Non-suicidal self-injury (NSSI), or deliberate self-harm, and suicidal behaviors are significant public health concerns, and college students may be at particular risk. For instance, approximately 17% of college students engage in NSSI and suicide is the 2nd leading cause of death in college students. Commonalities between NSSI and suicidal behavior exist, including etiology; as an example, misuse of substances and interpersonal difficulties are related to both outcomes. For college students, substance use disorders and social dysfunction are two of the most common psychosocial problems; for instance, 22% of students report illicit drug use and social isolation, loneliness and separation from traditional support systems are common collegiate stressors. According to the Interpersonal Theory of Suicide, two pertinent interpersonal risk factors are perceived burdensomeness (the belief that one is a liability to others) and thwarted belongingness (the unmet need to belong among others). When present, substance misuse and interpersonal dysfunction may facilitate the transition between NSSI and suicidal behavior; however, this premise has not been previously examined. As such, we hypothesized that substance abuse would mediate the relation between NSSI and suicidal behavior, such that engagement in NSSI would be related to greater use of substances and, in turn, to suicidal behavior. Further, we hypothesized that thwarted interpersonal needs would moderate this mediating effect, such that increased TB and PB would exacerbate the mediating effect of substance misuse. Our sample of college students (N=338) was primarily white (89.6%; n=294), female (67%; n=225), and had an average age of 21.8 years (SD=4.7). Participants completed the Suicide Behaviors Questionnaire-Revised, the Self-Harm Inventory, the Interpersonal Needs Questionnaire, and the Drug Abuse Screening Test. Supporting hypotheses, substance abuse partially mediated the relationship between NSSI and suicidal behavior (DE=1.30, SE=.10, p

Lesões autoprovocadas por autointoxicação intencional por medicamento (AIM) e óbitos por suicídio são passíveis de prevenção e representam grave problema de saúde pública mundial. Este estudo investigou lesões autoprovocadas e suas recorrências por AIM e fatores sociodemográficos, clínicos e farmacológicos associados, bem como óbitos por suicídio por AIM e fatores sociodemográficos, clínicos e farmacológicos associados. Trata-se de estudo quantitativo, transversal, analítico e documental. Foi realizado a partir de dados secundários de bancos de dados do Sistema de Informação de Agravos de Notificação e do Sistema de Informação sobre Mortalidade da Secretaria de Estado de Saúde de Mato Grosso, Brasil. Foram incluídos no estudo todos os casos registrados de lesões autoprovocadas e os óbitos por suicídio de pessoas acima de nove anos de idade, no período de 1º de julho de 2015 a 31 de dezembro de 2017, em todos os municípios do estado de Mato Grosso. Para análise dos dados foram elaborados modelos de regressão logística com efeitos aleatórios, pertencentes à classe dos modelos Generalized Estimating Equations, utilizando-se o software Statistical Analysis System 9.2. O estudo foi aprovado por Comitê de Ética em Pesquisa. Constatou-se que, no período em estudo, foram notificadas 1.507 lesões autoprovocadas, sendo 27,34% delas por AIM, com destaque para utilização de medicamentos que atuam no Sistema Nervoso. O modelo de regressão logística constatou maior chance de lesão autoprovocada por AIM entre pessoas com idade de 10 a 19 anos e de 20 a 59 anos, quando comparadas àquelas com mais de 60 anos, mulheres comparadas aos homens, de raça branca em relação às de outras raças, ocorrência em zona urbana comparada a não urbana e ocorrência em residência comparada a outros locais. Observou-se menor chance de lesão autoprovocada por AIM entre pessoas com suspeita de uso de álcool quando comparadas àquelas sem tal suspeita. Das 381 pessoas com lesões autoprovocadas por AIM na primeira notificação, nove pessoas tiveram mais de uma lesão autoprovocada por esse método, com destaque para utilização de medicamentos que atuam no Sistema Nervoso. No modelo de regressão logística para analisar os fatores associados às recorrências de lesões autoprovocadas por AIM, nenhuma das variáveis contribuiu significativamente. Dos 412 casos de lesões autoprovocadas por AIM, 13 pessoas foram a óbito por suicídio por AIM. Em 11 desses casos não havia informações sobre o medicamento e em dois casos foram utilizados medicamentos que atuam no Sistema Nervoso. No modelo de regressão logística, para analisar os fatores associados aos óbitos por suicídio por AIM, houve menor chance de óbito por suicídio por AIM entre pessoas com idade de 10 a 19 anos e de 20 a 59 anos, quando comparadas àquelas com mais de 60 anos. Os achados deste estudo fornecem importantes subsídios para estratégias direcionadas à prevenção do suicídio e de lesões autoprovocadas por AIM, bem como para a qualificação da assistência de enfermagem / Self-injuries by intentional drug self-poisoning and suicide deaths are preventable and represent a serious public health problem worldwide. This study investigated selfinjuries and their recurrences by intentional drug self-poisoning and associated sociodemographic, clinical and pharmacological factors, as well as suicide deaths by intentional drug self-poisoning and associated sociodemographic, clinical and pharmacological factors. It is a quantitative, cross-sectional, analytical and documentary study. It was carried out from secondary databases of the Notification of Injury Information System and Mortality Information System of the Health Secretariat of the state of Mato Grosso, Brazil. This study included all registered cases of selfinjuries and suicide deaths of people aged above nine years, from July 1, 2015 to December 31, 2017, in all municipalities of the state of Mato Grosso. For data analysis, logistic regression models with random effects, based on Generalized Estimating Equations models, were developed using the software Statistical Analysis System 9.2. The study was approved by the Research Ethics Committee. It was found that, during the study period, 1,507 self-injuries were reported, of which 27.34% were by intentional drug self-poisoning, with emphasis on the use of drugs that act on the Nervous System. The logistic regression model found a greater chance of self-injuries by intentional drug self-poisoning among people aged from 10 to 19 years and from 20 to 59 years, when compared to those over 60 years, women compared to men, white category compared to all other race categories, occurrence in urban areas compared to non-urban areas and occurrence at home compared to other places. It was observed a lower chance of self-injury by intentional drug self-poisoning among people suspected of using alcohol when compared to those without such suspicion. Of the 381 people with self-injuries by intentional drug self-poisoning in the first notification, nine of them had more than one self-injury by this method, with emphasis on the use of drugs that act on the Nervous System. In the logistic regression model to analyze the factors associated with recurrences of self-injury by intentional drug self-poisoning, none of the variables contributed significantly. Of the 412 cases of self-injury by intentional drug selfpoisoning, 13 people died by suicide by intentional drug self-poisoning. In 11 of these cases, there was no information about the drug and, in two cases were used drugs that act on the Nervous System. In the logistic regression model, to analyze the factors associated with death by suicide by intentional drug self-poisoning, there was a lower chance of death by suicide by intentional drug self-poisoning among people aged from 10 to 19 years and from 20 to 59 years, when compared to those over 60 years old. These findings provide important subsidies for strategies aimed at suicide prevention and self-injuries by intentional drug self-poisoning, as well as for the qualification of nursing care

