Background: The purpose of the present study was to investigate the prevalence and characteristics of deliberate self-harm in a Swedish University population. Method: A random sample of first year students at University of Kalmar was invited to participate in an Internet-based survey in the autumn of 2007. A total of 139 (53,1 %) completed the anonymous survey. Results: The results showed that 25,2 % (n=35) of the students reported having engaged in some kind of deliberate self-harm at least once, and deliberate self-harm was endorsed by 7,9 % within the past year. The most frequently procedures to self-harm were to tear, carve or pinch self, cutting skin and hitting self on purpose. 37,1 % reported that they had told no one about their self-injurious behaviors and 36,4 % significantly reported that they had no one they trusted and who they could talk to if they were concerned about something. Students with self-injurious behavior were also more likely to report a history of emotional, sexual and/or physical abuse, alcohol and drug use, cut classes and questioning their sexual orientation. Conclusions: Findings suggest that self-harm is associated with risk factors and that self-injury is not only associated with adolescence but also with adulthood. It is therefore important to continue studies in both populations.

For over a decade, suicides of young people have been a very important public health concern. The number of suicides among the school-aged children varies from 20 to 33 per annum, whereas suicide as the cause of death is number three on the list of causes. Research carried out in various countries provide clear evidence that one of the most threatening signs of the possible suicidal behaviour is self-harm or attempted suicide at an early age. Therefore, in-depth knowledge of the risk factors for deliberate self-harm is very important not only for scientific reasons, but for the prevention of suicides of young people. The aim of dissertation is to research social and psychological peculiarities of deliberate self-harm of 15-17 year old Lithuanian pupils. In order to achieve the aim, the following objectives were set: 1. To assess distribution of pupils’ deliberate self-harm, types of self-harm, and socio-demographic irregularities. 2. To disclose subjective reasons for deliberate self-harm of pupils. 3. To analyse the relationship between stressful life experience and pupils’ deliberate self-harm. 4. To identify the importance of smoking, alcohol, and drug abuse to deliberate self-harm. 5. To investigate the relationship between the pupils’ deliberate self-harm and subjective indices of psychic health and general condition. 6. To assess the need for help to pupils who deliberately harm themselves. / Jaunų žmonių savižudybės jau daugiau kaip dešimtmetį išlieka labai svarbia visuomenės sveikatos problema. Mokyklinio amžiaus vaikų savižudybių skaičius per metus svyruoja nuo 20 iki 33, o savižudybė pagal dažnį yra trečioje vietoje mirties priežasčių sąraše. Įvairiose šalyse atlikti tyrimai pateikia neabejotinų įrodymų, jog vienas grėsmingiausių galimo savižudiško elgesio rizikos ženklų yra sąmoningas savęs žalojimas ar bandymai žudytis jauname amžiuje. Todėl gilesnis sąmoningo savęs žalojimo rizikos veiksnių pažinimas yra labai svarbus ne tik mokslo, bet jaunų žmonių savižudybių prevencijos požiūriu. Disertacinio darbo tikslas — ištirti sąmoningai save žalojančių 15–17 metų Lietuvos moksleivių socialinius bei psichologinius ypatumus. Tikslui pasiekti iškelti šie uždaviniai: 1. Įvertinti moksleivių sąmoningo savęs žalojimo paplitimą, būdus bei jų sociodemografinius netolygumus. 2. Atskleisti subjektyvias moksleivių sąmoningo savęs žalojimo priežastis. 3. Išanalizuoti ryšius tarp stresą sukeliančios gyvenimo patirties ir moksleivių sąmoningo savęs žalojimo. 4. Nustatyti rūkymo, alkoholio bei narkotikų vartojimo reikšmę moksleivių sąmoningam savęs žalojimui. 5. Išnagrinėti moksleivių sąmoningo savęs žalojimo, subjektyvių psichikos sveikatos bei savijautos rodiklių sąsajas. 6. Įvertinti save žalojančių moksleivių pagalbos poreikius.

