Background Violence is a global public health problem and violence among youth is a matter of high priority. Adolescence and young adulthood are important periods for the foundation of future health. Youth victimization may have serious health consequences, making it important to address the occurrence and socio-medical context for possible interventions against violence. Aims To analyze prevalence, risk patterns and gender differences in emotional, physical, sexual, and multiple-violence victimizations and the associations between violence victimization and sexual ill health, sexual risk behaviors and mental health in Swedish youth. Methods A cross sectional study using two samples, a national sample from nine youth health centers in Sweden and a population-based sample from a middle-sized Swedish city. The questionnaire included standardized instruments addressing violence exposure (NorAQ), socio-demographics, mental and sexual ill-health and sexual risk behaviors, alcohol and substance use. Proportions and crude and adjusted odds ratios with a 95% CI were calculated. Results A total of 2,250 young women and 920 men, aged 15-23, answered the questionnaire at the youth health centers. In upper secondary school, 1,658 women and 1,589 men, aged 15-22, answered the questionnaire. High prevalence rates with gendered differences both in rates and in co-occurrence of different types of violence were found. Women were more often exposed to emotional violence and sexual violence than men, while men were more often physically victimized. For both women and men, violence victimization before the age of 15 was strongly associated with all types of violence victimizations during the past year. Strong associations were found between multiple-violence victimization and poor mental health in both genders. Among the sexually experienced students, consistent associations between lifetime multiple-violence victimization and various sexual ill-health and sexual risk behaviors were found in both genders, except for non-contraceptive use. Conclusions High prevalence of violence victimization in youth and strong associations between victimization, especially multiple victimization, and poor mental and sexual health were found. This needs to be recognized and addressed in social and medical settings.

Abstract   Author: Robert Andersson & Oskar Karlsjö Title:“My first thought is a girl that cuts herself” – A qualitative study about professionals in human service organizations description of self-injurious behavior. Supervisor: Ann Ottengrim Assessor: Rickard Ulmestig   The purpose of this study has been to understand how professionals in human service organizations (HSO) describe self-injuries behaviour, how they describe the individuals that self-harm and if the professionals describe any possible differences in how men and women self-harm as well as how professional’s knowledge concerning self-injurious behaviour is contructed. The study answers three questions; - What kind of actions do professionals in HSO describe as being self-injurious behaviour? - How is knowledge constructed by professionals in HSO concerning self-injurious behaviour? - How are people who engage in self-injurious behaviour being described? - How do professionals in human service organizations describe potential differences between men and women´s self-injurious behaviour?   Qualitative interviews have been chosen as the method in this study to gather empirical data and the social constructionism theory has been implemented to analyse the empirical data. The result of this study shows that self-injurious behaviour is a complex and at the same time a dynamic phenomenon. There are a lot of different actions that are being describes as being self-injurious behaviour. An individual that cuts its own body tissue or an individual that often gets involved in psychical fights are examples of acts that are being described as having a self-injurious behaviour. The informants also described that their knowledge and what they define as self-injurious behaviour has changed over time in the field which indicates that self-injurious behaviour is a dynamic category. According to our results it doesn’t seem to exist a stereotype of whom and why someone engages in self-harm. But men tend to self-harm in a more severe way than women.

The following thesis outlines a study assessing the levels of perfectionism, self-injurious behaviour, and functions of anorexia nervosa (AN) through use of a cross-sectional online survey, among English speaking participants 15 years or older, self-reporting a current, previous, or suspected diagnosis of AN. Three distinct clusters were found using self-report measures from individuals with a current or suspected diagnosis, with each cluster corresponding to a unique theoretical understanding of AN. The three clusters can be distinguished by high asceticism, appearance, and avoidance of fertility/sexuality functions for AN respectively. Two distinct clusters were found for participants with a previous diagnosis of AN. These clusters can be differentiated by lingering sentiments held for the condition, as the first cluster viewed AN negatively, and the second cluster continued to see some benefits of the condition. Possible implications for understanding etiology, mechanisms, and treatment of AN are discussed. / Canadian Institute of Health Research

The emotions associated with initiating, maintaining, and reinforcing hairpulling disorder (trichotillomania) were studied. Studies conducted have only looked at small community or inpatient samples, and little is known about the interplay of hairpulling subtypes and emotions. For this study, 427 participants completed an online questionnaire around their hairpulling subtype, severity, emotions experienced by hairpulling, and comorbid anxiety and depression. Using the Milwaukee Inventory for Subtypes of Trichotillomania-Adult Version (MIST-A; Flessner, Woods, Franklin, Cashin, & Keuthen, 2008), this is the first study to address the regulation of emotions across subtypes. Participants were divided as either high- or low-focused and either high- or low automatic. Significant differences between hairpulling subtypes and hairpulling severity were reported. Subtypes differed in the severity they experienced emotions; individuals with high-focused pulling reported more intense negative emotions, and a greater number of emotions regulated by pulling. Positive emotions⎯happiness, relief, and calm⎯were also found to play a significant role in reinforcing hairpulling. For high-focused subtypes, negative emotions before- and after-pulling were associated with greater severity, indicating that altering negative emotions via pulling plays an important role for high-focused subtypes. High-focused subtypes also reported higher stress, depression and anxiety than either automatic subtypes or the general population, and were found to have anxiety and depression significantly associated with hairpulling severity and experiencing negative emotions that initiated hairpulling. Clinical and treatment implications, study limitations, and areas of future research are discussed / xviii, 227 leaves ; 29 cm

