No description available.

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.

No description available.

Background: Self-injury is a serious behaviour undertaken by those in distress. Attitudes to self-injury both with and without intent to end life is often studied in terms of professionals working in Accident and Emergency (A&E), with little attention paid to other professionals or non-professionals. There are several potential aspects to one's stigmatising attitudes, such as willingness to help individuals, perceived causes for behaviour, optimism for prognosis and general empathy experienced. Moreover, some research suggests stigmatising attitudes may be different depending on the severity of the self-injury, including the presence or absence of suicidal intent. The aim of this study was to investigate the impact on these factors of the form of self-injury and professional background. Methods: Using an online survey methodology 436 respondents completed the survey. The attitudes of Mental Health Professionals, Primary Care Professionals and those not working in either of these settings ('Non-Professionals') were compared to explore their attitudes towards self-injury. Participants were randomly shown a vignette depicting either self-injury with or without intent to end life and reported their overall empathy, willingness to help, attributions for the behaviour and optimism for prognosis. Results: On all measures Non-Professionals reported more negative attitudes than either healthcare professional group, who had similar attitudes towards self-injury. Both professional groups differed in their attitudes towards self-injury with and without suicidal intent on all measures expect for optimism for prognosis. Across all professional groups a difference was seen between the optimism for personal and others' intervention. Conclusions: The study outlined the current attitudes of different healthcare professionals and the general public towards self-injury both with and without intent to end life. Differences in attitudes were seen, showing the potential to improve the stigmatising attitudes experienced by those who self-injure; methods were suggested by which to do this. Further research is needed in order to assess the clinical effectiveness of attempts to improve stigmatising attitudes.

Bakgrund: I Sverige vårdades år 2011 drygt 7700 personer på sjukhus för självskador. Självskadebeteendet används ofta som en copingstrategi för att hantera och lindra psykisk smärta och ångest, men kan även vara ett rop på hjälp. Handlingarna väcker ofta starka känslor, såsom ilska, maktlöshet och antipati, hos sjukvårdspersonal. Patientgruppen upplevs ofta svår att ge bra vård till och patienterna utsätts för mycket tvångsvård och tvångsåtgärder. Syfte: Syftet är att belysa hur patienter med självskadebeteende upplever bemötandet i vården. Metod: Studien, en kvalitativ innehållsanalys med induktiv ansats, har utförts medelst analysering av tre självbiografier skrivna av personer med ett tidigare självskadebeteende. Resultat: Självbiografiförfattarnas upplevelser av bemötandet i vården delades in i två huvudkategorier; positiva respektive negativa upplevelser. Under positiva upplevelser utkristalliserades fyra kategorier; Trygghet och tillit, Erhålla information, Bli tagen på allvar och känna sig förstådd respektive Omtanke och stöd. Under huvudkategorin negativa upplevelser hittades kategorierna Utlämnad och maktlös, Ej bli tagen på allvar och ej känna sig förstådd, Ej känna sig värdig vård samt Bristande information. Slutsats: Bemötandet inom vården är avgörande för relationen mellan vårdare och vårdtagare. Då patienterna hade positiva upplevelser av bemötandet grundlades en tillitsfull relation. Ett dåligt bemötande bidrog till ett vårdlidande för patienterna. Klinisk betydelse: Resultatet kan ge vårdpersonal en ökad kunskap och bättre förståelse för vad i bemötandet som upplevs positivt respektive negativt av patienten. Detta kan leda till ett förbättrat och mer professionellt bemötande av dessa patienter, vilket är viktigt för ett gott tillfrisknande. / Background: During 2011 more than 7700 people were hospitalized for self-injuries in Sweden. Self-injury behavior is often used as a coping strategy to manage and relieve mental pain and anguish, but can also be a cry for help. The actions often generate strong emotions, such as anger, powerlessness and antipathy, among health care staff. This group of patients is often perceived difficult to provide good care for and the patients are exposed to many coercive measures. Purpose: The purpose is to illustrate how patients with self-injury behavior experience their treatment. Method: The study, a qualitative content analysis with an inductive approach, has been performed by analyzing three autobiographies written by persons with a previous self-injury behavior. Result: The patients/authors experiences of their treatment were divided into two main categories; positive and negative experiences. Under positive experiences four categories crystallized; Security and trust, Receive information, Be taken seriously and feel understood and Care and support. Under the main category negative experiences four categories were developed; Left out and powerlessness, Not be taken seriously and not feel understood, Not feel worthy of care and Lack of information. Conclusion: The treatment in health care is critical to the relationship between caregiver and care recipient. When the patients´ had positive experiences of the treatment from the staff a trusting relationship was founded. A bad attitude contributed to patients suffering. Clinical significance: The results may give health care professionals a better knowledge and understanding of the treatment that is perceived positively or negatively by the patient. This can lead to an improved and more professional treatment of these patients, which is important for a good recovery.

