Increasing rates of self-injury in the United Kingdom coupled with the apparent lack of understanding, highlights a need for research to be conducted in this area. A dearth of research illuminating the experiences of self-cutting, together with increased awareness of the differences in perspective between people who self injure and professionals, also provides a rationale for this study. This study aims to explore the experiences of people who self-injure in order to identify and understand the processes involved in self-cutting, and develop a theory which aids this understanding. A grounded theory approach is used to meet the aim of the study, generating data through in-depth interviews with 10 people who engage in self-cutting. Participants shared their experiences of self-injury emphasising both the meaning and function of cutting for them, and the struggle they face living with the behaviour. Although the experiences of participants were unique to each individual, clear commonalities in experience emerged during data analysis and were explored with subsequent participants,in keeping with the grounded theory method. As data generation and analysis developed, the aim of the study became more focused, resulting in an exploration of the urge to self-injure and how people who engage in self-cutting respond to this urge. Findings relate to the core category, living with the urge and main categories of experience namely underlying urge, triggering the urge, satisfying the urge and resisting the urge. Discussion of the findings offers a substantive theory, asserting that people who self-injure face a paradox of finding it very difficult to live with self-cutting, while simultaneously facing the challenge of living without the behaviour. This paradox can be understood within the context of the core category, living with the urge, a process which begins before the participants start self injuring, continues while they are cutting, through to when they are trying to live without cutting. The discussion contributes knowledge relating to commonalties between self-cutting and the experience of addiction; issues for prevention; repetitive nature of cutting; the relationship between people who cut and their cutting tools; and ultimately highlights how difficult it is for the participants to break-free from the world of cutting. Implications of the findings for health and social care practitioners, and education and training are discussed, and recommendations for research are made.

The notion that acts of deliberate self-harm serve an expressive or communicative function is the central premise upon which many of the main functional models of selfharm are based. However despite the importance of this notion, very little empirical evidence exists to support it. Within this project the notion that acts of DSH serve an expressive or communicative function was explored in detail. Four studies investigating the expressive and communicative qualities of acts of DSH, the content which such behaviours serve to express, and the dynamics by which several different modalities of DSH do this were performed utilising Internet methods of data collection. The use of online methods of data collection findings of this project only apply to the sub-group of individuals who engage in DSH and also participate in online discussion forums. Photographs of words and phrases engraved into the skin along with detailed first person narratives of past episodes of deliberate self-harm were used as data sources in this project. Due to their high frequency of occurrence, acts of skin-cutting, self-burning, self-hitting, and self-poisoning were the main modalities of deliberate self-harm investigated in the four studies. Acts of skin-cutting, self-burning, self-hitting, and self-poisoning were all reported to serve expressive functions which allowed emotions and issues to be released or discharged from the body. Conversely, acts of skin-cutting and self-poisoning were also reportedly used to communicate emotional distress and a need for support from others. The content expressed or communicated by such behaviours, and indeed the dynamics by which they did so depended largely upon the modality by which injuries were inflicted. However in general the content expressed and communicated by the acts of deliberate self-harm reported in this project typically related to the events which preceded such behaviours, how they were interpreted, the types of psychological experiences they represented, and the emotions which they evoked. Such events were overwhelmingly interpersonal in nature, and typically involved the dissolution or disruption of relationships with primary support group members. The dynamics by which acts of deliberate self-harm reportedly served these functions differed widely, however the concept of symbolism was central to all modalities. The data collected within this project relating to the expressive and communicative functions of acts of skin-cutting, self-burning, self-hitting, and selfpoisoning was finally collated with the existing literature on the subject.

No description available.

