Suicidality and self-harm behaviors among sex offenders remain underreported in the clinical literature and are often misunderstood in this complex population. The present study aims to identify rates of suicide attempts and self-injurious behaviors in a sample of 1,184 psychiatric inpatients, 462 of whom are sexual offenders. Between-group comparisons revealed significant differences in history of suicide attempts and self-harm behaviors, with sexual offenders evidencing greater rates of both. Significant psychiatric correlates of suicide attempts and self-harm behaviors among sex offenders varied by group and included a variety of psychiatric symptom presentations. These are compared with the general literature on suicide risk and the sex offender population. Implications for treatment of these behaviors in a sex offender population are discussed.

Past work has linked self-injurious behavior (SIB) to a history of traumatic experiences and to problems regulating affect. While this affect dysregulation is conceptualized as occurring at a biological (as well as a behavioral) level, relatively little is known about the biological mechanisms involved. The current study explored whether reactivity of the hypothalamic-pituitary-adrenal (HPA) axis to an interpersonal stressor mediated the relation between trauma and SIB in a sample of 178 18-21 year-old heterosexual dating couples. As predicted, both trauma experience and symptoms positively predicted SIB. While the mediating model was not supported, SIB was associated with an HPA axis response marked by heightened reactivity to interpersonal stress within the context of lower cortisol levels. Trauma symptoms and experience interacted with adult attachment security to predict HPA axis response in different ways for men and women, a compelling set of findings suggesting the importance of contextual factors in the study of trauma and HPA axis function. Future directions for the study of trauma, HPA axis reactivity, and SIB are discussed.

Self-injurious behavior (SIB) is a behavioral pathology seen in a small percentage of humans and non-human primates. In one previous study, macaques with SIB had more sleep disruption than controls, but observations were limited. Two studies were conducted: a baseline study to investigate nighttime activity in rhesus macaques (Macaca mulatta) displaying SIB and controls, and a probiotic study to assess probiotic Bifidobacterium infantis 35624 for high nighttime activity. Subjects were 13 rhesus macaques, 5 with SIB (3 females; 1 SIB). Videocapture of Nighttime Activity (VNRA) was developed to record in complete darkness. IR-receptive webcams were connected to a laptop running ISPYCONNECT, software which recorded movement. Subjects were observed during the entire lights-off period (8pm-7am). Measures included total movement time (TMT), movement in hour 1 (HR1) and hour 11 (HR11), and number of videos. In the baseline, SIB subjects had higher TMT (pBifidobacterium infantis 35624 had no effect on sleep disruption, and also that increased nighttime activity seems to be a persistent characteristic of SIB subjects. It is unknown if increased nighttime activity affects SIB subjects; it may result in elevated SIB, or the SIB pathology could result in sleep disruption.

published_or_final_version / abstract / Community Medicine / Doctoral / Doctor of Philosophy