Bakgrund: En ökning av självskadebeteende som lett till sjukhusinläggning i Sverige har redovisats, vilket visar på ett behov av ökad medvetenhet och kunskap kring området. Beteendet är vanligast förekommande bland tonåringar och unga vuxna, och används som en strategi för att hantera emotionell smärta. Tidigare forskning visar att patientgruppen generellt inte är populär bland sjuksköterskor. Samtidigt poängteras vikten av en terapeutisk relation mellan patient och sjuksköterska för tillfrisknandet. Syfte: Syftet med denna studie är att belysa sjuksköterskors upplevelser av att vårda patienter som lider av självskadebeteende. Metod: En litteraturstudie gjordes där tio kvalitativa artiklar valdes ut för granskning, analys och resultatredovisning. Resultat: Efter analysen bildades sex huvudkategorier: Svårigheter i vårdandet av självskadande patienter, Att skapa terapeutiska relationer, Den emotionella påverkan, Synen på självskadande patienter, Brister i stöd och resurser samt Behov av mer utbildning och träning. Patienter med självskadebeteende ses som en svår patientgrupp att vårda, och det uppstår många olika känslor hos sjuksköterskan, främst negativa, i samband med omvårdnaden. Mer utbildning önskas av merparten av de sjuksköterskor som deltagit i de undersökta studierna. Slutsats: De negativa upplevelserna beror till stor del på okunskap och bristande färdigheter i omvårdnaden av patientgruppen. / Background: An increase in self -destructive behavior that led to hospitalization in Sweden has been reported, indicating a need for increased awareness and knowledge about the area. This behavior is most common among teenagers and young adults, and is used as a strategy to manage emotional pain. Previous research shows that the patient population is generally not popular among nurses. At the same time the importance of a therapeutic relationship between the patient and the nurse is emphasized for the recovery. Aim: The aim of this study is to illuminate nurses' experiences of caring for patients who suffer from self-injurious behavior. Method: A literature review was conducted where ten qualitative articles were selected for examination, analysis and presentation of results. Results: After analysis, six main categories were put together: Difficulties in the care of self-harming patients, Creating therapeutic relationships, Emotional impact, Perception of self-harming patients, Deficiencies in support and resources, and Need for more education and training. Patients with self-injurious behavior are seen as a difficult group of patients to care for and cause many different emotions, mostly negative, in the context of nursing care. More training is desired by the majority of the nurses who participated in the examined studies. Conclusion: The negative experiences depend largely on ignorance and lack of skills in the nursing care of the patient group.

No description available.

The perspective of the individual who self-injures has been under-represented in research. This study places the meaning of self-injury for these individuals at its core. People who self-injure can offer comprehensive and discerning insights into the behaviour. This study confirms the findings of earlier research that self-injury is often rooted in processes of suffering. The social and personal cost experienced by people who self-injure can be high, not only in direct relation to the self-injury itself, but also regarding the legacy of the processes of suffering in general from which self-injury emerged. In this study the processes of suffering, ritual and stigma are explored. Using a qualitative approach, data was collected from 25 self-injuring participants though semi-structured interviews. Interview data was supplemented by diaries and collections of poetry. The main findings from the study are that self-injury can emerge as an action scheme of escape from the processes of suffering. It is a highly stigmatised behaviour which can also develop into an extremely ritualised practice involving a complexity of meanings regarding the surroundings, the apparatus and the process. The self-injury ritual can be viewed as an extreme but therapeutic workout for the five senses of the human body.

Nonsuicidal self-injury (NSSI) is prevalent among young adults, and is associated with increased suicide risk. The self-punishment hypothesis theorizes that individuals who are highly self-critical may engage in NSSI due to finding the experience of pain as ego-syntonic. Although evidence links self-critical views to NSSI, minimal research has examined how these views are influenced by more proximal social stressors, such as peer criticism, to trigger NSSI urges. The current study addresses the following questions: (1) Will the effects of recalled peer criticism (vs. praise and a neutral interaction) on pain endurance (a proxy measure for NSSI urges) and self-reported NSSI urges be moderated by group status (i.e., whether or not an individual has a history of NSSI)? We hypothesized that group status would moderate the effects of recalled peer criticism on pain endurance and NSSI urges, such that the relationships between these constructs would be stronger among the NSSI group vs. the no NSSI group; (2) If these interaction effects are present, will they be mediated by self-critical views? We hypothesized that the interaction between group status and peer criticism on pain endurance and NSSI urges would decrease in magnitude after accounting for self-critical views. Participants were 137 young adult women with either a recent or recurrent history of NSSI (n = 79) or no NSSI history (n = 58). Idiographic scripts of a recalled peer interaction involving critical, praising, or neutral feedback were used as the experimental manipulation, and measures of pain endurance (via a pressure algometer) and self-reported NSSI urges were administered at baseline and post-manipulation. The NSSI group demonstrated marginally higher pain endurance and stronger self-critical views than the control group. The overall effects of recalled peer criticism were not moderated by group status in predicting pain endurance or NSSI urges. Exploratory pairwise comparisons revealed that those in the NSSI group who received criticism (vs. the other conditions) demonstrated a significant increase in NSSI urges. Findings highlight peer criticism as one context in which risk for NSSI urges may be elevated among those with a history of NSSI, and underscore self-critical views as an important intervention target.

This article provides readers with an understanding of self-injury assessment. The article begins with a critical review of a number of self-injury assessments. The latter section of the article introduces a comprehensive two-tiered approach to accurately assessing self-injury. Implications for counselors related to the assessment of self-injury are also provided.