Rheumatoid arthritis (RA) is a chronic disease characterized by an overactive immune system and joint inflammation. Population-based administrative health data (AHD) are widely used for RA outcomes research and surveillance. However, AHD may not completely capture all cases of RA in the population. Capture-recapture (CR) methods have been proposed to describe the completeness of AHD for estimating disease population size, but AHD may not conform to the assumptions that underlie CR models. A Monte Carlo simulation study was used to investigate the effects of violations of the assumptions for two-source CR methods: dependence between data sources and heterogeneity of capture probabilities. We compared the Chapman estimator and an estimator based on the multinomial logistic regression model (MLRM) to study relative bias (RB), coverage probability (CP) of 95% confidence intervals, width of 95% confidence intervals (WCI), and root-mean-square-error (RMSE) in prevalence estimates. The effects of misspecification of the MLRM were also investigated. In addition, the Chapman and MLRM estimators were used to estimate RA prevalence using AHD data from Saskatchewan, Canada. Population sizes were consistently underestimated for CR methods when the assumptions were violated. The estimated population size for both of the estimators did not differ substantially except for the RMSE values. Parameter estimates became biased when the MLRM model was misspecified, but there was little impact on population size estimates. In conclusion, CR methods are recommended to reduce bias in prevalence estimates based on AHDS. Because these methods may be sensitive to assumption violations, researchers should consider potential dependence between data sources. As well, sufficient overlap in the cases captured by each data source (e.g., 50% of the cases are captured by both data sources) or balanced capture probability in each data source is needed to effectively implement these methods. Researchers who estimate population size using CR methods in AHDs should favour the MLRM estimator over the Chapman estimator.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background: A triathlon comprises of a combination of swimming, cycling and running. Triathlons are usually classified as sprint distance, Olympic distance, and Ironman or ultra-distance. Triathlon was popularized in the 2000 Summer Olympic Games and, despite this, there is insufficient data relating to injuries in the South African context. This study aimed to determine the injury profile of amateur and semi-professional Kwa-Zulu Natal triathletes. Methods: This Institutional Research Board approved, cross sectional study, included 80 active members of the Kwa-Zulu Natal Triathlon Association. All triathletes completed a questionnaire on training and injury profiles; with only those having had a musculoskeletal complaint additionally completing a clinical consultation. In order to assess associations between presence of injury and explanatory variables, binary logistic regression using backward selection based on likelihood ratios was used. Data was described using frequency tables for categorical data and summary statistics for continuous data. Odds ratios was reported and a p value <0.05 was considered statistically significant. For triathletes reporting injuries, linear regression was used for factors associated with injury severity. Results: Fifty seven triathletes responded giving a response rate of 71% (68% male, 32% female). The point and period (year) prevalence of triathlon-related musculoskeletal pain was 17.5% and 68.4% respectively. The ranking of the most common site of injury in the last 12 months included the knee (64%), low back (21%) and thigh (18%); with females having had a significantly higher risk of injury than males (p=.019). Additionally, injury risk also increased with weight (p=.055), number of triathlons undertaken in the previous year (p=.031), number of triathlons in the last 4 months (p=.009) and running distance during competition times (p=.011). Injury risk decreased with increasing distance of cycling (p=.061) and swimming (p=.030) in a competition, and length of training in- and off-season (p=.105 and p=.043 respectively). Strong trends were demonstrated between injury severity and long-slow training distance (p=.006) and weight (p=.006). By contrast to risk of injury, injury severity was negatively associated with weight, while a long-slow distance was positively associated with the severity of the injury. Of all the health professions, chiropractic was the most utilized health profession. Conclusion and recommendations: The results concur with previous research, but add insights into factors predisposing triathletes to injury. The most common injuries require investigation to develop preventative interventions to reduce injuries in triathletes. Health professionals require education about triathlon-related injuries to improve preventative and curative interventions.