<p>Det psykiska hälsoläget har förbättrats totalt sett i befolkningen de senaste åren, men trots det är detfortfarande oroväckande många unga som upplever att de mår psykiskt dåligt. Ett fenomen som ökat under senare tid och som kopplats samman med psykisk ohälsa, är olika former av självskadehandlingar. Det har tidigare visats att andra typer av riskbeteenden sprids i populationer genom att individer influeras av varandra. Bakgrunden till den här studien var en tanke om att ökningen av självskadehandlingar kan vara ett resultat av en form av smittspridning snarare än enbart ett tecken på försämrad psykisk hälsa. Som primär kanal för spridningen av beteendet undersöktes Internet eftersom mycket av ungdomars sociala liv utspelar sig på den arenan. Studien grundar sig på en enkät (n=192) till gymnasieelever. Syftet var att undersöka hur väl ungdomar kände till fenomenet självskadebeteende samt hur de kommunicerade med och influerades av sina vänner. Resultatet visade att mer än hälften av ungdomarna kommit i kontakt med självskadebeteende i form av bilder eller skriftliga inlägg på Internet och 86 % av tjejerna och 71 % av killarna kände dessutom till minst en person i sin närhet som medvetet skadat sig själv. Eftersom ungdomar exponeras av beteendet från många håll är det rimligt att anta att individer som upplever någon form av psykisk stress kan influeras av andra att prova ett självdestruktivt beteende. Beteendet förefaller mer utbrett än vad som skulle kunna förväntas om en svårare psykisk ohälsa var den enda orsaken. Att tidigt arbeta med självkänsla och se till att barn och unga har trygga sociala nätverk runt omkring sig kan vara ett sätt att förse dem med den motståndskraft som behövs för att stå emot negativa influenser från omgivningen.</p> / <p>The mental health status has improved in the overall population recent years although it is still worrying many young people who feel that they have a poor psychological health. A phenomenon that has increased recently, and are linked to mental illness, are various forms of self-injury acts. It has previously been shown that other types of risk behaviours spread in populations by individuals influenced by each other. The background of this study was to examine whether the increase in selfinjury acts can be the result of a form of contagion, rather than merely a sign of impaired mental health. Since a lot of young people's social life takes place on the Internet, this was the arena which was investigated. The study is based on a survey (n = 192) and was designed to examine how well young people were aware of the phenomenon of self-injury, and how they communicated with and how they were influenced by their friends. The results showed that more than half of the participants had been in contact with self-injury such as pictures or written messages on the Internet. Among the respondents 86% of the girls and 71% of the boys also knew at least one person who deliberately harmed themselves. Since adolescents are exposed to this behaviour from many directions, it is reasonable to assume that individuals who experience some form of mental stress may be influenced by others to try self-destructive behaviour. The behaviour seems to be more prevalent than would be expected if a severer mental illness was the solely cause. Early work on self-esteem and ensuring children and young people have a safe social network around them can be a way to provide them with the resilience needed to withstand the negative influences from their surroundings.</p>

