A ocorrência do comportamento autolesivo logra índices significativos na população adolescente e pré-adolescente, tornando-se queixa frequentemente observada no contexto escolar e clínico, preocupando a todos os envolvidos. Na atualidade, a Organização Mundial da Saúde (OMS) a categoriza como um problema de saúde pública global, e, portanto, foco de atenção de políticas públicas e sociais prementes dada a gravidade e aumento do risco de tentativa de suicídio no futuro. No Brasil, as pesquisas realizadas ainda são incipientes quando comparadas com a produção internacional, ainda mais no que diz respeito à dinâmica psíquica do jovem que se autolesiona e meios de intervenção. Assim, considerando a perspectiva investigativa atribuída à Psicologia Clínica e a indissociabilidade entre prática e pesquisa, este trabalho buscou contribuir por meio da realização de um estudo de caso único com vistas à análise dos traços de personalidade de uma adolescente, estudante de uma escola pública do Estado de São Paulo, sem diagnóstico psiquiátrico e/ou em atendimento psicológico, além de investigar dados do funcionamento familiar e a relação de tal conduta com a sintomatologia depressiva e ansiosa. Para tanto, o método clínico-qualitativo de cariz psicanalítico foi empregado em consonância com o delineamento de estudo de casos único e o processo Psicodiagnóstico Compreensivo e Interventivo. O Psicodiagnóstico previamente esquematizado contemplou duas etapas: 1) primeira aplicação, que contabilizou sete atendimentos, e, 2) fase de follow-up, com três atendimentos. Em ambas as etapas, abarcou a realização de entrevistas com a responsável, entrevistas com a participante, aplicação do Questionário Desiderativo, Teste de Apercepção Temática Infantil - Figuras Humanas (CATH), Inventário de Depressão Infantil (CDI) e Inventário de Ansiedade de Beck (BAI). Os resultados do caso foram examinados individualmente, em cada etapa, e, posteriormente, em conjunto, com a comparação entre essas duas fases por meio da livre inspeção do material à luz das observações oferecidas pelos instrumentos projetivos e objetivos fundamentados na abordagem psicanalítica psicodinâmica. Assim, com base nos aportes winnicottianos, pode-se observar que, no caso analisado, a conduta autolesiva revelou uma dupla função: impedir o aniquilamento total do Eu, e, concomitantemente, comunicar ao ambiente sobre falhas nos cuidados em fases primitivas, reatualizados na adolescência, na tentativa de resgatar algo ofertado, porém percebido como perdido. Adicionalmente, integrando os achados iniciais com os obtidos na reavaliação de follow-up, a significativa remissão de aspectos dissociados da personalidade da participante e sintomas clínicos após o processo Psicodiagnóstico comporta correlações com o conceito winnicottiano de distúrbio psicossomático, recuperável após a presença de condições ambientais favoráveis, ou ainda com o trânsito da posição kleiniana esquizo-paranóide para a depressiva, denotando a retomada do processo de amadurecimento. Por fim, os dados obtidos permitem sintetizar sobre a importância do ambiente para a restauração do sentimento de confiança e de esperança no caso investigado, corroborando a teoria winnicottiana sobre a subordinação da saúde psíquica ao longo da vida aos cuidados iniciais recebidos / The occurrence of self-injurious behavior achieves significant rates in the adolescent and preadolescent population, becoming a frequent complaint in the school context, causing concern to all involved. Currently, the World Health Organization (WHO) categorizes it as a global public health problem, and therefore, focus attention on pressing public and social policies given the seriousness and increased risk of attempted suicide in the future. In Brazil, the research carried out is still incipient when compared to international production, especially with regard to the psychic dynamics of the self-injuring young person and means of intervention. Thus, considering the research perspective attributed to Clinical Psychology and the indissociability between practice and research, this work sought to contribute through the accomplishment of a single case study with a view to the investigation and analysis of the personality traits of a teenager, student of a school of the State of São Paulo and without psychiatric diagnosis, besides the family functioning and the relation of such conduct with the depressive and anxious symptomatology. The clinical-qualitative psychoanalytic method was used in consonance with the design of a single case study and the Comprehensive and Interventive Psychodiagnostic process. The psychodiagnosis previously planned included two stages: 1) the first application, which counted seven meetings, and 2) the follow-up phase, with three sessions. Interviews with the participant, interviews with the participant, application of the Desiderative Questionnaire, Child Thematic Apperception Test - Human Figures (CAT-H), Infant Depression Inventory (CDI) and Anxiety Inventory of Beck (BAI). The results of the case were examined individually at each stage and then together with the comparison between these two phases through the free inspection of the material in the light of the observations offered by the projective and objective instruments based on the psychoanalytic psychoanalytic approach. Thus, on the basis of Winnicott\'s contributions, it can be observed that, in the case analyzed, self-defeating behavior revealed a double function: to prevent the total annihilation of the ego, and, at the same time, to communicate to the environment about the failures in care, in an attempt to rescue something offered, but perceived as lost. Additionally, integrating the findings with those obtained in the follow-up reassessment, the significant remission of aspects dissociated from the participant\'s personality and clinical symptoms after the Psychodiagnostic process correlates with the winnicottian concept of psychosomatic disorder, recoverable after the presence of favorable environmental conditions , or with the transit from the kleinian position schizopanoid to the depressive, denoting the resumption of the maturation process. Finally, the data obtained allow us to synthesize the importance of the environment for the restoration of the feeling of trust and hope in the case investigated, corroborating the Winnicottian theory about the subordination of the psychic health throughout the life to the initial care received