Deliberate self-harm (DSH) is a major health concern, especially for high-risk populations such as incarcerated youth. DSH refers to socially unacceptable, deliberate behaviour that causes harm to the body regardless of intent to die. There is limited research concerning prevalence rates as well as risk and protective factors for high-risk, adolescent groups. Participants were recruited from a correctional facility for youth aged 12-18. Male (n = 36) and female (n = 51) incarcerated adolescents (N = 87; mean age = 15.9) completed a survey that measured social-demographic characteristics, current depressed mood, lifetime alcohol and drug use, perceptions of social support (availability and satisfaction), approach-avoidance coping, problem-solving confidence, and DSH. The prevalence rates (81% lifetime, 74% annual, and 51% while incarcerated) for this mainly Aboriginal and Métis population were much higher than previous offender, community, and hospital findings. Youth reported much higher rates of DSH on a checklist than in response to a general question previously used in such research, suggesting that previously reported prevalence rates are likely grossly underestimated. Hypotheses regarding risk and protective factors were only partially supported. Depressed mood and drug use were positively, directly related to annual DSH frequency. Depressed mood proved to be a significant risk factor as well for incarcerated DSH. Overall, protective factors did not predict DSH well for this group of offenders. Only approach coping was inversely related to DSH frequency. Participants in this study reported very low levels of protective factors, which likely affected the outcome of statistical analyses. In general, youth reported high rates of risk factors and low rates of protective factors. Rates of DSH warranting medical attention increased with duration and frequency of such behaviour, as did actually receiving medical attention. Although 74% of offenders indicated that medical attention had been warranted at least once, only 50% actually received medical attention. Offenders were equally likely to receive medical attention whether they had engaged in DSH once or repetitively. It is likely that offenders prefer to keep their behaviour private, which affects how often they seek medical attention, even if they believe it is warranted. Recommendations are advanced for detecting and responding to DSH in incarcerated youth.

Tyrėjai vis dažniau skiria dvi save žalojančių paauglių grupes: mėginančius nusižudyti ir nesuicidiškai save žalojančius, kurie nesiekia mirties. Tačiau iki šiol buvo atlikta mažai populiacinių tyrimų, mėginančių šias dvi grupes tiesiogiai palyginti, todėl informacija apie šių grupių psichologinių ypatumų ir save žalojančio elgesio vidinių veiksnių skirtumus yra gana prieštaringa. Tyrime buvo naudojamas „Gyvenimo būdo ir prisitaikymo klausimynas“ (orig. Lifestyle and Coping Skills Questionnaire), kurį Lietuvoje adaptavo ir paauglių save žalojančio elgesio tyrimui pritaikė A. Laskytė ir N. Žemaitienė. Dalis jų surinktų duomenų analizuojama šiame darbe. Tikslas: ištirti bendros populiacijos paauglių suicidinio ir nesuicidinio save žalojančio elgesio vidinius veiksnius: motyvus, savižudiškus ketinimus, žalojančio elgesio ypatumus ir su šiais faktoriais galimai susijusius asmens psichologinius ypatumus. Taip pat atskleisti būdingus šių veiksnių skirtumus merginoms ir vaikinams. Tiriamieji: 15-17 metų amžiaus Lietuvos moksleiviai, kurie pildydami „Gyvenimo būdo ir prisitaikymo klausimyną“, atsakė, kad bent kartą gyvenime sąmoningai save žalojo. Klausimyno pildymo metu paaiškindami save žalojančio elgesio priežastis, prie teiginio „Aš norėjau numirti“ paaugliai galėjo atsakyti „Taip“ arba „Ne“. Pagal šį atsakymą jie buvo suskirstyti į dvi grupes: suicidiškai save žalojančių – norėjusiųjų numirti (n=163), ir nesuicidiškai save žalojančių – nenorėjusiųjų numirti (n=118). Rezultatai:... [toliau žr. visą tekstą] / Researches often differentiate two groups of self-harming adolescents: those who attempters a suicide, and those who are harming themselves in a non-suicidal way, and they don‘t seek the death. However just a few community-based research, which would directly compare these groups, were done so far, and therefore information about the differences of the psychological peculiarity and self-harming behavior‘s internal factors between the groups is ambivalent. Lifestyle and Coping Skills Questionnaire (Hawton, 2006), adapted and adjusted for the research of adolescents self-harming behavior by A. Laskytė and N. Žemaitienė in 2006, was used in this work. A part of their collected data is also used in this work. The aim: to examine the intrapersonal factors of suicidal and non-suicidal self-harm in a community sample population: the motives, suicidal intentions, the peculiarities of harming self-harm and person‘s psychological traits that could be possibly related to those factors. It also aimed to reveal the typical differences of these factors between the genders. The sample: 15-17 year old Lithuanian pupils who, while answering into Lifestyle and Coping Skills Questionnaire, responded that they were harming themselves at least once in a life time. In the questionnaire while explaining the reasons of self-harming behavior, into the proposition “I wanted to die” they could write “Yes” or “No”- in this way they were separated into two groups: suicidal self-harmers – who wanted to... [to full text]