A large number of people all over the world suffer from skin conditions. Dermatological problems comprise about 10 % of a general practitioner's caseload and probably more for pharmacists. The literature furthermore emphasises that skin diseases are becoming a significant problem in the developing world. There is a need to establish an effective method to achieve good health and quality of life for patients with dermatological problems. The general objective of this study was to investigate the usage patterns and cost of dermatological products in the private health care sector of South Africa by using a medicine claims database. The focus was specifically on dermatological products with a prevalence of more than 10 % in the database. A quantitative retrospective drug utilisation research design was used to evaluate the usage patterns and costs of dermatological products in three four-monthly intervals of 2001 and 2004. Data were analysed by using the Statistical Analysis System, 9.1 (SAS). The dermatological product groups for this study were antibacterial and antifungal drugs, corticosteroids and anti-acne products and were analysed according to the MIMS classification. Of all analysed prescriptions issued only 8.57 % (n = 126 447) during 2001 (N = 1 475 380) and 6.82 % (n = 177 122) during 2004 (N = 2 595 254) consisted of dermatological products. Of the total number of products prescribed, the dermatological products constituted 4.77 %I (n = 140 701) for 2001 (N = 2 95 1 326) and 3.77 % (n = 199 976) for 2004 (N = 5 305 882). The total cost of the dermatological products was 4.98 % (n = R18 913 889.92) of the total cost of all medicine products during 200 1 (N = R379 708 489). During 2004 (N = R66 1 223 146) the total cost of dermatological products was 4.09 % (n = R27 025 540.48) of the total cost of all medicine products in the database. The cost-prevalence index for 2001 and 2004 respectively showed that the dermatological products were relatively expensive with values of 1.03 and 1.09. The antibacterial and antifungal drugs, corticosteroids and anti-acne products represented 91.92 % (n = 129 336) and 87.97 % (n = 175 9 16) of all dermatological products during 2001 (N = 140 701) and 2004 (N = 199 976), respectively. These dermatological groups named above represented 91.57 % (n = R17 319 645.61) and 85.85 '% (n = R23 200 594.71), respectively, of the total cost of dermatological products during 200 1 (N = R18 9 13 889.92) and 2004 (N = R27 025 540.48). It was further found that the majority of dermatological products prescribed during the research periods was innovator products. The prevalence of innovator products for 2001 was 86.17 % (n = 12 1 249) with a total cost representing 94.16 % (n = R17 809 603.12). For 2004 the prevalence was 82.33 % (n = 164 640) with a total cost representing 91 .O1 '% (n = R24 594 923.72) of all the dermatological products prescribed. The number of innovator and generic products claimed during 2001 amounted to 86.17 % (n = 12 1 249) and 13.83 % (n = 19 452) respectively of the total number of products claimed (N = 140 701). During 2004 the number of innovator and generic products represented respectively 82.33 % (n = 164 640) and 17.67 O/o (n = 35 336) of the total number of products claimed (N = 199 976). The prevalence in the use of the dermatological products during 2004 increased with 55.25 % from January to April versus September to December. The cost-prevalence index indicated that the dermatological products were relatively expensive during January to August 2004. During September to December 2004 the cost-prevalence decreased and indicated that dermatological products became inexpensive. The average cost of dermatological products during the 2004 study period showed that the cost decreased. January to April (before implementation of the new single exit price structure) was compared to September to December (after implementation of the new single exit price structure). This comparison indicated that the average cost decreased by 22.88 %. It can be summarised that the average cost in the last study period decreased due to the changed price structure. The innovator products' prevalence was high and therefore more generics are needed in dermatology. If more generics are used the total cost of dermatological products might also decrease. The number of dermatological prescriptions increased towards 2004, but this may be because of more members or more medical aids claiming through this database. / Thesis (M.Pharm.)--North-West University, Potchefstroom Campus, 2006.