<p>This essay is focused on the phenomena of self-injurious behavior of two young men. The purpose of the essay is to enlighten their experiences of their earlier self-injurious behavior, and to further enlighten which factors they believe have been contributed to the origin and the ending of the behavior. The research questions the essay raises are: Which factors has contributed to the origin of the self-injurious behavior? Which functions did the self-injurious behavior have for the young men? What made the two young men quit their self-injurious behavior? The essay is qualitative and do not imply to generalize the results and it is made from interviews with respondents and earlier research on self-injurious behavior. The results show that there are differences in the factors that origin of the self-injurious behavior between the respondents. The differences are for example the family situation and experiences of childhood traumas. There are also similarities in the origin of the self-injurious behavior, both respondents have had experiences of rejection from the environment. There are several differences between the respondents in the functions of the self-injurious behavior. One of the respondents used the self-injurious behavior to end a state of dissociation, other differences were the frequency and procedure of the self-injurious behavior. There are also similarities in the functions with the self-injurious behavior between both respondents, for them it was a way to cope with difficult situations and to let out emotions for example anxiety. There are differences in factors that can be correlated with the ending of the self-injurious behavior among the respondents. One of the respondents claims the positive treatment of his surroundings and therapy, when his self-injurious behavior became known, was contributing factors to the ending of hurting himself. The other respondent claims that a sense of responsibility for someone else was the most important factor in ending the self-injurious behavior. A similarity in the ending of the self-injurious behavior among the respondents is that both of them could manage to express their feelings and experiences in words. One of the conclusions is that self-injurious behavior among the young men, referring to the origin, function and ending of the behavior, shows many similarities with young women who has a self-injurious behavior.</p> / <p>Studien behandlar fenomenet självskadebeteende hos två unga män. Studiens syfte är att belysa unga mäns upplevelser av sitt tidigare självskadebeteende, samt att belysa vilka faktorer som de upplevt som bidragande till uppkomst och avslutning av självskadebeteendet.</p><p>Studiens frågeställningar lyder vidare: Vilka bakomliggande orsaker finns till de unga männens självskadebeteende? Vilka funktioner fyllde självskadebeteendet för de unga männen? Vad fick de unga männen att sluta med sitt självskadebeteende? Studien är kvalitativ, utan generaliseringsanspråk och bygger på intervjuer med respondenter samt tidigare forskning inom ämnet självskadebeteende. Resultaten visar att de bakomliggande orsakerna till respondenternas utvecklande av självskadebeteende skiljer sig delvis åt t.ex. familjesituationen och upplevda trauman. Även likheter påvisas i de bakomliggande orsakerna, båda respondenterna har i sin uppväxt upplevt avvisanden från omgivningen. De funktioner som självskadebeteendet har för respondenterna skiljer sig åt på ett flertal punkter, varav en av respondenterna använde självskadebeteendet till att häva ett dissociativt tillstånd, andra skillnader var frekvens och tillvägagångssätt. Funktioner med självskadebeteendet hos de bägge respondenterna rymmer också likheter, då båda respondenterna använde självskadebeteendet som ett sätt att hantera svåra situationer på, samt för att få utlopp för t.ex. ångest. Verksamma delar i avslutningen av självskadebeteendet skilde sig åt mellan respondenterna. En av respondenterna menar att omgivningens goda bemötande och terapi, då självskadebeteendet uppdagades, var bidragande faktorer till att respondenten senare kunde sluta att skada sig själv. Den andra respondenten menar att en känsla av ansvar för någon annan än sig själv var den största bidragande faktorn till avslutning av självskadebeteendet. Då båda respondenterna kunde sätta ord på sina känslor och upplevelser av sin situation bidrog detta till avslutningen av självskadebeteendet. En av de slutsatser som presenteras är att självskadebeteendet hos de unga männen avseende bakomliggande orsaker, funktion och bidragande orsaker till avslutning är att det finns många likheter med unga kvinnors självskadebeteende.</p>