Bakgrund: Patienter som vårdas på grund av självskadebeteende inom slutenvården har ökat sedan 1990- talet. Det första mötet dessa patienter har med sjukvården är ofta på akutmottagningar, som främst är utformade för att effektivt vårda patienter som är fysiskt sjuka. Patienter som med självskadebeteende har ofta svårt att kommunicera sina känslor till andra. Samtidigt som de upplever att de bemöts negativt av sjuksköterskor i vården. Attityder hos sjuksköterskor påverkar omvårdnaden genom hur de tänker, känner och handlar gentemot patienten. Syfte: Syftet med detta examensarbete är att beskriva akutsjuksköterskors attityder gentemot patienter med ett självskadebeteende. Metod: En allmän litteraturöversikt baserad på 9 vetenskapliga studier varav 6 var kvantitativa och 3 kvalitativa. Studierna valdes ut genom kritisk granskning och utifrån urvalskriterier. De översattes från engelska till svenska och analyserades utifrån attitydbegreppets tre komponter; tankar, känslor och handlingar. Resultat: Resultatet presenterar utifrån följande teman och rubriker: Tankar: sjuksköterskors tankar om självskadebeteende, uppfattningar om att vårda patienter med självskadebeteende, brist på kunskap och kompetens i omvårdnaden av patienter som skadar sig själva. Känslor: starka känslor framkallas i vårdandet av patienter som skadar sig själva, faktorer som påverkar känslorna gentemot patienter med självskadebeteende. Handlingar: patienter med självskadebeteende bortprioriteras på akutmottagningen, brister riktlinjer och bedömningar i vården av patienter med självskadebeteende. Diskussion: Hur tankar, känslor och handlingar hör samman diskuteras utifrån Orlandos interaktionsteori. Att utbildning påverkar attityderna positivt diskuteras, samt en problematisering kring det medicinska fokus som finns på akutmottagningen. Vidare diskuteras praktiska implikationer och vidare forskning. / Background: The numbers of patients that are treated for self-harm in inpatient care have increased since 1990's. The first meeting these patients have with healthcare often take place in the emergency department, which is primarily designed to efficiently care for patients who are physically ill. Patients who engage in self-harm have often difficulties communicating their feelings to others. These patients experience that they are negatively treated by nurses in health care. The attitude of nurses is affecting care by the way they think, feel and act towards the patient Aim: The aim of this literature review is to describe emergency nurses' attitude towards patients with self-injurious behavior. Methods: A general literature review based on 9 scientific studies, of which 6 were quantitative and 3 qualitative studies. The studies were selected through critical review and selection criteria. They were translated from English to Swedish and analyzed by the three components of the attitude concept; thoughts, feelings and actions. Results: The results is presented on the following themes and headlines: Thoughts: nurses thoughts about self-injurious behavior, views of caring for patients with self-injurious behavior, lack of knowledge and skills in the care of patients who harm themselves. Emotions: strong feelings are evoked in the care of patients who harm themselves, factors that affect the feelings towards patients with self-injurious behavior. Actions: Patients who engage in self-harm are deprioritized in the emergency department, deficits in assessment and guidelines regarding the care of patients with self-injurious behavior. Discussion: How thoughts, feelings and actions are associated is discussed based on Orlando's interaction theory. That education affects attitudes positively is discussed as well the problematisation of the medical focus that exists in the emergency department. Furthermore, we discuss practical implications and further research.

[Truncated abstract]The overall aim of the research reported in this thesis was to develop and validate an instrument that would identify children among the general population at risk of self-harm. To achieve this, four separate yet interrelated studies were conducted. Study One, which sought to explore the risk factors of self-harm in children comprised a series of focus interviews with three paediatricians and 24 mothers of children who had self-harmed or who had verbalized self-harm ideation. The findings revealed that prior to the onset of self-harming or self-harm ideation these children reportedly manifested other problem behaviours that prompted their mothers to seek specialist advice from a paediatrician. The majority of these problem behaviours were characteristic of externalizing problems, either in the form of conduct problems, aggressive behaviours or impulsiveness. Conversely, some problem behaviours were characteristic of internalizing problems such as anxiety and depression. These findings provided valuable information which in addition to the current literature created the conceptual framework for the subsequent studies. Study Two incorporated the information obtained from Study One, along with that obtained from a review of existing instruments that measure self-harm or suicide, to develop a new instrument specifically designed to assess the risk of children in the general population developing self-harming behaviours. Initially, 159 items were generated and using the extant knowledge regarding the risk factors of self-harm as a guide, the items were categorized into risk factors of anxiety, depression, low self- ii worth, social difficulty, social withdrawal, helplessness, hopelessness, atypical cognition, emotional lability, impulsivity, self-harming ideation and self-harm. ... Study Four comprised four interrelated investigations, the purposes of which were to (i) examine the prevalence rates of self-harming ideation and self-harm among young school aged children in the general population; (ii) investigate differences of risk of self-harm between the referred group and community comparison group; (iii) examine the relationship between impulsivity and risk of self-harm in these children and, (iv) examine the relationship between executive function and risk of self-harm among these children. The results from these investigations revealed that approximately 3.5% of children aged between 6 to12 years in the general population manifest self-harming ideations and approximately 2.5% actually self-harm. No significant age or gender differences were found. Children that presented with a higher level of risk of self-harm also presented with a complex array of internalizing and externalizing problem behaviours. Furthermore, children who displayed significantly higher levels of hyperactive-impulsive symptomatology scored higher on the SHRAC instrument, as did the children who had higher levels of executive functioning impairment. The findings are discussed and interpreted in line with the current research literature and are used to make suggestions for future research.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv. / Härtill 6 uppsatser.

Thesis (Ph.D.)--University of Western Australia, 2007.

Thesis (M.S.)--State University of New York at Binghamton, Department of Psychology, 2009. / Includes bibliographical references.