Acne is a very common disease affecting approximately 85% of people in some stage of their life (Wolff et al., 2005:2). The systemic drug isotretinoin is the only acne drug which has an influence on all the pathophysiological factors of this highly prevalent disease and is considered as the most effective treatment for acne, although it should be limited to the treatment of severe acne. Isotretinoin prescribing is under the largest risk-minimisation programme (called iPLEDGE) ever implemented for a drug in the United States of America, due to concerns with pregnancies during isotretinoin treatment (Honein et al., 2007:11). In comparison South Africa has no equal managing programme to regulate isotretinoin prescribing and the need to identify certain prescribing patterns is deemed necessary. The general objective of this study was to analyse the prescribing patterns of isotretinoin, including aspects of cost, in a section of the private healthcare sector of South Africa. A quantitative, retrospective drug utilisation review was performed to evaluate the prescribing patterns and cost of isotretinoin containing products claimed through a pharmacy benefit management organisation, over the study period of 2005 and 2006. Data were analysed by using the Statistical Analysis System, 9.1 (SAS). The information of prescriber, age, gender, and cost of isotretinoin usage were considered and evaluated. A total number of 6 427 and 6 927 patients claimed 18 589 and 20 232 isotretinoin prescriptions respectively during 2005 and 2006. Isotretinoin total costs contributed to 34.4% (n = R6 810 090) and 36.3% (n = R6 533 241) of the total identified acne medicine costs for 2005 and 2006 respectively. Isotretinoin represented the highest percentage of total costs in relation to any other acne product identified in both study years. Average costs of R314.82 ± 205.92 per prescribed isotretinoin item in 2005 and R277.63 ± 192.63 in 2006 were recorded in comparison to the total database medicine item cost of R95.33 ± 192.21 in 2005 and R95.33± 227.99 in 2006. The generic products of isotretinoin were claimed at a lower ratio (generic vs. innovator product ratio of 1.8:1 in 2005 and 2.2:1 in 2006) in relation to the total database (generic ratio of 3:1 in both years). Dermatologists prescribed 68.2% and 65.7% of isotretinoin prescriptions and general practitioners 27.5% and 29.7%. General practitioners were more likely to prescribe the generic equivalents of isotretinoin (68.9% in 2005 and 72.1% in 2006) in comparison to dermatologists (59.7% in 2005 and 63.4% in 2006). The teenage group 12 to 19 years received 48.4% (n = 8 989) and 47.7% (n = 9 656) of isotretinoin prescriptions claimed respectively at an estimated cost of R275 000 and R260 000 per 10 000 beneficiaries in this age group respectively for 2005 and 2006. There were 71 patients identified over both study years in the age group younger than 12 years, in which isotretinoin use is not recommended. Female patients received 56.2% (n = 10 450) and 57.4% (n = 11 610) of the total number of isotretinoin prescriptions claimed respectively for 2005 and 2006. The average cost per isotretinoin prescription claimed for male patients was higher (R406.36 ± 233.76 and R358.69 ± 218.29 respectively for 2005 and 2006) in relation to female patients (R335.15 ± 209.98 and R296.36 ± 197.74 respectively for 2005 and 2006). The median ages for female and male patients were 21 years and 18 years respectively. The concern, however, was the high number of female patients of child-bearing potential identified (2 892 and 3 201 female patients respectively for 2005 and 2006), claiming their isotretinoin prescriptions. Systemic isotretinoin occurred alone in 70.8% and 69.3% of prescriptions claimed respectively for 2005 and 2006. Oral contraceptives occurred in combination with isotretinoin in only 8.6% and 9.2% of isotretinoin prescriptions claimed. The contra-indicated use of a systemic tetracycline in combination with systemic isotretinoin occurred in 139 (0.75%) and 130 (0.64%) prescriptions. It can be concluded that the use of isotretinoin increased. Dermatologists played the major role in prescribing isotretinoin. The number of female isotretinoin users (especially of child-bearing potential) could be a concern, although pregnancy prevalence should be identified in South Africa. It is recommended that further studies be conducted in South Africa regarding the usage and control of isotretinoin, including the extension of regulating programmes, with special reference to age and gender. Effective management of the increasing popularity of this ultimately successful acne treatment is of utmost importance to ensure the effective and safe usage of isotretinoin. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Purpose: To accurately and precisely evaluate the validity and reliability of the English-language Pelvic Floor Inventories (PelFIs) administered questionnaire. Participants: Fifty female patient volunteers (ages 24 to 82 years) plus fifty female control volunteers (ages 21 to 83 years) completed the 149-item questionnaire. Results: Construct validity of the English-language PelFIs was established by quantifying the differences in prevalence of pfm dysfunction between the patient population and the control population. Very significant findings of F=10.83, p<0.0001 were found for the document as a whole. Content validity was attained by experts, and additional information gathered for further improvement of this tool. Test-retest reliability for all domains was established with ICC=0.905 and no significant differences were found between time-one and time-two. Internal consistency was obtained with significant Pearson's Correlation noted between the domains. The prevalence of co-occurrence of pfm disorders with patients presenting for treatment of a single pfm dysfunction was quantified and 100% of the patients reported symptoms in domains additional to the domain they sought treatment for. The presence of pfm dysfunction was also quantified in the control population and 94% were found to display symptoms of pelvic floor dysfunction. Conclusions: The English-language PelFIs was shown to be valid and reliable. Co-occurrence of pfm dysfunction was found to be highly prevalent.

