Minimising harm from alcohol misuse: Challenges to the development of effective policy

Successive substance misuse strategies in Northern Ireland and elsewhere have
been underpinned by the goal of minimising the harm accruing from the use of alcohol and other drugs. However, what it means for a person’s alcohol use to cause harm is an evolving concept. As the understanding of harm changes, the type of evidence needed to estimate the scale of harm and to evaluate the success of a given initiative changes also.
This paper does three things. We first highlight a recent model by Laslett and
colleagues for estimating the harm of one individual’s alcohol use to other individuals, the centrepiece of a report to the Alcohol Education and Research Foundation (AERF) in 2010. This model has been hugely influential in identifying areas where harms from alcohol use accrue and in attempting to quantify those harms (e.g. the cost of injuries inflicted during intoxication). We suggest three ways in which this model could be improved by accounting for: (a) the influence of one individual’s drinking on the drinking behaviour of their peers; (b) the level of use which triggers a given harm; and (c) the degree of time-lag in each of
the domains of harm.
Secondly, we explore specific challenges to developing effective policy on
adolescents’ drinking behaviours, drawing on research which specifically elicits the perspectives of young people on why they drink.
Thirdly, we examine the relative harms of allowing moderate levels of drinking
among mid-adolescents versus promoting zero use up until late adolescence.

A Slow March from Social Evil to Harm Reduction: Drugs and Drug Policy in Vietnam

The suppression of drug consumption and trade is high on the Government of Vietnam’s agenda. To accomplish this goal, Vietnam employs repressive policies that often contravene international human rights law. Among the most detrimental and problematic policies are the incarceration of drug users in compulsory treatment centers, and the stigmatization and abuse of consumers by the police. That said, Vietnamese drug policy is slowly changing in the face of one of Asia’s worst ongoing HIV epidemics. While the Communist Government of the early-1990s designated illicit drugs as a “social evil” to be eradicated through punitive and often repressive means, the recent implementation of harm reduction approaches have reduced the level of needle sharing, and thus HIV transmission. This briefing will explore the current trends in drug consumption, production, and trafficking before looking at the key harms and threats associated with drugs in Vietnam. This will be followed by a summary of Vietnam’s drug policies, including the country’s approach to drug treatment, harm reduction, and illicit opium suppression—Vietnam is one of a small number of states to have suppressed illicit opium production, an intervention that centred upon coercive negotiations with limited alternative development. The briefing will conclude with some tentative recommendations for reform and thoughts on what could be expected from Vietnam during the Special Session of the United Nations General Assembly on the World Drug Problem (UNGASS 2016).

Changing patterns of first injection across key periods of the French Harm Reduction Policy: PrimInject, a cross sectional analysis

Background: Monitoring of emerging modes of drug consumption in France has identified new patterns of injection among youths with diverse social backgrounds, which may explain the persistence of high rates of hepatitis C virus infection. The circumstances surrounding the first injection have been poorly documented in the group of heavy drug users and in the context of the French opioid substitution treatment (OST) policy that provides expanded access to high-dosage buprenorphine (BHD). Methods: An Internet survey (Priminject) was conducted from October 2010 to March 2011 with French drug users. Four time periods were compared based on critical dates throughout the implementation of the Harm Reduction Policy in France. Results: Compared with drug users who injected for the first time prior to 1995, the aspects of drug use for users who recently injected for the first time were as follows: (1) experimentation with miscellaneous drugs before the first injection; (2) an older age at the time of first injection; (3) heroin as the drug of choice for an individual’s first injection, notwithstanding the increased usage of stimulant drugs; (4) BHD did not appear to be a pathway to injection; and (5) an increased number of users who injected their first time alone, without the help or presence of another individual. Conclusion: The PrimInject study showed that there is a group of injection drug users that is larger than the group of injection drug users observed in previous studies; therefore, it is necessary to diversify programs to reach the entire spectrum of high-risk users.

Students who self-harm: coping style, rumination and alexithymia

Counsellors working with students or other young adults may encounter individuals who have self-harmed, either with suicidal or non-suicidal intent. Recent US studies reported rates of self-injury of up to 37% of the student population, but studies in the UK have focussed primarily on younger adolescents. This study examined reported self-harm incidents (scratching, cutting, poisoning, overdose etc) from a sample of 617 university students. A total of 27% reported at least one incident of self-harm, with almost 10% having harmed themselves while at university. Gender differences were not significant but psychology students reported significantly more self-harm than other students. Participants reporting self-harm scored significantly higher on maladaptive coping styles, rumination, and alexithymia (specifically difficulty in identifying emotions) and these differences were most marked for students reporting repetitive and recent self-harm. Rumination and Alexithymia factor 1 (difficulty identifying feelings) emerged as the most robust factors predicting self-harm status. Comments from students who self-harmed at university highlighted the importance of accessible services and academic staff support. The implications of these findings for counselling interventions are discussed, including challenging negative rumination tendencies and developing mindfulness skills.