This essay is focused on the phenomena of self-injurious behavior of two young men. The purpose of the essay is to enlighten their experiences of their earlier self-injurious behavior, and to further enlighten which factors they believe have been contributed to the origin and the ending of the behavior. The research questions the essay raises are: Which factors has contributed to the origin of the self-injurious behavior? Which functions did the self-injurious behavior have for the young men? What made the two young men quit their self-injurious behavior? The essay is qualitative and do not imply to generalize the results and it is made from interviews with respondents and earlier research on self-injurious behavior. The results show that there are differences in the factors that origin of the self-injurious behavior between the respondents. The differences are for example the family situation and experiences of childhood traumas. There are also similarities in the origin of the self-injurious behavior, both respondents have had experiences of rejection from the environment. There are several differences between the respondents in the functions of the self-injurious behavior. One of the respondents used the self-injurious behavior to end a state of dissociation, other differences were the frequency and procedure of the self-injurious behavior. There are also similarities in the functions with the self-injurious behavior between both respondents, for them it was a way to cope with difficult situations and to let out emotions for example anxiety. There are differences in factors that can be correlated with the ending of the self-injurious behavior among the respondents. One of the respondents claims the positive treatment of his surroundings and therapy, when his self-injurious behavior became known, was contributing factors to the ending of hurting himself. The other respondent claims that a sense of responsibility for someone else was the most important factor in ending the self-injurious behavior. A similarity in the ending of the self-injurious behavior among the respondents is that both of them could manage to express their feelings and experiences in words. One of the conclusions is that self-injurious behavior among the young men, referring to the origin, function and ending of the behavior, shows many similarities with young women who has a self-injurious behavior. / Studien behandlar fenomenet självskadebeteende hos två unga män. Studiens syfte är att belysa unga mäns upplevelser av sitt tidigare självskadebeteende, samt att belysa vilka faktorer som de upplevt som bidragande till uppkomst och avslutning av självskadebeteendet. Studiens frågeställningar lyder vidare: Vilka bakomliggande orsaker finns till de unga männens självskadebeteende? Vilka funktioner fyllde självskadebeteendet för de unga männen? Vad fick de unga männen att sluta med sitt självskadebeteende? Studien är kvalitativ, utan generaliseringsanspråk och bygger på intervjuer med respondenter samt tidigare forskning inom ämnet självskadebeteende. Resultaten visar att de bakomliggande orsakerna till respondenternas utvecklande av självskadebeteende skiljer sig delvis åt t.ex. familjesituationen och upplevda trauman. Även likheter påvisas i de bakomliggande orsakerna, båda respondenterna har i sin uppväxt upplevt avvisanden från omgivningen. De funktioner som självskadebeteendet har för respondenterna skiljer sig åt på ett flertal punkter, varav en av respondenterna använde självskadebeteendet till att häva ett dissociativt tillstånd, andra skillnader var frekvens och tillvägagångssätt. Funktioner med självskadebeteendet hos de bägge respondenterna rymmer också likheter, då båda respondenterna använde självskadebeteendet som ett sätt att hantera svåra situationer på, samt för att få utlopp för t.ex. ångest. Verksamma delar i avslutningen av självskadebeteendet skilde sig åt mellan respondenterna. En av respondenterna menar att omgivningens goda bemötande och terapi, då självskadebeteendet uppdagades, var bidragande faktorer till att respondenten senare kunde sluta att skada sig själv. Den andra respondenten menar att en känsla av ansvar för någon annan än sig själv var den största bidragande faktorn till avslutning av självskadebeteendet. Då båda respondenterna kunde sätta ord på sina känslor och upplevelser av sin situation bidrog detta till avslutningen av självskadebeteendet. En av de slutsatser som presenteras är att självskadebeteendet hos de unga männen avseende bakomliggande orsaker, funktion och bidragande orsaker till avslutning är att det finns många likheter med unga kvinnors självskadebeteende.

Archived data was utilized for the present study which examined knowledge about non-suicidal self-injury, or NSSI, in individuals who engage in various degrees of the behavior and those who do not self-injure. Knowledge about NSSI was measured in three groups of respondents: those with no history of self-injurious behavior (no NSSI group), those with more limited experience with NSSI who reported 1-30 incidences of NSSI (limited NSSI group), and those with an extensive history (extensive NSSI group) who reported over 30 incidences of NSSI. To measure knowledge, participants were asked level of agreement with myths and facts about NSSI using Jeffery and Warm’s (2002) knowledge measure. It was hypothesized that the knowledge base would be higher in individuals with more extensive histories of NSSI. Further, individuals with limited histories of NSSI were predicted to have more knowledge than those who have never self-injured. Additionally, this study also hypothesized that the individual item response will vary; depending on extent of NSSI behavior. Group mean scores on the measure were analyzed for differences using a one-way analysis of covariance (ANCOVA) while controlling for the differing group demographic variables of age, sexual orientation, and education level. Results indicated that individuals who have more extensive histories of NSSI evidenced higher mean scores on the measure when controlling for age, sexual orientation and educational level. Individuals with limited histories of NSSI evidenced lower mean scores, and those with no history of NSSI evidenced the lowest scores. In regard to individual item response, items were correlated with seven levels of NSSI (no NSSI, one incident of NSSI, 2-4 incidences, 5-10 incidences, 11-20 incidences, 21-30 incidences and more than 30 incidences). It was found that accuracy was significantly correlated with degree of self-injurious behaviors, with the exception of one item. This item and three additional items also produced weak correlations with other items on the measure. Each item is discussed with regard to group item performance and possible deletions in order to strengthen the measure. Overall, the results of this investigation supported the reliability and validity of the Jeffery and Warm (2002) knowledge measure for use with individuals who self-injure. Results are discussed in relation to the need for accurate knowledge about NSSI, the importance of refining and strengthen the measure for this use, and additional research directions.

