Fatal self-injury in the United States, 1999–2018: Unmasking a national mental health crisis

Background Suicides by any method, plus ‘nonsuicide’ fatalities from drug self-intoxication (estimated from selected forensically undetermined and ‘accidental’ deaths), together represent self-injury mortality (SIM)—fatalities due to mental disorders or distress. SIM is especially important to examine given frequent undercounting of suicides amongst drug overdose deaths. We report suicide and SIM trends in the United States of America (US) during 1999–2018, portray interstate rate trends, and examine spatiotemporal (spacetime) diffusion or spread of the drug self-intoxication component of SIM, with attention to potential for differential suicide misclassification. Methods For this state-based, cross-sectional, panel time series, we used de-identified manner and underlying cause-of-death data for the 50 states and District of Columbia (DC) from CDC's Wide-ranging Online Data for Epidemiologic Research. Procedures comprised joinpoint regression to describe national trends; Spearman's rank-order correlation coefficient to assess interstate SIM and suicide rate congruence; and spacetime hierarchical modelling of the ‘nonsuicide’ SIM component. Findings The national annual average percentage change over the observation period in the SIM rate was 4.3% (95% CI: 3.3%, 5.4%; p6.0% increase (p<0.05). Interpretation Depiction of rising SIM trends across states and major regions unmasks a burgeoning national mental health crisis. Geographic variation is plausibly a partial product of local heterogeneity in toxic drug availability and the quality of medicolegal death investigations. Like COVID-19, the nation will only be able to prevent SIM by responding with collective, comprehensive, systemic approaches. Injury surveillance and prevention, mental health, and societal well-being are poorly served by the continuing segregation of substance use disorders from other mental disorders in clinical medicine and public health practice

What Have You Done for Me Lately? Friendship-Selection in the Shadow of the Dark Triad Traits

The current studies examined how the Dark Triad personality traits (i.e., Machiavellianism, narcissism, and psychopathy) facilitate the strategic structuring of an individual's social environment in terms of same- and opposite-sex friends. In one study using normative questions ( N = 267) and another using a budget-allocation task ( N = 114), we found that the Dark Triad traits were associated with choosing friends for strategic purposes and to create a volatile environment. Narcissistic individuals reported relatively more reasons to form friendships, such as shared interests, makes me feel good, and intelligence. Women high in narcissism chose same-sex friends who were attractive and women high on Machiavellianism chose same-sex friends who have social status. Men high on psychopathy devalued traits associated with good social relationships in favor of friends who could facilitate their mating efforts and to offset risks incurred in their life history strategy. Results are discussed using the selection-manipulation-evocation framework for explaining how personality traits interact with social environments and integrated with findings from evolutionary biology