In 1987, American psychiatrist Armando Favazza published "Bodies Under Siege: Self-mutilation in Culture and Psychiatry", the first psychiatric text on the subject of self-harm. Marilee Strong was an American journalist who had spent several weeks in Mozambique on a Pulitzer Fellowship reporting on the psychological trauma experienced by children as a result of the civil war. When she returned to the United States, she heard about self-harm and decided to research the subject. In 1993, she wrote an article for "San Francisco Focus" entitled "A Bright Red Scream", part of a surge in media interest in the topic in the years following the publication of Favazza's book. Strong's was the first in-depth magazine article on self-harm and was the cover story for that issue. To research the book, she interviewed over 50 people who intentionally harm themselves, many of them by cutting. She also interviewed neuroscientists, psychologists and psychiatrists, including Favazza, a recognised expert on self-harm, and Bessel van der Kolk, a specialist in posttraumatic stress disorder. The title of the article and book came from an interview with a self-harmer who described the action of self-mutilation as a cry for help, calling it "a bright red scream".