Mapping non-suicidal self-injury in adolescence: Development and confirmatory factor analysis of the impulse, self-harm and sucidal ideation questionnaire for adolescents (ISSIQ-A)

Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.

Climate Change, Neutrality and the Harm Principle

This paper aims at evaluating the compatibility of coercive climate policies with liberal neutrality. More precisely, it focuses on the doctrine of state neutrality as associated with the "harm principle". It argues that given the difficulty of attributing causal responsibilities for climate harms to individuals, the harm principle doesn't work in this case, at least if one endorses a liberal atomistic ontology. Furthermore, the definition of what constitutes climate harms implies making moral assumptions, which makes it impossible to justify climate policies in a neutral way. Finally, the paper shows another consequence of applying neutrality to the case of climate change, that is the risk of a shift from political forms of decision-making to technocracy. Focusing too much on liberty of choice may (paradoxically) be to the detriment of political freedom. The paper concludes that climate change is an intrinsically moral issue and that it should be the occasion of a political debate about our current values and lifestyles. It should not be reduced to a mere question of carbon metric.

Violent Video Game Playing, Moral Reasoning, and Attitudes Towards Violence in Adolescents: Is There a Connection?

In this study of 109 adolescents from the eighth grade of seven public elementary schools in Ontario, the relationship among adolescents’ violent video game playing patterns, habits and attitudes, their levels of moral reasoning, and their attitudes towards violence in real life was investigated. In addition, gender differences were addressed. The mixed-methodology was employed combining qualitative and quantitative data. The research results confirmed that playing video games in general is a very popular activity among those adolescents. Significant negative relationship was found between adolescents’ amount of time playing violent video games during the day and their scores on The Sociomoral Reflection Measure. Significant difference was also found between adolescents who play violent video games and those who do not play violent video games on their scores on The Attitudes Towards Violence Scale. Boys and girls significantly differed in the amount of playing video games during the day, the reasons for playing video games, their favourite video game choices, and their favourite video game character choices. Boys and girls also significantly differed on their choices of personality traits of selected video game characters, the identification with video game characters, and their mood experiences while playing video games. The findings are put into the educational context and the context of normal development, and suggestions are given for parents, for educators, and for future violent video game research.

Canadianness is Wilderness? Violent Love Relationships with ‘Wild’ Bodies

This thesis reveals contradictions that Canadians experience with groups attached to western construction of wilderness namely Indigenous people and wildlife. My study analyzes how the discourse of Canadian wilderness identity is played out in Algonquin Provincial Park and Bruce Peninsula National Park in comparison to non-nature/urban spaces (Greater Toronto Area). My investigation employs a critical discourse analysis and participant observation. I undertake three main tasks: 1) I describe how violent love is a dominant discourse at the Parks, 2) I examine evidence of animals and Indigenous people being produced relationally in the Parks, and 3) I analyze how relationships are spatially organized. My research reveals that the Parks conceal practices of violence that are central to the intersections of speciesism and colonialism. I demonstrate how violent love operates across a continuum that is influenced by spatial belonging and distance. This research is a contribution to the production of non-speciesist knowledge.

Is Brand Equity an Asset or a Liability in Brand Harm Crisis? Buffering and Amplifying Effects and Contingent Conditions

Brand harm crisis often result in negative consumer responses. This thesis addresses the buffering and amplifying theoretical perspectives of brand equity effects. We theorize that brand equity may interplay with the nature of brand-harm crisis in shaping consumer reactions. Results from focus group studies provide interesting insights into the amplifying and buffering effects. Moreover, research findings from two experiment studies show that brand equity amplifies consumer negative responses in a performance-related crisis but only when the crisis is extremely severe. When the crisis becomes less severe, the amplifying effect diminishes from outset. However, in a value-related crisis, the amplifying effect of brand equity is pervasive regardless of the level of crisis severity. The current thesis adds to the extant literature by demonstrating that brand equity can have very complex effects on consumer responses, which are contingent on the severity and domain of a crisis. Theoretical and managerial implications are discussed.

