Deliberate self-harm are a growing problem among young people in Sweden. It's not only the child that suffers from the behaviour, even the whole family. Parent´s need the right support from the healthcare staff for their own wellbeing, but also to be able to give good support for their child. Par-ent´s experiences are of importance for the nurse in the healthcare of the child and their families. The aim of this study was to describe parent´s experiences of living with a child with a deliberate self-harm behavior. In this literature study ten qualitative articles were analyzed using the method of Friberg (2012). Eight articles were found by a systematic search and two articles were found in an unsystematic search. This study showed four main themes and ten subthemes. Main themes were parent´s experience of support, parent´s experience of different feelings, parent´s experience of fam-ily relations and parent´s experience of parenting. Subthemes were to experience lack of support from healthcare staff, to need support from the environment, to feel guilt and shame, to feel concern and fear, to experience chock, to communicate with their child, to experience a different relation-ship in the family, to maintain trust in the relationship between parent and child, wanting to protect their child, to feel unsecure in their parenting. Conclusion were that parent´s need better support from the healthcare staff and from others in their environment. Nurses need more knowledge about parent´s experiences to be able to understand their needs and to be able to support them.

The prevalence of sexual harassment among college women has been reported to range from 33% to 97% (Klein, Apple, & Khan, 2011; Yoon, Funk, & Kropf, 2010) across the lifespan. In any one year of college, the prevalence of sexual harassment reported by women ranges from 33% to 57% (Crown & Roberts, 2007; Huerta, Cortina, Pang, Torges, & Magley, 2006). The severity and frequency of sexual harassment has been found to be related to reports of psychological distress (Nielsen & Einarsen, 2012), feelings of shame (Yoon et al., 2010), anxiety and depression symptoms (Murdoch, Pryor, Polusny, & Gackstetter, 2007), and social isolation (Pershing, 2003). These consequences of sexual harassment are concerning given the association between depression, isolation, and suicidality (Boardman, Grimbaldeston, Handley, Jones, & Willmott, 1999; DeWall, Gilman, Sharif, Carboni, & Rice, 2012). While there are numerous studies documenting the negative consequences experienced by women who are sexually harassed, little is known about the relationship of sexual harassment to the more severe negative outcomes of suicidal ideation and self-harm behaviors and what variables might facilitate this hypothesized relationship. Thus, the purpose of this study is to explore whether the experience of sexual harassment is related to increased suicidality and if this hypothesized relationship is mediated or moderated by other factors such as an individual’s response style and/or degree of connection to or isolation from others.

The widespread practice of non-suicidal self-injury suggests that it might no longer be reasonable to frame such behaviours as individual pathologies and highlights the need to understand such acts as sociological phenomena instead. This dissertation therefore explored the core elements of self-injury such as the self, the body, and meanings ascribed to acts of injuring the self/body, in relation to forms of sociation. Focusing on intent and aetiology, this qualitative enquiry used an interpretive mode of explanation, and collected data via indepth face-to-face interviews from a characteristically diverse community sample of fifteen participants. Findings indicated that respondents' aetiologies of self-injury were located in social interactions characterised by abuse, neglect, bullying, and invalidation. Individuals who perceived themselves as worthless and unlovable objects punished themselves, or branded themselves as failures. Paradoxically, sufficient castigation averted the complete annihilation of the existential self. Findings concur with previous studies which reported that, at its deepest level, self-injury is antithetical to suicide. This study also highlighted the body's communicative role in the symbolic expression of traumatic experiences, and emphasised its physiological role in (a) emotion regulation and (b) self-injury's propensity to become addictive. From a sociological perspective, instant emotion regulation via self-injury allowed individuals to avoid social stigma; well managed social performances in turn protected social bonds. Although self-injury constitutes a maladaptive coping mechanism, its reported physiological, psychological and social gains are significant and need to be considered in intervention programmes and policy. This dissertation therefore makes two recommendations: firstly, restorative practices should be reinstituted, particularly in schools; secondly, the growing and alarming trend of copycat behaviours reported in children and young teens needs to be researched further in relation to the mediation, ideation and imitation of self-injurious behaviours.