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.

Bakgrund: Självskadebeteende är ett folkhälsoproblem som är svårupptäckt. Personer med självskadebeteende väcker ofta starka känslor hos vårdpersonalen. Sjuksköterskor som vårdardessa personer konfronteras ofta med sina känslomässiga reaktioner som kan om det inte uppmärksammas påverka patientens välbefinnande. För att öka välbefinnandet och lindralidandet hos patienter med självskadebeteende är det därför värdefullt att sjuksköterskan förhåller sig professionellt. Syfte: Syftet med denna studie var att beskriva sjuksköterskorsupplevelser, erfarenheter och förhållningssätt i mötet med självskadande patienter. Metod: Detta är en litteraturstudie som är baserad på fyra kvantitativa studier, fem kvalitativa studier och en mixad studie som är publicerade mellan 2000-2014. Resultat: Resultatet presenteradesutifrån fem teman. Dessa teman var: attityder och uppfattningar, känslor, betydelsen avvårdande relation, behov av utbildning och riktlinjer samt betydelsen av stöd från kollegoroch ledning. Slutsats: Studien visade att sjuksköterskor som vårdar patienter med självskadebeteende upplever svårigheter och osäkerhet i att hantera denna patientgrupp vilket ofta ledde till frustration och undvikande av patienterna. Det framgick tydligt att det finns behov av utbildning i självskadebeteende, handledning och stöd för att sjuksköterskor skakunna ge en adekvat vård. Klinisk betydelse: Beskrivningen av sjuksköterskors upplevelserav mötet med patienter med självskadebeteende kan bidra till en ökad kunskap ochmedvetenhet kring faktorer som påverkar vårdandet för att sjuksköterskor framöver ska kunnage bättre och professionell vård till denna patient grupp. / Background: Self-injurious behavior is a public health issue that is difficult to detect. People who self-harm often evoke strong feelings among the nursing staff. Nurses who care for these individuals are often confronted with emotional reactions that will affect the patient's wellbeing if not addressed. In order to improve the wellbeing and alleviate the suffering of patients who self-harm it is therefore important that nurses meet these patients professionally. Aim: The purpose of this study was to describe nurses' experiences and attitudes towards selfharmingpatients. Method: This is a literature study based on four quantitative studies, five qualitative and one mixed study published between 2000 -2014. Results: The results were presented in five themes: attitudes and perceptions, emotions, the importance of the caringrelationship, the need for training and guidelines and the importance of support from colleagues and management. Conclusion: The result showed that nurses who care for patients with self-injurious behavior are experiencing difficulties and uncertainties inmanaging this patient group, which often led to frustration and avoidance of these patients. It was clear that there is a need for training in self-injury, need in supervision and support fornurses to be able to provide adequate care. Clinical significance: Description of the nurses'experience of working with self-harming patients may contribute to increased knowledge andawareness of factors affecting caring. This will help nurses to provide better and professionalcare to this patient group.

<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>