Det psykiska hälsoläget har förbättrats totalt sett i befolkningen de senaste åren, men trots det är detfortfarande oroväckande många unga som upplever att de mår psykiskt dåligt. Ett fenomen som ökat under senare tid och som kopplats samman med psykisk ohälsa, är olika former av självskadehandlingar. Det har tidigare visats att andra typer av riskbeteenden sprids i populationer genom att individer influeras av varandra. Bakgrunden till den här studien var en tanke om att ökningen av självskadehandlingar kan vara ett resultat av en form av smittspridning snarare än enbart ett tecken på försämrad psykisk hälsa. Som primär kanal för spridningen av beteendet undersöktes Internet eftersom mycket av ungdomars sociala liv utspelar sig på den arenan. Studien grundar sig på en enkät (n=192) till gymnasieelever. Syftet var att undersöka hur väl ungdomar kände till fenomenet självskadebeteende samt hur de kommunicerade med och influerades av sina vänner. Resultatet visade att mer än hälften av ungdomarna kommit i kontakt med självskadebeteende i form av bilder eller skriftliga inlägg på Internet och 86 % av tjejerna och 71 % av killarna kände dessutom till minst en person i sin närhet som medvetet skadat sig själv. Eftersom ungdomar exponeras av beteendet från många håll är det rimligt att anta att individer som upplever någon form av psykisk stress kan influeras av andra att prova ett självdestruktivt beteende. Beteendet förefaller mer utbrett än vad som skulle kunna förväntas om en svårare psykisk ohälsa var den enda orsaken. Att tidigt arbeta med självkänsla och se till att barn och unga har trygga sociala nätverk runt omkring sig kan vara ett sätt att förse dem med den motståndskraft som behövs för att stå emot negativa influenser från omgivningen. / The mental health status has improved in the overall population recent years although it is still worrying many young people who feel that they have a poor psychological health. A phenomenon that has increased recently, and are linked to mental illness, are various forms of self-injury acts. It has previously been shown that other types of risk behaviours spread in populations by individuals influenced by each other. The background of this study was to examine whether the increase in selfinjury acts can be the result of a form of contagion, rather than merely a sign of impaired mental health. Since a lot of young people's social life takes place on the Internet, this was the arena which was investigated. The study is based on a survey (n = 192) and was designed to examine how well young people were aware of the phenomenon of self-injury, and how they communicated with and how they were influenced by their friends. The results showed that more than half of the participants had been in contact with self-injury such as pictures or written messages on the Internet. Among the respondents 86% of the girls and 71% of the boys also knew at least one person who deliberately harmed themselves. Since adolescents are exposed to this behaviour from many directions, it is reasonable to assume that individuals who experience some form of mental stress may be influenced by others to try self-destructive behaviour. The behaviour seems to be more prevalent than would be expected if a severer mental illness was the solely cause. Early work on self-esteem and ensuring children and young people have a safe social network around them can be a way to provide them with the resilience needed to withstand the negative influences from their surroundings.

Author: Madeleine Ahlström and Hanna Puonti Title: To meet the invisible population - A qualitative study of men with deliberate self-injury [Att möta de osynliga - En kvalitativ studie om killar med självskadebeteende] Supervisor: Anders Östnäs Assessor: Jan Petersson   This study aims to provide a picture of the underlying causes why men deliberately hurt themselves. It also aims to provide a picture revolving how men self-harm and what the direct effects are from their self-harm. The study describes their behaviour and how the behaviour has evolved over time. There is also a focus in the study to illustrate how society´s operative approach towards men makes their self-harm invisible, and make them an invisible population that neither the scientists nor the general population chooses to see. Self-injury is strongly associated with girls and their way of harming themselves. Men have been excluded from studies of self-injury, also have there been very few scientists that found them of interest to study.   This is a study with a qualitative approach wich executed eight semi-structured interviews with men who have had a behavior of self-injury. The study takes on a hermeneutic approach to knowledge, to have the possibility to interpret in the analysis of the empirics. To analyse the data we have used a qualitative content analysis according to Graneheim and Lundman (2004). The results has been analysed by Antonovsky´s (2005) KASAM theory. The study has found that men have a self-injury that is multifaceted. The men in the study use different behaviours to manage various emotional factors that affect them. Deliberate self-injurious behaviours become a coping strategy for the men when they didn’t have other strategies to cope with when their faced difficulties.