<p>Background: The purpose of the present study was to investigate the prevalence and characteristics of deliberate self-harm in a Swedish University population.</p><p>Method: A random sample of first year students at University of Kalmar was invited to participate in an Internet-based survey in the autumn of 2007. A total of 139 (53,1 %) completed the anonymous survey.</p><p>Results: The results showed that 25,2 % (n=35) of the students reported having engaged in some kind of deliberate self-harm at least once, and deliberate self-harm was endorsed by 7,9 % within the past year. The most frequently procedures to self-harm were to tear, carve or pinch self, cutting skin and hitting self on purpose. 37,1 % reported that they had told no one about their self-injurious behaviors and 36,4 % significantly reported that they had no one they trusted and who they could talk to if they were concerned about something. Students with self-injurious behavior were also more likely to report a history of emotional, sexual and/or physical abuse, alcohol and drug use, cut classes and questioning their sexual orientation.</p><p>Conclusions: Findings suggest that self-harm is associated with risk factors and that self-injury is not only associated with adolescence but also with adulthood. It is therefore important to continue studies in both populations.</p>

Bakgrund: Självskadebeteende är ett symtom på psykisk ohälsa som sedan millennieskiftet uppmärksammats i allt högre utsträckning. Den första kontakten med vården personer med självskadebeteende tar sker ofta via den somatiska akutsjukvården. Patienter vittnar om negativa upplevelser i mötet med dessa vårdinstanser. Det är därför av värde att öka kunskapen om hur sjuksköterskor upplever mötet med patienter med självskadebeteende. Syfte: Syftet med litteraturöversikten var att beskriva sjuksköterskors upplevelser av att möta patienter med självskadebeteende inom somatisk akutsjukvård. Metod: Studien genomfördes som en litteraturöversikt där 15 vetenskapliga artiklar söktes via databaserna PubMed, CINAHL, PsycINFO och Web of Science. Artiklarna kvalitetsgranskades, analyserades och sammanställdes till ett resultat. Resultat: Av resultatet har framgått tre huvudkategorier vilka var: Sjuksköterskans tankar och känslor; Kompetens och kunskap; Faktorer som påverkar mötet och vården. Slutsats: Resultatet visade att sjuksköterskor inom somatisk akutsjukvård erfor både positiva och negativa upplevelser i mötet med patienter med självskadebeteende vilka frammanade olika känslor och tankar hos sjuksköterskor. Gemensamt för studierna var att sjuksköterskor uppgav att de hade bristande kompetens och kunskap i samband med omvårdnaden av dessa patienter. / Background: Deliberate self-harm is a symptom of mental illness that ever since the turn of the millennium has been increasingly highlighted. The first contact with healthcare a person with deliberate self-harm often takes place via the somatic emergency medical care. Patients testify to negative experiences in the meeting with these care instances. Therefore, it may be useful to investigate how nurses perceive the meeting with patients with deliberate self-harm. Aim: The aim of the literature review was to describe nurses’ experiences of meeting patients with deliberate self-harm in somatic emergency medical care. Method: The study was conducted as a literature review where 15 scientific articles were sought via the databases PubMed, CINAHL, PsycINFO and Web of Science. The articles were quality-reviewed, analyzed and compiled into a result. Results: In the process of describing nurses’ experiences, three main categories emerged which were: The nurse's thoughts and feelings; Competence and knowledge; Factors that affect the meeting and care. Conclusion: The result showed that nurses in somatic emergency medical care had both positive and negative experiences in the meeting with patients with deliberate self-harm which evoked different feelings and thoughts among nurses. Common to the studies was that nurses stated that they had a lack of competence and knowledge about this patient group.