The purpose of the present study was to increase our understanding of the relations among embarrassment, Theory of Mind (ToM), and emotion dysregulation in adolescents with Asperger's Syndrome and High Functioning Autism (AS/HFA), topics that have not previously been the foci of research in this population. The research sample consisted of 42 participants, split equally between adolescents with AS/HFA and typically developing (TD) adolescents. Participants with AS/HFA were matched with TD participants for chronological age and gender. Parents of all participants, typically mothers, were also required to complete measures. Participants were presented with vignettes of embarrassing or anger inducing scenarios, following which they were asked to provide ratings indicating the degree to which they would be embarrassed or angry in the protagonists' positions. Next they were asked to justify those ratings. Results indicated that the AS/HFA group experienced greater difficulty than the TD group with measures requiring ToM abilities. This was particularly true of embarrassment/social faux pas situations. In contrast, both groups performed similarly on measures involving anger-inducing situations that require less ToM. The significant difficulty of the AS/HFA group in understanding ToM in embarrassment measures was corroborated by their poor performance on an independent ToM measure. In addition to having significant difficulty in understanding embarrassment, the AS/HFA group was significantly less able than the TD group to recount personally embarrassing experiences. Regarding emotion regulation, participants with AS/HFA were significantly less able than their TD peers to regulate their emotions through reappraisal. Similarly, parents of the AS/HFA participants reported a significantly higher level of emotion dysregulation in their children than did the parents of the TD participants. Further, participants with AS/HFA had a significantly higher utilization frequency of negative strategies than their TD peers when embarrassed, which aligned with parent report. Negative strategies included internal, verbal, and physical self-injurious behaviors, as well as destructive interpersonal behaviors, e.g., falsely accusing, yelling at, or hitting others. These findings emphasize the critical and potentially harmful impact of embarrassing experiences in the daily lives of adolescents with AS/HFA.

Currently, most adolescent self injurious behavior research is focused on adolescent White females, indicating that self-injury may be more prevalent among females and those of Caucasian decent (Whitlock, 2010). This session will present data from a current study indicating that perhaps males and other ethnic groups are also engaging in this destructive coping mechanism, perhaps in differing ways (self hitting and/or physically aggressive behaviors resulting in injury) than are being focused on by current conceptual and empirical works.

Research has focused on adolescent white females indicating self-injury may be more prevalent among female Caucasian individuals. This presentation will present data from a current study that indicates males and other ethnic groups are engaged in self-injury, in differing ways than are being studied. Future research, clinical practice, and supervision needs to understand the importance of a broader holistic approach to conceptualize and treat self-injury.

University of Macau / Faculty of Social Sciences and Humanities / Department of Psychology