Gli esseri umani vengono definiti come membri di un gruppo quando assumono i significati che il gruppo stesso crea ed utilizza per concepire sè stesso, i suoi membri e l'universo in generale. Abbiamo studiato i significati che definiscono un essere umano nella versione dell'"autolesionista utente di un gruppo online". In primo luogo, tramite un'analisi tematica di post condivisi nel forum del gruppo siamo venuti a conoscenza delle teorie sul comportamento, la sofferenza ad esso associata ed altre tematiche che definiscono "l'autolesionista". I risultati ottenuti hanno dimostrato che i significati che descrivevano il dolore associato all'autolesionismo erano più rilevanti rispetto a quelli legati all'atto. In seguito tramite IPA di interviste individuali abbiamo compreso che la qualità dello spazio del forum e della relazione tra le dimensioni online e offline determinavano influenze reciproche tra la partecipazione al forum, gli effetti sul sè e sul comportamento e il tipo di utilizzo del forum. Infine abbiamo condotto quattro incontri online con un gruppo di utenti del forum e lavorando sui significati, abbiamo stimolato la loro capacità di diventare consapevoli del loro stato mentale in relazione al comportamento autolesionista. / Human beings are defined as members of a group when they assume the meanings that such group creates and uses to conceive itself, its members and the world in general. We studied meanings that shape a human being in the version of a “self-injurer member of an online group”. Firstly, through a thematic analysis of posts shared in the forum of the group we became acquainted with theories about the behavior, its associated sufferance and other issues that define “a self-injurer”. We found that the most important meanings related to the sufferance rather than to the practice of self-injurious gestures. Secondly, through IPA of individual interviews we understood that the quality of the space of the forum and the relationship between online and offline dimensions determined influences between the self-injurer's identity and her experience in the forum in terms of participation, effects on self and behavior, and type of use of the forum. Finally, we conducted four online meetings with a group of users of the forum and always focusing on meanings, we stimulated their capacity to be aware about their mental states in relation to self-injury.

Tyrimo tikslas - išsiaiškinti sąmoningai save žalojančių ir turinčių savižudiškų tendencijų paauglių sveikatai nepalankaus elgesio ypatumus. Tyrime dalyvavo 690 tiriamųjų. Iš jų 379 (54,9 %) vaikinai ir 311 (45,1 %) merginų. 38 (5,5 %) respondentai nurodė sąmoningai save žalojantys, iš jų tik 13 (1,9 %) tiriamųjų išsakė neturintys savižudiškų ketinimų. 86 (12,5 %) paaugliai nurodė turintys savižudiškų ketinimų, iš kurių 61 (8,9 %) respondentas turintis savižudiškų ketinimų, tačiau savęs nežaloja. Tai reiškia, kad 25 (3,6 %) tiriamieji ir sąmoningai save žaloja, ir turi savižudiškų ketinimų. Tiriamųjų amžius nuo 12 iki 19 metų. Tyrimo rezultatai parodė, jog paaugliai yra labiau linkę save žalojant turėti savižudiškų ketinimų, nei tie, kurie savęs nežaloja, tačiau turi savižudiškų ketinimų. Tik sąmoningai save žalojantys paaugliai be savižudiškų ketinimų vartoja alkoholinius gėrimus, elgiasi agresyviai ir turėjo ankstyvų lytinių santykių rečiau nei sąmoningai save žalojantys paaugliai turintys savižudiškų ketinimų, tačiau dažniau nei tik savižudiškų ketinimų turintys paaugliai. Taip pat galima pastebėti tendencijas, kad tik sąmoningai save žalojantys paaugliai be savižudiškų ketinimų rūko ir vartoja narkotines medžiagas rečiau nei sąmoningai save žalojantys paaugliai turintys savižudiškų ketinimų, tačiau dažniau nei tik savižudiškų ketinimų turintys paaugliai. / The survey has been targeted to find out the peculiarity of adolescents health untoward behavior between non-suicidal self-injury and suicidal tendencies. There were 690 participants in the survey, 379 (54,9 %) boys and 311 (45,1 %) girls. 38 (5,5 %) participants were self-injurers, 13 (1,9 %) of them were non-suicidal self-injurers. 86 (12,5 %) adolescents noted to have suicidal tendencies, 61 (8,9 %) of them noted to have only suicidal tendencies without self-injuring behavior. It means that 25 (3,6 %) respondents self-injure themselves and report suicidal tendencies. The participants age was from 12 to 19 years old. The results showed that adolescents are tend to report suicidal tendencies the same time when they are self-injuring compared to those who does not self-injure and report only suicidal tendencies. Adolescents who experience non-suicidal self-injure, use alcohol, drugs, behave aggressive and have early sexual intercourse more rarely than those who self-injure and report suicidal tendencies, but more often then those, who report only suicidal tendencies. Also there can be noted the tendency, that non-suicidal sel-injurers smoke cigarettes and use drugs more rarely than those adolescents who self-injure and report suicidal tendencies, but more often then those adolescents, who report only suicidal tendencies.

