Borderline personality disorder (BPD) is a form of psychopathology characterized by a pervasive pattern of instability with emotion regulation, impulse control, interpersonal relationships, and sense of self. While not a required diagnostic marker, the majority of individuals with BPD engage in some form of deliberate self-harm (e.g., suicide attempts, nonsuicidal self-injurious behavior) or suicide-related behavior (e.g., suicidal ideation, suicide threats). Longitudinal data from a sample of adolescent psychiatric inpatients who were hospitalized for deliberate self-harm and suicide-related behavior were followed for 5 years to investigate whether deliberate self-harm or suicide-related behaviors predicts BPD at 3-year follow-up and 5-year chart review. The extant data set consisted of 132 consecutively admitted adolescent psychiatric inpatients who completed a series of self-report questionnaires assessing deliberate self-harm and suicide-related behaviors, maladaptive familial behavior, peer victimization, and emotion regulation difficulties. Data regarding index psychiatric hospital admission diagnoses, childhood maltreatment, and BPD diagnoses were abstracted from the patient’s medical and psychiatric records and BPD was also assessed though a structured clinical interview. Suicide threats were the only variable found to be predictive of BPD at 5-year chart review. Other empirically (e.g., history of childhood maltreatment, maladaptive familial behavior, and peer victimization) and theoretically (e.g., emotion regulation difficulties) grounded constructs were also examined and were not found to be predictive of BPD in the current study. To our knowledge, this is the first study to investigate prospective associations between deliberate self-harm and suicide-related behaviors and BPD. Future directions and limitations of the research are discussed.

The aim of this thesis is to map self-harm characteristics of adolescents with personal history of traumatic experience including the purpose and development of self-harm over time. First, in the theoretical section of this paper, the developmental stage of adolescence and its risks for engaging in self-harm is portrayed. Then, the topic of trauma, its diagnostic background and neurobiological impact is described, followed by chapter about self-harming itself, its forms, frequencies, functions, etiology and its association with suicide. By the end of this section the role of adolescent resilience in coping with the impact of trauma and self-harm is discussed. The follow up empirical research project of qualitative nature conducted under Dětské krizové centrum includes a set of case studies that were holistically evaluated for all aspects of self- harm and its development over time. Keywords Adolescence; trauma; child abuse neglect; self-harm; suicide; resilience.

No description available.

Background: Self-harming behavior among adolescents has increased over the years and is the second most common cause of death among adolescents. Nurses who meet these teenagers in healthcare and schools have a central role in promoting the health of adolescents and analyzing risks in different forms of behavior. Aim: The aim of the literature study was to explore nurses' experiences of working with adolescents with self-harming behavior.Method: A general literature study with an inductive approach that is basedon nine scientific articles. Results: It appeared that education about selfharm and knowledge on how to manage self-harming behavior was requested by the nurses. It could generate a positive development for adolescents with self-injurious behavior, but also for the nurses who meet these adolescents. The challenge lies in the fact that nurses feel fear about the subject or set their own values and step away from the professional boundary. Conclusion: By highlighting the lack of resources, competence and the problems facing future development, the subject can be raised and generate more research and resources around self-harming behavior / Bakgrund: Självskadebeteende hos tonåringar har ökat genom åren, och ärglobalt sett den näst vanligaste dödsorsaken bland tonåringar.Sjuksköterskor som möter dessa tonåringar inom sjukvård och skola, har encentral roll i att främja tonåringars hälsa och analysera risker i olika formerav beteende. Syfte: Syftet med litteraturstudien var att utforskasjuksköterskors erfarenheter av att arbeta med tonåringar medsjälvskadebeteende. Metod: En allmän litteraturstudie med induktiv ansatssom utgår från nio vetenskapliga artiklar. Resultat: Det framkom attutbildning kring och kunskap om hantering av självskadebeteendeefterfrågades av sjuksköterskorna. Utbildning kunde generera en positivutveckling för tonåringarna, men även för sjuksköterskorna som möttetonåringarna. Utmaningen berodde på att sjuksköterskor ofta kände enrädsla kring ämnet eller hade egna värderingar och gick ifrån denprofessionella gränsen. Konklusion: Genom att belysa avsaknaden avresurser och kompetens samt problematiken inför den framtidautvecklingen, kan ämnet lyftas och generera i mer forskning och resurserkring självskadebeteende.