Mental health screening is frequently recommended to facilitate earlier detection of mental illness in prisons. For this goal to be achieved: (1) the screening process must be accurate; (2) appropriate follow-up treatment must be provided; (3) the treatment must lead to improved outcomes. The current thesis aimed to evaluate mental health screening in relation to these three criteria by studying 13, 281 prisoners admitted to Correctional Service of Canada. Screening achieved comparable accuracy to tools that have been studied internationally and many inmates received at least some treatment. However, interruptions in treatment were frequent and long-term treatment was rare. There was weak evidence that treatment led to reduced rates of institutional incidents of suicide, self-harm, victimization and violence. While screening remains widely endorsed, further study of its impacts is needed to maximize its value. This could include considering alternatives to screening itself, or as follow-up for those who screen positive.

Background: The current literature concerning self-harm and suicide has shown firstly that self-harm is a major public health problem, secondly that people who self-harm are at increased risk of suicide and thirdly, that women prisoners have a higher rate of self-harm than women in the general population and than male prisoners. Women prisoners are therefore particularly high risk of self-harm and suicide and yet to date, no specific intervention has been developed for this group. Aims: This study intends to build on an intervention found to be effective in the community and to describe a methodology of conducting a therapeutic intervention in a prison environment. Method: The research utilized both qualitative and quantitative methods conducted over four phases. In Phase 1, semi-structured interviews were completed with women prisoners who self-harm and with prison staff. Data was analysed thematically. In Phase 2, the results from the analysis were then used to inform the modification of a Psychodynamic Interpersonal skills Therapy (PIT) model originally used in the community. During the third phase of the study, prison staff were recruited and trained to deliver the therapy. Finally, the fourth phase consisted of a feasibility and acceptability study with 64 women prisoners who had recently self-harmed. Thirty-two were randomized to the treatment group which consisted of four sessions of individual PIT therapy and 32 to the control condition which consisted of four sessions with a member of staff not trained in the therapy. Rates of self-harm were measured pre- and post-treatment. Standardized measures for depression, suicide intention, hopelessness and interpersonal skills were also administered. These data were further supported by interviews conducted with participants who completed the intervention, therapists and therapy supervisors. The methods used in the study were constantly evaluated and amended when required to describe a methodology suitable for this environment. Results: There was evidence of a lack of understanding of self-harm by prison officers. The trial phase of the study did not show evidence of efficacy for the intervention. There was an overall reduction in rates of self-harm pre- and post- treatment across the sample. Comparison of scores on outcome measures, pre- and post-intervention, showed a reduction on all tests in both treatment groups but this was not significant. It was not feasible to deliver the therapy as originally envisaged and substantial changes to the methods were needed. The results showed that prison staff had the skill and capacity to deliver PIT therapy but that the prison was not able to support such a role. As a result external therapists had to be brought in to the study. Conclusions: It is acknowledged that the study was not feasible as originally designed, but due to the small sample size we cannot say it was not effective and therefore, not worthy of further study.

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.

Research on self-harm and children tends to focus on adolescent children (12 years of age and above). There is limited available information about self-harm in children ages 11 years and younger. This study utilized autoethnography as the methodology to provide a rich description of the professional experiences and practices of an elementary school principal who worked with self-harming primary-aged students. Based on an autoethnographical analysis, this study proposes future research and makes recommendations for school leaders implementing trauma-informed practices, educators working with self-harming students, and districts committed to proactive support.

No description available.

The SARS-CoV-2 pandemic has been a worldwide chronic, stress-inducing natural catastrophe associated with increased emotional challenging. Patients with Post-traumatic stress disorder (PTSD), self-injury behavior, and obesity are predisposed to aggravation of their symptoms at this time, requiring new therapeutic approaches to balance their disrupted neuro-hormonal stress axis. Here we present our observations of an off-label treatment with lamotrigine in an adolescent girl with PTSD, self-injury behavior, and obesity. Lamotrigine was an efficacious pharmaceutical intervention that helped the patient deal with chronic stress and associated anxiety. The results are discussed based on our previous basic research outcomes in animals and humans that focused on the glutamate-cortisol circuits within the limbic brain.