Deliberate self-harm (DSH) is a major health concern, especially for high-risk populations such as incarcerated youth. DSH refers to socially unacceptable, deliberate behaviour that causes harm to the body regardless of intent to die. There is limited research concerning prevalence rates as well as risk and protective factors for high-risk, adolescent groups. Participants were recruited from a correctional facility for youth aged 12-18. Male (n = 36) and female (n = 51) incarcerated adolescents (N = 87; mean age = 15.9) completed a survey that measured social-demographic characteristics, current depressed mood, lifetime alcohol and drug use, perceptions of social support (availability and satisfaction), approach-avoidance coping, problem-solving confidence, and DSH. The prevalence rates (81% lifetime, 74% annual, and 51% while incarcerated) for this mainly Aboriginal and Métis population were much higher than previous offender, community, and hospital findings. Youth reported much higher rates of DSH on a checklist than in response to a general question previously used in such research, suggesting that previously reported prevalence rates are likely grossly underestimated. Hypotheses regarding risk and protective factors were only partially supported. Depressed mood and drug use were positively, directly related to annual DSH frequency. Depressed mood proved to be a significant risk factor as well for incarcerated DSH. Overall, protective factors did not predict DSH well for this group of offenders. Only approach coping was inversely related to DSH frequency. Participants in this study reported very low levels of protective factors, which likely affected the outcome of statistical analyses. In general, youth reported high rates of risk factors and low rates of protective factors. Rates of DSH warranting medical attention increased with duration and frequency of such behaviour, as did actually receiving medical attention. Although 74% of offenders indicated that medical attention had been warranted at least once, only 50% actually received medical attention. Offenders were equally likely to receive medical attention whether they had engaged in DSH once or repetitively. It is likely that offenders prefer to keep their behaviour private, which affects how often they seek medical attention, even if they believe it is warranted. Recommendations are advanced for detecting and responding to DSH in incarcerated youth.

Background: Suicidal behaviour is increasingly widespread in South Africa and constitutes a significant burden of disease, often within resource-constrained hospital settings. Little is known about the factors associated with psychiatric admission following an act of deliberate self-harm (DSH) in South Africa. Aim: The aim of this study was to investigate the sociodemographic and clinical factors which differentiated DSH patients who were admitted to an emergency psychiatric unit compared to those who were treated in the emergency department and discharged. Setting: Data were collected for 272 consecutive patients presenting to the emergency department of a tertiary, public, urban hospital in South Africa, as a result of self harm, between 16 June 2014 and 29 March 2015, for an initial epidemiological study of DSH at the hospital. This study had a data subset of 174 of those patients (84 admitted to the emergency psychiatric unit and 90 treated in the emergency department and discharged). Methods: This study was a retrospective cross-sectional analysis, and it analysed existing data from the epidemiological study, using bivariate and multivariate logistic regression analysis. Results: Of the patients admitted to the emergency psychiatric unit, a greater proportion of patients were female (61,9%), were not in a relationship (83,3%), had no dependents (60,7%), were unemployed (73,8%), and had a low socioeconomic status (59,5%). Having dependants was associated with an increased likelihood of admission to the emergency psychiatric unit in bivariate analysis; however, when controlling for other sociodemographic variables, this was no longer significant. None of the clinical variables were significantly associated with admission to the emergency psychiatric unit. Conclusion: The lack of significant findings in the sociodemographic and clinical factors associated with an admission to the emergency psychiatric unit (compared to being treated in the emergency department and discharged) is surprising. At face value, it suggests that there are no obvious differences between the two groups. The use of a validated screening tool or more accurate measure of the clinical correlates (e.g. screening tool for substance-related 6 disorders) could have better highlighted, perhaps subtle, differences between the two groups. It is perhaps more important to question whether the perceived risk factors in DSH patients are associated with suicidal behaviour and whether emergency psychiatric unit admission, based on these factors, is more effective at treating DSH short-term, and reducing suicidal behaviour long-term, than say outpatient-based treatment interventions. Clinician-related factors that influence psychiatric admission decisions following DSH is also an important area for future research.