Repetitive self-mutilation (RSM) has become increasingly prevalent among adolescents. Empirical research has pinpointed several correlates of this behavior, but the initiation and maintenance of RSM among adolescents are not well understood. The experiential avoidance model (EAM) proposes that self-mutilation is a behavior that allows for the avoidance or alteration of unwanted internal experiences, and that it is negatively reinforced with repetition. The current study explored the usefulness of the EAM as an explanatory theory for adolescent RSM, with the additional incorporation of issues of social context. Adolescents (N = 211) from three school-based samples completed self-report questionnaires. One-third of students reported at least one incident of purposeful, non-suicidal self-mutilation and 16% had engaged in self-mutilation repeatedly within the past 6 months. Both regression and group analyses indicated that adolescents who engage in RSM report greater psychological distress, a greater incidence of functionally equivalent behaviors, and greater exposure to self-mutilation among peers and/or in the media, when compared to their counterparts who have not engaged in RSM. Suicidal ideation/behaviors were consistently the strongest predictors of current self-mutilation behaviors. Clinical implications, limitations, and suggestions for future research are discussed.

The current study is motivated by the relative lack of research on the contagion of deliberate self-harm, research on self-harm among adolescents in children's homes, as well as South African research on self-harm. In this study, I explore three aspects concerning deliberate self-harm in the South African context: The perceptions of adolescents in children's homes concerning the possible contagion of self-harm; the frequency, methods, duration and severity of self-harm among adolescents in children's homes; and lastly, the motivations of adolescent self-harm in children's homes. I make use of both quantitative measures, being the Deliberate Self-Harm Inventory (DSHI) developed by Gratz (2001) and the Functional Assessment of Self-Mutilation (FASM) developed by Lloyd (1997), and qualitative measures, being the logbooks completed by participants and three semi-structured interviews conducted, to address these questions. The current study uses both the functional approach to deliberate self-harm, that classifies self-harm according to the four functions that produce and maintain such behaviour, and the environmental model that emphasises the situational influences on the contagion of deliberate self-harm. The findings of the study indicate that 10 of the 12 adolescent participants have experienced either the acquisition or episodes of co-occurrence of self-harm through contagion, both outside the children's homes and within the children's homes. The contagion of self-harm is influenced by the desensitisation and growing prevalence of self-harm, frequent observations of self-harm, close personal relationships between individuals who selfharm, and the influence of the visual media. With regard to the findings of the DSHI, the methods most commonly employed for self-harm in the study include cutting, carving words into the skin, as well as the breaking of bones; the majority of the methods had been employed by the participants within the last year; and the emotions present immediately prior to the episode of self-harm include anger, depression, sadness, frustration, anxiety and disappointment. Findings from the FASM indicate that the motivation for the majority of the adolescent participants' self-harm is 'to stop bad feelings'. Furthermore, the findings of the study indicate that psychological intervention may be available to adolescents in several situations; that the personal histories of the adolescent participants include experiences of physical, emotional and sexual abuse, parental unavailability, the observation of parental alcoholism, as well as the experience of human trafficking; and suicide attempts have been made by the participants following instances of perceived ineffectiveness of self-harm. From the findings, it is evident that the contagion of self-harm is no longer a hypothetical phenomenon. Further implications of the study include the need for continued research on the methods reported by South African individuals who engage in self-harm that are not as prevalent in other research; and the influence of the study on the development and implementation of interventions to address self-harm in children's homes. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

Any form of self harm can be triggering and hard for most people to be confronted with. Sexually risky behaviour and sex as self-injury among young people is no exception. This study aims to explore and analyse how social workers in the field of psychiatric care for young people in Sweden work with this group. For this study four interviews were conducted and analysed with systems theory.  To further deepen the studies result, a variation of literature has been included. The result of the study showed how dedicated social workers worked in interprofessional teams as well as with the youths families, in ordr to provide the youth with care suitable for their needs. The results from both the interviews as well as the literature reviewshow that although there is currently a need for more structured and evidence-based guidelines and work methods, it is a field where forward-looking research and great development are constantly present.

