Self-mutilators' psychophysiological and subjective responses during an imaged self-mutilative act were examined. Differences in arousal to 3 imaged control events (neutral, accidental injury, and aggression) were examined between 3 self-mutilation groups (prisoner, prisoner control, and nonprison control). Imagery scripts were presented in 4 stages; scene setting, approach, incident, and consequence. Results indicated a decrease in psychophysiological and subjective response during self-mutilation imagery. No such decrease was evident for nonmutilators who were administered standard self-mutilation imagery. A lag between psychophysiological and psychological response to the self-mutilative act was evident. Responses elicited during self-mutilation imagery were different from those of control imagery. Results indicated that self-mutilative behavior is maintained by its reinforcing tension-reducing qualities.

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IMPORTANCERadiotherapy accelerates coronary heart disease (CHD), but the dose to critical cardiac substructures has not been systematically studied in lung cancer. OBJECTIVE To examine independent cardiac substructure radiotherapy factors for major adverse cardiac events (MACE) and all-cause mortality in patients with locally advanced non-small cell lung cancer (NSCLC). DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort analysis of 701 patients with locally advanced NSCLC treated with thoracic radiotherapy at Harvard University-affiliated