Alleviating Negative Spillover of a Brand-Harm Crisis: Sensegiving vs. Sensehiding in a Competitor’s Denial Response Strategy

A brand-harm crisis not only affects the scandalized brand, but may also influence competing brands. Thus, marketers of competing brands need to develop response strategies for reducing negative spillover effects. This research takes a competitor’s perspective and introduces two types of response strategies used to convey a sense of denial: sensegiving and sensehiding. It also investigates how the effects of response strategies are contingent upon brand relatedness and individual thinking styles. The results from three experimental studies show that using a sensegiving strategy reduces negative spillover effects more than using a sensehiding strategy. Additionally, the studies suggest that the observed difference in the effects of response strategy tends to be greater when the level of brand relatedness is high than when it is low. However, individual thinking styles (holistic vs. analytic) seem to have little impact on consumers’ responses to the two denial strategies. This research contributes to the brand-harm crisis literature and provides novel insights into a competitor’s response to potential negative spillover effects.

La circoncision des femmes en Afrique : repenser les politiques de santé

Section des étudiants / Student's section

La pensée des femmes violentes : les théories implicites liées au comportement violent.

Les théories implicites (TIs) sont des croyances sous-jacentes et interconnectées qui influencent les pensées conscientes et le comportement (Ward, 2000). Elles ont été étudiées chez les délinquants et les délinquantes sexuels, ainsi que chez les délinquants violents, mais pas chez les délinquantes violentes. La recherche montre que les cognitions des délinquants violents peuvent être organisées en quatre TIs: 1) Battre ou être battu, 2) Je suis la loi, 3) La violence est normale, et 4) Je perds le contrôle (Polaschek, Calvert & Gannon , 2008). L’objectif de la présente étude était de déterminer quelles sont les TIs des délinquantes violentes afin de mieux comprendre leur comportement. Des entrevues semi structurées ont été menées avec 21 femmes violentes incarcérées. Dans l'analyse, les cognitions des participantes ont été extraites en utilisant l’analyse du discours (Angers, 2005). Ces cognitions ont ensuite été plus profondément analysées pour en ressortir les TIs en suivant la méthode de la théorisation ancrée (Strauss & Corbin, 1990). Les résultats suggèrent qu’il existe six théories implicites liées au comportement violent des femmes. Deux d'entre elles sont neutres, car aussi retrouvées chez les hommes: 1) la violence est normale et 2) je perds le contrôle. Les quatre autres sont sexo-spécifiques: 3) ceux qui agissent injustement méritent d'être battus, 4) j'ai besoin de me protéger et protéger les autres, 5) je ne suis pas violente, et 6) ma vie est trop difficile. En outre, les résultats suggèrent qu'il existe deux groupes distincts d’agresseures en ce qui concerne les cognitions: les « antisociales » et les « classiques ». Les implications et explications théoriques de nos résultats seront discutées.

The word in the world : "Fallen preachers" in Zora Neale Hurston's Jonah's Gourd Vine and Flannery O'Connor's The violent bear it away

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Le processus de passage à l'acte violent chez les femmes

Objectif : Ce mémoire avait pour objectif de comprendre le processus par lequel les femmes en arrivent à commettre un acte violent. Plus spécifiquement, de connaître le sens que les femmes donnent à leur violence, de quelle façon elles reconstruisent le processus qui les a menées à cet acte et de quelle façon elles l’intègrent dans le cours de leur vie. Méthode : Pour atteindre cet objectif, 24 entrevues semi-structurées ont été réalisées auprès de femmes détenues ou prévenues ayant commis un acte de violence. Les participantes étaient rencontrées à la Maison Tanguay ou au secteur féminin du Centre de détention de Québec. Par la suite, les entrevues furent retranscrites et les données obtenues traitées à l’aide du programme NVivo. Nous avons analysé ces données selon le processus proposé par la théorisation ancrée. Résultats: Les résultats ont permis d’établir un modèle représentant le processus de passage à l’acte violent chez les femmes. Ce modèle se déroule en quatre phases. La première phase concerne le portrait de vie des participantes de l’enfance à l’âge adulte. Cette phase met principalement l’accent sur les difficultés vécues par les participantes et leurs stratégies d’adaptation. La deuxième phase est relative à la période précédant le délit. Elle comprend deux volets soit, l’entrée dans le processus qui réfère aux mois ou semaines précédant le délit et la phase aiguë qui réfère aux jours ou aux instants précédant le délit. La troisième phase concerne le déroulement de délit. Cette phase est divisée en deux profils différents, selon le type de violence utilisée soit, expressive ou utilitaire. Ces deux profils se distinguent quant aux circonstances, aux motifs, aux émotions et dans le recours, ou non, à des stratégies alternatives à la violence. Enfin, la dernière phase du modèle se concentre sur la période succédant l’acte de violence.