Bakgrund: Psykisk ohälsa är ett stort folkhälsoproblem i världen och i Sverige. I många fall är det sjuksköterskor inom akutsjukvården som erbjuder den inledande vården för personer med självskadebeteende. Både sjuksköterskor och patienter upplever att akutsjukvården är bristfällig och att akutsjukvårdsmiljön är dåligt anpassad för patientgruppen. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av att möta personer med självskadebeteenden inom akutsjukvården. Metod: En litteraturstudie genomfördes med en induktiv ansats. Resultat: Tio vetenskapliga resultatartiklar användes i studien. Tre huvudkategorier identifierades: känslor, brister inom vården, kompetensbrist. Sjuksköterskor som arbetar inom akutsjukvården känner att de inte har tillräcklig utbildning, vana och erfarenhet för att vårda personer med självskadebeteende. Konklusion: Träning, utbildning och praktiska strategier krävs för att personer med självskadebeteende ska bemötas med medkänsla, respekt och värdighet inom vården. / Background: Mental illness is a big public health problem in the world and in Sweden. In many cases it’s the emergency nurses who provides the initial care for persons with self-harm behavior. Both nurses and patients experience deficiency in the emergency care and that the emergency care environment isn’t suited for this type of care. Aim: The aim was to describe nurses´ experiences of encountering persons with self-harming behavior within the emergency care. Method: A literature study was conducted with an inductive approach. Result: Ten scientific result articles were used in the study. Three main categories were identified: emotions, deficiency in healthcare, lack of competence. Nurses who are working in the emergency care feels that they don’t have enough education, practice and experience to be able to provide the best care for persons with self-harm behavior. Conclusion: Training, education and practical strategies are required for persons with self-harming behavior to be treated with compassion, respect and dignity.

No description available.

Empirical research suggests a link between childhood abuse and adult onset of depression, anxiety, personality disorders, and psychosis. Research also suggests a positive relationship between childhood abuse and both self-harm behaviors and suicide. However, important relationships between these variables remain unclear, nor have they been studied within the context of significant comorbidity. The current study looks at the relationship between multiple occurrences of childhood abuse and self-harm behaviors and suicide attempts, within the context of depression, anxiety, borderline personality disorder, and psychosis. We hypothesize that these diagnoses mediate relationships between recurring childhood abuse and selfharm behaviors and suicide attempts. A sample of 494 psychiatric inpatients were used for analysis (54.7% Caucasian, 41.7% African American, 1.6% Hispanic, .5% Asian, .6% Native American, .6% Mixed, and .4% other/unknown). Over half of the patients presented with a mood disorder (55.9%) and/or a psychotic spectrum disorder (61.5%). The study found a positive and significant correlation between abuse history and the presence of self-harm (r=.241, p<.001) as well as number of suicide attempts (r=.176, p<.001). These results were expected and are consistent with the current empirical literature. The significant relationship between abuse and self-harm was mediated by depression (rpartial=.229), anxiety, (rpartial=.234), and borderline personality disorder (rpartial=.211). Similarly, the relationship between abuse and suicide attempts was significantly mediated by depression (rpartial=.166), anxiety (rpartial=.155), and borderline personality disorder (rpartial=.157). This suggests a strong relationship between abuse and self-harm behaviors as well as suicide attempts that is impacted be various psychiatric diagnoses. Depression, anxiety, and borderline personality disorder serve as significant mediators while psychosis showed no significant influence. These effects are interesting because psychosis is most impacted by biological factors where as depression, anxiety, and borderline personality disorder are influenced greatly by experience. These findings allow us to better understand the nature of suicide and self-harm behavior within the context of abuse and psychiatric comorbidity in order to help in treatment planning for such individuals.