Acne is a very common disease affecting approximately 85% of people in some stage of their life (Wolff et al., 2005:2). The systemic drug isotretinoin is the only acne drug which has an influence on all the pathophysiological factors of this highly prevalent disease and is considered as the most effective treatment for acne, although it should be limited to the treatment of severe acne. Isotretinoin prescribing is under the largest risk-minimisation programme (called iPLEDGE) ever implemented for a drug in the United States of America, due to concerns with pregnancies during isotretinoin treatment (Honein et al., 2007:11). In comparison South Africa has no equal managing programme to regulate isotretinoin prescribing and the need to identify certain prescribing patterns is deemed necessary. The general objective of this study was to analyse the prescribing patterns of isotretinoin, including aspects of cost, in a section of the private healthcare sector of South Africa. A quantitative, retrospective drug utilisation review was performed to evaluate the prescribing patterns and cost of isotretinoin containing products claimed through a pharmacy benefit management organisation, over the study period of 2005 and 2006. Data were analysed by using the Statistical Analysis System, 9.1 (SAS). The information of prescriber, age, gender, and cost of isotretinoin usage were considered and evaluated. A total number of 6 427 and 6 927 patients claimed 18 589 and 20 232 isotretinoin prescriptions respectively during 2005 and 2006. Isotretinoin total costs contributed to 34.4% (n = R6 810 090) and 36.3% (n = R6 533 241) of the total identified acne medicine costs for 2005 and 2006 respectively. Isotretinoin represented the highest percentage of total costs in relation to any other acne product identified in both study years. Average costs of R314.82 ± 205.92 per prescribed isotretinoin item in 2005 and R277.63 ± 192.63 in 2006 were recorded in comparison to the total database medicine item cost of R95.33 ± 192.21 in 2005 and R95.33± 227.99 in 2006. The generic products of isotretinoin were claimed at a lower ratio (generic vs. innovator product ratio of 1.8:1 in 2005 and 2.2:1 in 2006) in relation to the total database (generic ratio of 3:1 in both years). Dermatologists prescribed 68.2% and 65.7% of isotretinoin prescriptions and general practitioners 27.5% and 29.7%. General practitioners were more likely to prescribe the generic equivalents of isotretinoin (68.9% in 2005 and 72.1% in 2006) in comparison to dermatologists (59.7% in 2005 and 63.4% in 2006). The teenage group 12 to 19 years received 48.4% (n = 8 989) and 47.7% (n = 9 656) of isotretinoin prescriptions claimed respectively at an estimated cost of R275 000 and R260 000 per 10 000 beneficiaries in this age group respectively for 2005 and 2006. There were 71 patients identified over both study years in the age group younger than 12 years, in which isotretinoin use is not recommended. Female patients received 56.2% (n = 10 450) and 57.4% (n = 11 610) of the total number of isotretinoin prescriptions claimed respectively for 2005 and 2006. The average cost per isotretinoin prescription claimed for male patients was higher (R406.36 ± 233.76 and R358.69 ± 218.29 respectively for 2005 and 2006) in relation to female patients (R335.15 ± 209.98 and R296.36 ± 197.74 respectively for 2005 and 2006). The median ages for female and male patients were 21 years and 18 years respectively. The concern, however, was the high number of female patients of child-bearing potential identified (2 892 and 3 201 female patients respectively for 2005 and 2006), claiming their isotretinoin prescriptions. Systemic isotretinoin occurred alone in 70.8% and 69.3% of prescriptions claimed respectively for 2005 and 2006. Oral contraceptives occurred in combination with isotretinoin in only 8.6% and 9.2% of isotretinoin prescriptions claimed. The contra-indicated use of a systemic tetracycline in combination with systemic isotretinoin occurred in 139 (0.75%) and 130 (0.64%) prescriptions. It can be concluded that the use of isotretinoin increased. Dermatologists played the major role in prescribing isotretinoin. The number of female isotretinoin users (especially of child-bearing potential) could be a concern, although pregnancy prevalence should be identified in South Africa. It is recommended that further studies be conducted in South Africa regarding the usage and control of isotretinoin, including the extension of regulating programmes, with special reference to age and gender. Effective management of the increasing popularity of this ultimately successful acne treatment is of utmost importance to ensure the effective and safe usage of isotretinoin. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

The distorted illusion that drinking alcohol in excess and/or using drugs is fun, sexy, and accepted as the ‘thing to do’ has unfortunately become mainstream. The health effects associated with substance use and abuse in Canada have direct implications on health service utilization, especially when emergent services are required. The prevalence of substance related ED visits in Winnipeg have never been reported, so it was not known if the prevalence of such presentations in Winnipeg were consistent with those rates in other developed nations. The overall aim of this study was to explore, using retrospective secondary analysis methodology and being guided by the Circle of Frequency, what the prevalence, patient profiles, and visit characteristics of substance-related ED presentations in Winnipeg from January 1, 2011-December 31, 2013. 14,255 substance-related ED visits were identified during this study time, accounting for 2.1% of the overall ED visits. Following frequency analysis, young-adult, unmarried men were identified as the ones most likely to arrive to the ED in Winnipeg with substance-related care needs arriving during inopportune times (on weekends and during the night when staffing levels and support are less), via ambulance, with acute CTAS scores secondary to substance misuse/intoxication, however not requiring admission. The significance of such presentations to the ED in Winnipeg has direct and indirect clinical implications which impacts clinical nursing practice, education, research, and patient care. Strategies to better identify and treat such care needs in the ED are evident and paramount to ensure best practice is provided, and optimal care is achieved.