This study sought to hear the narratives of individuals that have recovered from self-harming, with the intention of bearing witness to both the narratives and remaining scars in order to better understand and inform clinical practice. A purposive sample of seven individuals was recruited. Participants were asked to photograph their scars and bring them to an interview. Narratives were generated and explored through a relatively unstructured individual interview. Both the images and narratives were analysed using a narrative approach exploring content, performance and structural aspects, emphasising researcher reflexivity throughout. Findings were understood through psychoanalytic theory and highlighted a theme of validation and ‘being seen’, evidenced in stories of past invalidation that had been internalised into the self-structure and defended against by presenting a ‘defended’ self. Self-harm enabled this ‘unseen self’ to be expressed, validated and contained. Recovery was storied in terms of internalising experiences of validation, which enabled integration of the invalidated parts of the self. Many of the participants highlighted how their scars told a story of discovery; of becoming, coping and surviving. In the healing of scars this recovery is evident, but they may also continue to convey the unseen and unspoken experiences of pain, incoherence and invalidation. Self-harm and remaining scars may be understood as connecting, containing and re-embodying the internalised invalidation and ‘unseen’ aspects of the self. These findings are discussed with reference to the clinical implications, strengths and limitations of the methodology and directions for future research.

Despite a well-documented gender pattern of adolescent mental health, public health research investigating possible influencing factors from a gender-theoretical approach is scarce. This study aimed to explore what factors and circumstances are related to adolescent mental health and to apply a gender analysis to the findings in order to improve the understanding of the relationships between life circumstances and the gendered patterning of mental health among young people.   The study population was 16-19-year-old Swedish students and data was collected by means of focus groups (N=29) and self-administered questionnaires (N=1,663, 78.3% response rate) in school settings. Mental health problems were defined in a broad sense including the adolescents’ own understandings, perceived stress, psychological distress and deliberate self-harm.   The mental health problems of perceived stress, psychological distress and deliberate self-harm were twice as common among girls as boys. The findings suggest that adolescent mental health is associated with the life circumstances of social relationships, demands and responsibility taking and experiences of violence and harassment.  Supportive relationships with friends, family and teachers were found to be of importance to positive mental health, whereas poor social relationships, loneliness and lack of influence were associated with mental health problems.  Perceived demands and responsibility taking regarding school work, relationships, future plans, appearance and financial issues were strongly related to mental health problems, particularly among girls regardless of social class. The results indicate that physical violence, sexual assault, bullying and sexual harassment are severe risk factors for mental health problems in young people. Boys and girls experienced different types of violence, and the victim-perpetrator relationships of physical violence differed. These diverging experiences appeared to influence the associations with mental health problems in boys and girls.   A gender analysis provides the tools to gain knowledge about the ways that boys’ and girls’ lives are shaped by gender relations and constructions at different levels in society and how these life circumstances represent risk- or protective factors for mental health. For example, unequal power structures and the ways girls are expected to ‘do’ femininity likely influence their life circumstances in ways that place them at greater risk of mental health problems. Hegemonic constructions of masculinity and advantaged positions likely contribute to life circumstances that are positive for mental health but are also implying risk factors for poor mental health among boys, e.g., violence. It is also important to recognise how the intertwined cultural and structural aspects of gender and social class influence the lives and mental health of boys and girls. In conclusion, gendered and class-related mechanisms at the different levels in society influence the distribution of risk factors unevenly among boys and girls, which could be a possible explanation for the gender differences in reports of perceived stress, psychological distress and deliberate self-harm.   