Bakgrund: Självskadebeteende är ett problem som ökat i samhället. Personer med självskadebeteende som söker vård upplever ofta att de blir bemötta av stigmatiserande attityder och att de inte blir sedda som individer. Vårdpersonal uppger att de saknar kunskap om självskadebeteende och att detta bidrar till ett fördomsfullt bemötande gentemot patientgruppen. Stigmatisering kan få personer med självskadebeteende att känna sig mindre värda. Detta kan utgöra hinder för en tillitsfull relation mellan dem och vårdpersonal. Genom att sammanställa aktuell forskning kan det bidra till en ökad medvetenhet om hur vårdpersonalens bemötande påverkar personer med självskadebeteende.   Syfte: Syftet med denna studie var att beskriva hur personer med självskadebeteende upplever bemötandet inom hälso- och sjukvården.  Metod: En icke-systematisk litteraturöversikt som baserades på 18 vetenskapliga originalartiklar med kvalitativ eller mixad metod. Artiklarna samlades in från databaserna PubMed, CINAHL och PsycINFO. Samtliga artiklar har kvalitetsgranskats utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultatet sammanställdes och analyserades med en integrerad dataanalys. Resultat: Vid sammanställning av resultatet identifierades fyra huvudkategorier; Negativt bemötande, Positivt bemötande, Upplevelser av vårdmiljön samt Önskemål till vårdpersonal. Resultatet visade att personer med självskadebeteende ofta upplevde ett stigmatiserat bemötande från vårdpersonal. Upplevelser av negativt bemötande ledde till känslor av skam och minskad tillit. Ett empatiskt och fördomsfritt bemötande, där de blev sedda som unika individer, beskrevs som betydelsefullt för personer med självskadebeteende. Slutsats: Denna litteraturöversikt belyste betydelsen av ett professionellt bemötande. Utbildningar om självskadebeteende och kommunikationsstrategier kan bidra till en ökad förståelse och kunskap om patientgruppen. Detta kan i sin tur främja ett bemötande där sjuksköterskan och personer med självskadebeteende möts på ett mellanmänskligt plan. / Background: Self-harm is a problem that has increased in society. People with self-injurious behavior that seek care experience that they are often met with stigmatizing attitudes and that they are not seen as individuals. Healthcare staff state that they lack knowledge about self-harm and that this contributes to a judgmental attitude towards the patient group. Stigmatization can make people who self-harm feel less valuable. This could hinder a trusting relationship between them and healthcare staff. By compiling existing research, it could contribute to an increased awareness of how interactions with the healthcare staff affect people with self-injurious behavior. Aim: The aim of this study was to describe how people with self-injurious behavior experience the interaction within healthcare. Method: A non-systematic literature review based on 18 original scientific articles using a qualitative or mixed method. The articles were collected from the databases PubMed, CINAHL and PsycINFO. All articles underwent a quality review based on Sophiahemmet University's assessment document for scientific classification and quality. The results were compiled and analyzed using an integrated data analysis. Results: When compiling the results, four main categories were identified; Negative interaction, Positive Interaction, Experiences of the healthcare environment and Wishes to healthcare staff. The results showed that people with self-injurious behavior often experienced a stigmatizing attitude from healthcare staff. Experiences of negative interactions led to feelings of shame and distrust. People with self-injurious behavior described that an empathic and non-judgmental encounter, where they were seen as unique individuals, was of great importance. Conclusions: This literature review showed the importance of a professional approach. Education about self-injurious behavior and communication strategies can contribute to further understanding and knowledge of the patient group. This, in turn, can promote interactions where the nurse and people with self-injurious behavior meet on an interpersonal level.

The phenomenon of cutting is extremely complex, as is the care of those who engage in it. This work provides exhaustive knowledge of the kinds of clinical interpretations of cutting that exist and interventions offered to curb this maladaptive behavior. It empowers volunteer youth workers to feel more confident in responding to young women who are cutting. It also encourages those who work in evangelical Christian contexts to draw carefully, cautiously, and judiciously, from the resources of their faith tradition as their contribution to the care of young women who cut.

Awareness of sexual exploitation has increased over the past decade. However, physical and psychological health needs, risks, health seeking behaviour and use of health services by sexually exploited young people have been inadequately explored. Methodology/method Phase 1: descriptive, phenomenological, approach to encourage young people involved in or vulnerable to sexual exploitation to describe their personal accounts of health, risks, health seeking and support. Phase 2: quantitative methodology consisting of a questionnaire survey with professionals supporting young people involved in or vulnerable to sexual exploitation. Data analysis Phase 1: phenomenological approach to data analysis (Giorgi, 1985). Phase 2: questionnaire data were analysed using software S.P.S.S. and thematic content analysis (Burnard, 2006). Results/findings Intentional self harm and substance misuse were concordant themes from phase 1 and 2. Novel themes that emerged from this study included a taxonomy of risk behaviours related to health, and the use of youth offending teams for health support Conclusion A significant range of physical and psychological health problems were reported alongside risks to health and barriers to health support for sexually exploited young people. Psycho-social vulnerability factors undermine health and impact on health seeking behaviour. / University of Bradford