Non-suicidal self-injury (NSSI), such as intentionally cutting, burning or hitting oneself, is a behavior with potentially detrimental consequences and empirical studies are necessary to gain knowledge of how to prevent NSSI in adolescents. The aims of this thesis were to investigate the prevalence, methods, characteristics and functions of NSSI in a large community sample of Swedish adolescents, and to examine the relationship between NSSI and adverse life events and trauma symptoms. All empirical studies had a cross-sectional design and were based on 3,097 adolescents in the county of Östergötland, aged 15-17 years, in their first year of high school. Participating school classes were selected through a randomization process and administered self-report questionnaires. In study I (n = 3,060) a single item NSSI question resulted in a prevalence rate of 17.2%, while 35.6% of adolescents reported having engaged in NSSI at least once during the past year when given a checklist. The most commonly reported type of NSSI in this sample was “bit yourself”, followed by “hit yourself on purpose”, “erased your skin” and “cut or carved on your skin”. Applying the proposed DSM-5 diagnostic criteria of NSSI resulted in a prevalence rate of 6.7%. Results in study II (n = 2,964) showed that after controlling for gender, parental occupation and living conditions, adolescents with no self-injurious behavior reported the lowest level of adversities and trauma symptoms, while adolescents with both NSSI and suicide attempts (5.7%) reported the highest levels compared to those with only NSSI or a suicide attempt. Adolescents reporting frequent NSSI reported more adversities and trauma symptoms than those with less frequent NSSI. Automatic functions, such as affect regulation, self-punishment and feeling-generation, were the most commonly reported functions of NSSI. Attempts in study I to confirm Nock and Prinstein’s (2004) four-factor model of underlying factors of NSSI functions resulted in a close to acceptable fit. An attempt to refine the factor analysis on this community sample of Swedish adolescents, using Mplus with cross-validation, was made in study III (n = 836). An exploratory factor analysis resulted in a three-factor model (social influence, automatic functions and non-conformist peer identification), which was validated in confirmatory analysis. In order to adhere more closely to learning theory and the concept of negative and positive reinforcement, the third factor was then split into two factors, resulting in a four-factor model (social influence, automatic functions, peer identification and avoiding demands), which showed excellent fit to the data in the confirmatory factor analysis. Study IV (n = 816) showed that NSSI frequency, gender (female), self-reported experience of emotional and physical abuse, having made a suicide attempt, prolonged illness or handicap and symptoms of depression and dissociation were significant predictors in the final model of the automatic functions, indicating that these variables are important in understanding the mechanisms underlying the need to engage in NSSI to regulate emotions, generate feelings, gain control or to self-punish. Symptoms of depression and dissociation mediated the relationship between sexual, physical and emotional abuse and the automatic  functions. Furthermore, frequency of NSSI, gender, emotional abuse, prolonged illness or handicap and symptoms of depression uniquely predicted automatic functions but not social functions. Self-reported experience of physical abuse, having made a suicide attempt, symptoms of anxiety and dissociation were significant in the final model of social functions, i.e., performing NSSI to influence or  communicate with others, to avoid demands or to identify with peers. Of these, symptoms of anxiety were uniquely associated with social functions. Symptoms of anxiety and dissociation mediated the relationship between physical abuse and social functions of NSSI. Taken together, this thesis has shown that NSSI is prevalent in Swedish adolescents and findings contribute to the discussion of a potential NSSI diagnosis. It is important to consider the effect of different types of negative life events and trauma symptoms in relation to NSSI in adolescents. Assessing the specific reinforcing functions of NSSI and the underlying factor structure can be helpful in developing functionally