The likelihood of gender and socioeconomic differences in mental health problems should be taken into account in prevention and health promotion strategies at all levels in society. A greater awareness about gender relations and the gendered social circumstances under which young people live is required. The school environment is an important arena with respect to prevention and health promotion. There is also a need for a joint action against violence and harassment at all levels in society. Implications do not only concern young people; social policy and legislation should focus on reducing gender and class inequalities in general. / Sammanfattning Svensk titel: Livsvillkor och ungdomars psykiska hälsa: uppfattningar, associationer och en genusanalys.   Trots ett väldokumenterat genusmönster i ungdomars psykiska hälsa finns det en kunskapslucka i den folkhälsovetenskapliga forskningen avseende genusteoretiska analyser av sambanden mellan ungas livsvillkor och psykisk hälsa. Föreliggande studie syftade till att undersöka vilka faktorer och omständigheter som är relaterade till psykiska problem, samt att analysera fynden ur ett genusperspektiv för att fördjupa förståelsen av relationerna mellan ungas livsvillkor och genusmönster i psykiska hälsa.   Studiepopulationen var gymnasielever i åldern 16-19 år. Studien genomfördes i skolmiljö och data insamlades genom fokusgrupper (N=29) och en enkätstudie (N=1,663, 78.3% svarsfrekvens). En bred definition av psykisk ohälsa tillämpades vilken representerades av ungdomarnas egen förståelse, samt de psykiska problemen upplevd stress, psykiska besvär samt självskadebeteende.   Resultaten visade att stress, psykiska besvär och självskadebeteende var dubbelt så vanligt bland flickor som bland pojkar. Psykiska problem var relaterade till livsvillkoren sociala relationer, krav och ansvarstagande samt utsatthet för våld och trakasserier. Stödjande relationer med vänner, familj och lärare var av stor betydelse för psykisk hälsa medan dåliga relationer, ensamhet och brist på inflytande var relaterat till psykiska problem. Psykiska problem var starkt kopplade till erfarenheter av höga krav och ansvarstagande avseende skolarbete, relationer, framtidsplaner, utseende och ekonomi, i synnerhet bland flickor oavsett socioekonomisk bakgrund. Resultaten indikerar att olika former av våld och trakasserier är allvarliga riskfaktorer för psykiska problem och att flickors och pojkars skiljda erfarenheter av olika former av våld samt relationen till förövaren, kan vara relaterade till skillnader i psykiska problem.   Genusanalysen av resultaten föreslår att flickors livsvillkor påverkas av ojämlika maktstrukturer och konstruktioner av femininitet och att dessa livsvillkor bidrar till en ökad risk för psykisk ohälsa bland flickor. Livsvillkor kopplade till manlig överordning och hegemoniska konstruktioner av maskulinitet influerar sannolikt pojkars psykiska hälsa positivt. Dessa villkor kan dock också innebära risk faktorer för psykiska problem, t.ex. i fråga om våld. Studien uppmärksammar även hur kulturella och strukturella aspekter av både genus och social klass kan påverka livsvillkor och psykisk hälsa för pojkar och flickor. Studiens slutsats är att genusifierade och klassrelaterade mekanismer på olika nivåer i samhället bidrar till en skev fördelning av riskfaktorer för psykiska problem vilket kan vara en möjlig förklaring till skillnaderna mellan pojkar och flickor i fråga om upplevd stress, psykiska besvär och självskadebeteende.   Genus- och socioekonomiska skillnader i psykiska problem bör tas i beaktande i preventivt och hälsofrämjande arbete på alla nivåer i samhället. Detsamma gäller för en ökad medvetenhet om hur ungas livsvillkor är relaterade till psykisk hälsa och hur dessa villkor är genus- och klassrelaterade. Studien uppmärksammar skolan som en viktig arena för preventivt och hälsofrämjande arbete samt att gemensamma insatser krävs på olika arenor för att motverka våld och trakasserier. Implikationer av studien omfattar även generella samhällspolitiska insatser för minskad ojämlikhet. Nyckelord: Stress; psykiska besvär; självskadebeteende; gymnasieelever; maskulinitet; femininitet; sociala determinanter; sociala relationer; krav; ansvarstagande; våld och trakasserier; skola. / Forskarutbildningsämne: Hälsovetenskap.

The aim of this study is to shed light on the phenomenon of destructive sexual behavior among youth from the perspective of professionals working at nonprofit organizations. To examine this, we used a qualitative method; we interviewed professionals working at nonprofit organizations. To analyze our results we used gender theory and empowerment theory. Our main results are that the professionals view this behavior as deliberate self-harm, such as cutting, as they do it to achieve relief from anxiety. Also, the professionals think that gender norms affect young people with destructive sexual behavior in that it imposes guilt and shame, which inflicts their already low self-esteem and makes them feel inferior. The profes- sionals view this as the common denominator for this group of young people. Therefore it is very important for professionals to help these young people build self-esteem by using empowerment. Hopefully, this study can provide additional knowledge to the field of social work, due to the focus on a relatively new perspective on the phenomenon of deliberate self-harm. It is therefore important for agents in social work to have knowledge and comprehension about how to approach the phenomena and how to view and work with this group of young people.