The purpose of this investigation was to examine the role of suicide-related mental imagery in suicidal behavior. It was hypothesized that engagement (frequency, emotional impact, vividness, realism) with suicidal imagery would be related to suicidality, with greater engagement with imagery associated with more suicidal behaviors. Acquired capability for suicide was expected to be a mediator of this relationship. These hypotheses were tested by surveying 237 undergraduate university students (59% female; mean age = 20). Students completed a packet of self-report measures: The Modified Suicidal Cognitions Interview, The Acquired Capability for Suicide Scale, and the Self-Harm Behavior Questionnaire. Results suggested that engagement with suicide-related imagery was positively correlated with suicidality. The correlational analyses showed that an additional mediational analysis was unwarranted. The implications of these findings are that understanding suicide-related mental imagery could play an important role in clinical risk assessment and treatment for suicidality, and that further research is needed to clarify the mechanisms underlying the relationship between suicide-related mental imagery and suicidal behavior.

This study explored mindfulness in eight self–injuring psychiatric adolescents. A concurrent triangulation mixed–method design was used. In–depth semi–structured clinical interviews and clinical records constituted the qualitative data, while quantitative data was gathered using the Five–Facet Mindfulness Questionnaire (FFMQ). Thematic analysis was used to generate themes and subthemes for both selfinjury and mindfulness. Findings regarding self–injury were in line with the literature. In terms of mindfulness, two groups emerged: one sometimes acting mindfully and the other often acting mindfully. Both similarities and differences were found between the groups. Similarities in self–injuring behaviour can be explained by their similar scores on Observe and Nonreact, while the differences can be explained by the differences in their scores on Describe, Act with Awareness and Nonjudge. Those who sometimes act mindfully tend to be more self–critical, report more severe and lethal self–injuring episodes and more often use self–injury for self–punishment. Although those who often act mindfully self–injure more often, they show more selfcompassion and report less severe injuries and less lethal methods. Future research should explore the usefulness of mindfulness–based interventions, especially teaching Nonjudge and Nonreact skills, to not only increase mindfulness, but to decrease selfinjuring behaviour. Seeing that this is an exploratory study on a small sample, the results presented here should be considered to be preliminary until replicated with a larger clinical sample. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.

This study explored mindfulness in eight self–injuring psychiatric adolescents. A concurrent triangulation mixed–method design was used. In–depth semi–structured clinical interviews and clinical records constituted the qualitative data, while quantitative data was gathered using the Five–Facet Mindfulness Questionnaire (FFMQ). Thematic analysis was used to generate themes and subthemes for both selfinjury and mindfulness. Findings regarding self–injury were in line with the literature. In terms of mindfulness, two groups emerged: one sometimes acting mindfully and the other often acting mindfully. Both similarities and differences were found between the groups. Similarities in self–injuring behaviour can be explained by their similar scores on Observe and Nonreact, while the differences can be explained by the differences in their scores on Describe, Act with Awareness and Nonjudge. Those who sometimes act mindfully tend to be more self–critical, report more severe and lethal self–injuring episodes and more often use self–injury for self–punishment. Although those who often act mindfully self–injure more often, they show more selfcompassion and report less severe injuries and less lethal methods. Future research should explore the usefulness of mindfulness–based interventions, especially teaching Nonjudge and Nonreact skills, to not only increase mindfulness, but to decrease selfinjuring behaviour. Seeing that this is an exploratory study on a small sample, the results presented here should be considered to be preliminary until replicated with a larger clinical sample. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.