the nature of suicidal behavior in adolescents with BPD differs from that seen in MDD with respect to the role of anger and aggression.

Adolescent↗
PubMed2003

Suicide and the suicidal body. 2002 Dublin Award Address.

This paper focuses on the bodily experiences and attitudes toward the body in suicidal individuals. It is argued that bodily experiences and attitudes toward the body, such as rejection of the body, detachment, numbness, physical anhedonia, and lack of protection can facilitate acts of self-destruction. This argument is supported by theories of developmental psychology, theories on suicide, and empirical data. It is demonstrated that suicidal individuals experience their body differently from other populations and that these are related to suicidal behavior.

Adult↗
PubMed2003

Mental pain: a multidimensional operationalization and definition.

An operationalization of mental pain is presented in three studies. The first study describes the operationalization of mental pain and the factor structure of the items produced by a content analysis of self-reports yielding a scale with nine factors: the experience of irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, estrangement, confusion, social distancing, and emptiness. Study 2 tested the relationship between mental pain and depression and anxiety in a normal population. Study 3 focused on the relationship between mental pain and coping. Mental pain is conceptualized as a perception of negative changes in the self and its functions that are accompanied by negative feelings. It is suggested that it can be meaningfully applied to the study of different mental states, life conditions, and transitions in life.

Adolescent↗
PubMed2003

Mental pain and its relationship to suicidality and life meaning.

Shneidman (1996) proposed that intense mental pain is related to suicide. Relatedly, Frankl (1963) argued that the loss of life's meaning is related to intense mental pain. The first goal of this research was to test Shneidman's proposition by comparing the mental pain of suicidal and nonsuicidal individuals. Meaning in life and optimism are the polar opposites of suicidality and hopelessness, and the examination of these variables in relation to mental pain was undertaken to provide a test of Frankl's proposition. In two studies, a relationship between a newly developed measure of mental pain--the Orbach & Mikulincer Mental Pain Scale, 2002 (OMMP; see also Orbach, Mikulincer, Sirota & Gilboa-Schechtman, 2002)--and suicidal behavior and life meaning were examined. Results confirmed both propositions. Implications for the study of mental pain and suicide are discussed.

Adult↗
PubMed2003

Mental pain and suicide.

Different models of mental pain (emotional pain, psychological pain, psychache) are described: (A) the literary model that is based on a content analysis of Styron's book Darkness visible: A memoir of madness, describes mental pain as an inner turmoil of hostile forces; (B) the narrative model based on a qualitative analysis of pain narratives by patients defines pain as a sense of brokenness (Bolger); (C) the phenomenological-psychache model focuses on psychache as a frustration of the most important needs (Shneidman); (D) the theoretical model and (E) the empirical model view mental pain as a perception of negative changes in the self and its function (Baumeister) (Orbach & Mikulincer). The common aspects in all models include intense negative emotions, loss of self, surfeit of the negative. Other aspects appear in some of the models, but not in others (e.g., incompleteness, emptiness). The relevance of mental pain to treatment of suicidal people is discussed.

Humans↗
PubMed2002

Discovering the truth in attempted suicide.

The findings of an international workshop on improving clinical interactions between mental health workers and suicidal patients are reported. Expert clinician-researchers identified common contemporary problems in interviews of suicide attempters. Various videotaped interviews of suicide attempters were critically discussed in relation to expert experience and the existing literature in this area. The working group agreed that current mental health practice often does not take into account the subjective experience of patients attempting suicide, and that contemporary clinical assessments of suicidal behavior are more clinician-centered than patient-centered. The group concluded that clinicians should strive for a shared understanding of the patient's suicidality; and that interviewers should be more aware of the suicidal patient's inner experience of mental pain and loss of self-respect. Collaborative and narrative approaches to the suicidal patient are more promising, enhancing the clinician's ability to empathize and help the patient begin to reestablish a sense of mastery, thereby strengthening the clinical alliance.

Adult↗
PubMedDate not supplied

Suicidal tendencies and body image and experience in anorexia nervosa and suicidal female adolescent inpatients.

BACKGROUND: The aim of this study was to assess the relationship between body image and suicidal tendencies in anorexia nervosa (AN). METHODS: Three groups of hospitalized female adolescents--nonsuicidal AN, suicidal psychiatric and nonsuicidal psychiatric patients, as well as a community control group with no psychiatric disturbances were compared with regard to suicidal tendencies (in the form of attitudes to life and death), body image and experience, depression and anxiety. RESULTS: The AN and suicidal patients showed less attraction to but more repulsion by life, and more attraction to and less repulsion by death compared with the other two groups. The AN and suicidal patients were also different from either one or both control groups in showing more negative attitudes and feelings towards their bodies, lower sensitivity to body clues, less body control, and elevated depression and anxiety. These between-group differences in suicidal tendencies were retained after controlling for age, body mass index, the different body image dimensions, anxiety and depression. CONCLUSIONS: Our findings suggest that female AN inpatients with no evidence of overt suicidal behavior demonstrate elevated suicidal tendencies that are similar to those of suicidal psychiatric inpatients. These self-destructive tendencies are highly associated with a pervasive sense of disturbance of body image and experience.

Adolescent↗
PubMedDate not supplied

Self complexity of suicidal adolescents.

UNLABELLED: This study examined the positive and negative self-complexity of suicidal adolescents. METHODS: Thirty-two Israeli suicidal inpatients, thirty-two nonsuicidal inpatients and thirty-two control participants completed scales on self-complexity and suicidal tendencies. Self-complexity was based on Linville's measure and revealed four different aspects of self-complexity: number of positive/negative traits, number of positive/negative/neutral self-aspects, amount of redundancy of the positive/negative traits and subjective similarity between each two self-aspects. RESULTS: In comparison with both psychiatric and control, the suicidal self was characterized by the highest number of negative traits and negative self-aspects. In comparison with control, the suicidal self was characterized by the highest number of positive categories and the lowest number of neutral categories and redundancy in the positive traits. No significant differences were found between the suicidal and the psychiatric in the number of positive and neutral self-aspects and in the level of redundancy of the positive traits. After Bonferroni post-hoc correction for multiple testing, the effects for the number of negative traits (F = 28.53; p < .001), the number of negative self-aspects (F = 15.59; p < .001) and the number of neutral self-aspects (F = 28.14;p < .001) were still significant. CONCLUSIONS: The suicidal self is characterized by flooding of the negative aspects and a high differentiation of the positive ones. The suicidal self should be taken into consideration in both assessment and treatment of adolescents suicidality.

Adolescent↗