Students of a south central university provide data for this study investigating knowledge of self-injury (SI), experiences with those who self-injure, and perceptions of SI. This study proposes that college peers of those who self-injure have higher levels of SI knowledge than professionals who work with individuals who self-injure. In addition, the study proposes that individuals who have experience with others who self-injure have higher levels of SI knowledge than individuals who do not have experience with others who self-injure. An additional purpose of this study is to explore information regarding experiences people have with others who self-injure and their perceptions of self-injurious behavior. A convenience sample of 495 members solicited from psychology courses at a south central university completed the survey, which consisted of four sections including the following: demographics, knowledge of SI, experiences with SI, and perceptions of SI. The knowledge section of the survey contains a 20-item measure previously used by Jeffrey and Warm (2002). A knowledge score was created based on participants responses to these 20 items. This score was used in the analysis of both hypotheses one and two. Results indicate that participants have a poor understanding of SI, based on their mean knowledge score. In addition, results reveal that the current sample’s mean SI knowledge level is lower than seven of the seven groups' mean knowledge scores. Mean knowledge scores are significantly greater for individuals indicating experience with others who self-injure than individuals reporting no experience with others who self-injure as assessed through independent t tests. Descriptive information indicates that participants do not reject those who self-injure, but rather are supportive in peer relationships with others that engage in the behavior. However, participants indicate considerable confusion surrounding the behavior and are generally not accepting of the behavior, choosing to encourage cessation of the behavior. Limitations discussed include sample demographics, possibility for misinterpretation of survey items, and potential social desirability bias.

SAMMANFATTNING Vårdpersonal möter patienter med självskadebeteende på olika avdelningar inom sjukvården. Vårdpersonalen har ofta svårt att bemöta denne patientgrupp eftersom de trots allt vårdar patienterna efter bästa förmåga ändå skadar sig igen. Detta väcker frustration och negativa känslor som vrede och mindre sympati för dessa patienter. Oftast är det unga kvinnor som lindrar sin ångest med att skada sig själva medan unga män oftare väljer att vara våldsamma eller aggressiva. Syftet med studien var att belysa vårdpersonalens uppfattning och bemötande av patienter med självskadebeteende. Metoden är en artikelgranskning. Resultatet visade att det är viktigt att vårdpersonal ser, förstår och bemöter patienterna med respekt för att de skall få ett bättre självförtroende. Varje person är unik och en egen individ. Det är därför viktigt att se bakom självskadande för att se till varje persons behov och förstå att det oftast är andra problem som ligger bakom självskadandet. Vårdpersonal med utbildning till att vårda patienter med självskadebeteende är bättre på att ta hand om dessa patienter än personal utan utbildning. Mera kunskap och utbildning om självskadandet skulle hjälpa personal till att upptäcka problemet tidigare. Vården skulle då bli bättre och kanske kortare för patienter med självskadebeteende.

<p>SAMMANFATTNING</p><p>Vårdpersonal möter patienter med självskadebeteende på olika avdelningar inom sjukvården. Vårdpersonalen har ofta svårt att bemöta denne patientgrupp eftersom de trots allt vårdar patienterna efter bästa förmåga ändå skadar sig igen. Detta väcker frustration och negativa känslor som vrede och mindre sympati för dessa patienter. Oftast är det unga kvinnor som lindrar sin ångest med att skada sig själva medan unga män oftare väljer att vara våldsamma eller aggressiva. Syftet med studien var att belysa vårdpersonalens uppfattning och bemötande av patienter med självskadebeteende. Metoden är en artikelgranskning. Resultatet visade att det är viktigt att vårdpersonal ser, förstår och bemöter patienterna med respekt för att de skall få ett bättre självförtroende. Varje person är unik och en egen individ. Det är därför viktigt att se bakom självskadande för att se till varje persons behov och förstå att det oftast är andra problem som ligger bakom självskadandet. Vårdpersonal med utbildning till att vårda patienter med självskadebeteende är bättre på att ta hand om dessa patienter än personal utan utbildning.</p><p>Mera kunskap och utbildning om självskadandet skulle hjälpa personal till att upptäcka problemet tidigare. Vården skulle då bli bättre och kanske kortare för patienter med självskadebeteende.</p>

Research in the area of self-injurious behaviors and the family context is still emerging. The majority of research available is quantitative in nature. The limited qualitative research available in this area has been conducted outside of the United States. A collective case study was conducted with four parents with an adolescent that had been admitted to an inpatient psychiatric residential facility with a presenting problem of self-injurious behavior. The purpose of this study was to gain an in-depth, qualitative understanding of the parent perspective and comprehension of adolescent self-injurious behavior including the parents' ideas on how the parent-child relationship or other family relationships may have influenced the self-injury. With-in case and cross-case analyses were utilized from the collected data including field notes, interview scripts, member checking sessions, and medical record reviews. Themes identified using an inductive content analysis were discussed based on each primary interview question. Clinical implications included the importance of providing parental education, encouraging parent participation in therapy, treating self-injurious behavior from a trauma-informed perspective, and others were considered. Limitations of the present study, directions for the use of the present research, as well as implications for future research were reported.

Abstract   Author: Robert Andersson &amp; 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.