Indiana University-Purdue University Indianapolis (IUPUI) / While deliberate self-harm (DSH) in adolescents and adults has been established as a reliable predictor of future suicidal behavior and attempts, whether the same is true for younger children has rarely been studied. Two separate articles will address issues regarding intentional self-injury in young children. The first identified describes the demographic profile of young children who engage in NSSI and evaluated whether predictors of adolescent NSSI are also associated with NSSI in children. The second manuscript analyzed NSSI behaviors to see if they can be correctly predicted from knowledge of a child's history of maltreatment to identify which trauma variables are central in prediction of NSSI status. A Chi-square and logistic regression were run on data from 16,271 records of children ages 5-9 years who received services from the IDMHA in 2018. NSSI was significantly (p < .000) associated with trauma history (x2 = 75.54, df = 1), anxiety (x2 = 107.59, df = 1), depression (x2 = 217.011, df = 1), suicide risk (x2= 993, df = 1), and impulsivity (x2 = 122.49, df = 1. Presence of a caregiver mental health problem (x2 =38.29, df = 1), age (x2 = 14.18, df = 4), being male (x2 = 11.59, df = 1), and being Caucasian (x2 = 23.29, df = 6) at p < .05. Regression results indicated the overall model of seven predictors (sexual abuse [OR 1.14], physical abuse [OR 1.26], emotional abuse [OR1.3], neglect [OR .895], medical trauma [OR 1.34], exposure to natural disaster [OR 1.81] and victim of a crime [1.14] was statistically reliable in distinguishing between children who self-injure and those who do not. [-2 Log Likelihood = 6228.78, x2(6) = 105.416, p < .000]. NSSI does occur in preadolescent children and while there is some indication that the risk factors and co-variates are like those of adolescents, there are some differences which need further study. Training clinicians to inquire about self-injury during assessment of younger children is a simple step. The variables of age and sex throughout development as well as identifying protective as well as risk factors with children should be studied.

There is a growing literature supporting the idea that those who engage in non-suicidal deliberate self-harm (DSH) have altered pain perception compared to individuals who do not. For example, individuals who report a history of non-suicidal DSH behavior have a decreased sensitivity to transient pain during laboratory-based pain induction (e.g., Glenn et al., 2014). Research suggests that brief manipulations targeting individual beliefs can affect performance on subsequent tasks, including measures of pain sensitivity. To date, however, no study has examined the effects of experimentally manipulated pain perception on DSH behavior. The Self-Aggression Paradigm (SAP: Berman & Walley, 2003; McCloskey & Berman, 2003) allows for the prospective observation of the effects of experimental manipulations on a laboratory analogue of DSH. Therefore, the aim of the current study was to determine if experimentally manipulated false feedback about pain tolerance affects DSH behavior during the SAP, thus potentially providing evidence for a causal linkage between pain perception and DSH. Eighty participants were randomly assigned to one of three feedback groups: High pain tolerance, low pain tolerance, and a control condition with neutral feedback provided after completing the SAP. Participants were provided false feedback regarding their pain tolerance after a pressure algometer task. It was predicted that participants in the high pain tolerance feedback groupwould have the highest DSH on the SAP, with DSH defined as the level of shock self-administered during a series of reaction-time trials. No significant group differences, however, emerged based on group assignment. Men engaged in more DSH than women during the study independent of feedback group assignment. A secondary aim of the current study was to provide further validation for the SAP using multiple pain induction modalities. Implications of the current findings and future research directions are discussed.

This cross-sectional study aimed to generate an exploratory functional model of deliberate self-harm (DSH) occurring among a South African student population (n = 603) using Principle Component Analysis (PCA). A battery of instruments, including the Deliberate Self-Harm Inventory (DSHI) and the Functional Assessment of Self-Mutilation (FASM) were administered to students. Following Nock and Prinstein’s (2004) four-factor model on the functions of DSH, self-reported reasons for DSH on the FASM were conceptualised in light of the reinforcement mechanisms of social learning theory. PCA revealed a four-factor model for the reasons students engaged in DSH, constituent of the following components: social positive reinforcement, social negative reinforcement, automatic reinforcement, and reinforcement regarding self-image. A unique factor manifests in the self-image reinforcement component, suggesting divergence in the functions of DSH between student and adolescent populations. / Dissertation (MA)--University of Pretoria, 2013. / gm2014 / Psychology / unrestricted