relevant individualized treatment. / Självskadebeteende, t ex att avsiktligt skära, bränna eller slå sig själv är potentiellt skadliga beteenden. Empiriska studier är viktiga för att kunna förebygga självskadebeteende hos ungdomar. Föreliggande avhandling syftar till att undersöka självskadebeteendets förekomst, funktion, karaktäristik och metoder hos svenska ungdomar, samt att undersöka relationen till negativa livshändelser och traumasymptom. Samtliga fyra empiriska studier hade en tvärsnittsdesign och baserades på 3,097 ungdomar i Östergötland, 15-17 år, i gymnasieskolans årskurs 1, vars skolklasser valts ut slumpmässigt och som besvarat självskattningsformulär. I studie I (n = 3,060) angav 17.2%, som svar på en allmän självskadefråga, att de avsiktligt skadat sig under sin livstid. När ungdomarna däremot svarade på en checklista med olika självskadebeteenden, angav 35.6% att de hade ägnat sig åt någon typ av självskadebeteende under det senaste året. De vanligaste metoderna var att avsiktligt bita eller slå sig själv, sudda på huden och att skära sig. De föreslagna diagnoskriterierna för icke-suicidal självskada i DSM-5 resulterade i en förekomst av 6.7%. Studie II (n = 2,964) visade att ungdomar utan självskadebeteende rapporterade de lägsta antalet negativa livshändelser och traumasymptom, medan de med erfarenhet av både självskadebeteende och självmordsförsök (5.7%) rapporterade de högsta antalen jämfört med de med endast självskadebeteende eller självmordsförsök. Ungdomar med fler självskadetillfällen rapporterade fler negativa livshändelser och traumasymptom än de med färre tillfällen. Automatiska/intrapersonella funktioner, såsom att generera och reglera känslor samt att straffa sig själv var de vanligaste funktionerna som rapporterades. Försök att konfirmera Nock och Prinsteins (2004) fyrfaktormodell av underliggande funktionsfaktorer i studie I resulterade i en modell med nära acceptabel passform. Ett försök att förbättra faktoranalysen på den aktuella urvalsgruppen gjordes med Mplus i studie III (n = 836). En exploratorisk analys resulterade i en trefaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion samt ”icke-konformistisk” kamratidentifikation), vilken även validerades i den konfirmatoriska analysen. Med utgångspunkt i inlärningsteori och begreppen negativ och positiv förstärkning delades därefter den tredje faktorn upp i två faktorer. Det resulterade i en fyrfaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion, kamratidentifikation samt undvikande av krav). Fyrfaktormodellen visade utmärkt passform i den konfirmatoriska analysen. Studie IV (n = 816) visade att självskadebeteendets frekvens, kön (flicka), självrapporterade erfarenheter av psykisk och fysisk misshandel, självmordsförsök, kronisk sjukdom eller handikapp under uppväxten, liksom symptom på depression och dissociation predicerade automatiska självskadefunktioner. De variablerna är potentiellt viktiga för förståelsen av de mekanismer som är involverade när ungdomar skadar sig själva för att generera och reglera känslor, få kontroll, liksom att straffa sig själva. Relationen mellan psykisk och fysisk misshandel och de automatiska funktionerna medierades av symptom på depression och dissociation. Självskadefrekvens, kön, psykisk misshandel, sjukdom/handikapp och symptom på depression predicerade enbart automatiska men inte sociala funktioner. Självrapporterad fysisk misshandel, självmordsförsök, symptom på ångest och dissociation var signifikanta prediktorer för de sociala funktionerna (att påverka/kommunicera med andra, undvika krav eller identifiera sig med kamrater). Ångestsymptom var unikt associerade med sociala funktioner. Symptom på ångest och dissociation medierade vidare relationen mellan fysisk misshandel och sociala självskadefunktioner. Sammanfattningsvis visade resultaten att självskadebeteende är vanligt förekommande hos ungdomar. Avhandlingen bidrar med empiri till diskussionen gällande icke suicidal självskada i DSM-5. Det är viktigt att beakta olika negativa livserfarenheter och traumasymptom i relation till självskadebeteende hos ungdomar. Att undersöka självskadebeteendets funktioner kan vara kliniskt hjälpsamt för att utveckla och utvärdera individuellt anpassade behandlingsstrategier.

Thesis (M.S.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 89 pages. Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2007. / Härtill 4 uppsatser.