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The aim of this study is to increase the understanding of why young women use sex as a form of self-injury. The empiricism consists of fifteen life stories either written by the young women themselves or with the help of an author. The study is based on a narrative method and the theoretical framework is founded on Goffman’s role theory; Goffman’s theory of social stigma and the concept of shame. The result of the study shows among other things that the young women often describe themselves as disgusting, filthy and have feelings of self- hatred and shame. They self-harm through sexual intercourse or acts as a way to regulate and relieve anxiety, but it only helps in the short run as the anxiety tends to get even stronger than before which leads to more self-harm. The young women often end up in a vicious circle that is hard to break. Furthermore the young women describe their upbringings lacking the presence and love of their parents.

Facilities housing non-human primates are required to make provisions for their psychological wellbeing, which may include monitoring animals for signs of decreased wellbeing such as the presence of abnormal behaviors or alopecia. By analyzing archival behavioral data collected by the Behavior Management Unit at the Yerkes National Primate Research Center (YNPRC), I aimed to identify behavioral predictors of self-wounding and alopecia and to evaluate the effectiveness of current treatments in reducing abnormal behavior and alopecia in rhesus macaques (Macaca mulatta). The behaviors of self-biting and hair plucking (conditional logistic regression, p < .05) as well as floating limb and self-oral behaviors (Mantel-Haenszel chi-square tests, p < .05) were identified as behavioral predictors of self-wounding. Fear behaviors were associated with an increased risk of developing alopecia (Mantel-Haenszel chi square, p < .05). An inverse relationship was found between alopecia and stereotypic locomotor behaviors such as pacing, with animals who displayed these behaviors being less likely to develop significant hair loss (conditional logistic regression, p < .05). Overall, the type of treatment provided (e.g., additional foraging opportunities, the provision of toys, or the provision of visual barriers) did not predict improvement in levels of abnormal behavior or alopecia (logistic regression, p > .05). The results of these analyses add to the literature on self-wounding and alopecia and will allow refinement of the quantitative behavioral monitoring system at YNPRC such that more at-risk animals can be identified and treated prior to the development of abnormal or harmful behaviors.

Prison self-injury rate accelerates at four times the rise in population” (The Howard League for Penal Reform; 2008a) The rise in self-harm figures in forensic settings in 2003 may largely be due to the improvement in the reporting of self-harm levels in prisons in December 2002. However it does not account for the continued rise in self-harm figures during the years that followed. Despite the increase, there have been few interventions to support prisoners who self-harm, particularly in remand settings. For this purpose the Carousel programme was designed by a counselling psychologist specifically to meet the demands of the female remand population. The aim of this study was to evaluate the effectiveness of Carousel. Forty women who had a history of deliberate self-harm entered and completed the programme through means of self-referral. The study employed both a quantitative and qualitative methodology to evaluate the programme. Participants were interviewed and assessed both at the start and completion of Carousel. This included monitoring levels of self-harm incidents, levels of anxiety and depression using the 14-item Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983), and coping levels using the 60-item Coping Styles Questionnaire (CSQ) (Roger, Jarvis & Najarian, 1993). Results showed a significant decrease in depression and anxiety, a reduction in self-harm levels and a change of coping styles in the desired direction. Qualitative methodology using content analysis was employed to ascertain the components of the programme which were deemed most helpful or unhelpful to the participants. Findings suggest that the most useful components within the programme are coping strategies, management of self-harm behaviours, antecedent, behaviour and consequence (ABC) sessions and the understanding of the brain and associated emotions with self-harm behaviours. Implications for counselling psychology and clinical practice are highlighted and limitations of the current study and directions for future research suggested within the report.

Bakgrund och problemformulering: Sex som självskadebeteende är ett ämne som fått ökad medial uppmärksamhet de senaste åren. Den vetenskapliga forskningen är emellertid eftersatt. Syfte: Att undersöka upplevd erfarenhet och befintligt kunskapsläge om sex som självskadebeteende samt vilka omvårdnadsinsatser som ges till patienter med självskadebeteende. Detta för att kunna se hur lidande lindras och hälsa främjas i det dagliga vårdandet. Metod: Tvärsnittsstudie där 70 legitimerade sjuksköterskor besvarade en enkät med en kvantitativ del som redovisades med deskriptiv statistik samt en kvalitativ del där redovisningen skedde i form av en innehållsanalys enligt Graneheim och Lundman (2004). Resultatsammanfattning: Flertalet av sjuksköterskorna (83%) ansåg sig veta vad sex som självskadebeteende innebär. Dock upplevde 77% (n=54) att deras kunskaper ej var tillräckliga. Drygt hälften (60%) hade erfarenhet av sex som självskadebeteende och faktorer som kunde sammankopplas med det sexuella självskadebeteendet var andra psykiatriska diagnoser och låg självkänsla. De omvårdnadsåtgärder som främst användes vid kontakt med personer med ett självskadebeteende var rekommendationer om sömn, nutrition och fysisk aktivitet samt stödsamtal. Slutsats: Vetskapen om ämnet bland sjuksköterskorna finns men mer kunskap behövs inom området för att kunna förbättra omvårdnaden av patienter med ett sexuellt självskadebeteende. / Background: Sex as self-injury is a topic that has received increased media attention in recent years. Scientific research, however, is neglected. Objective: To investigate the perceived experience and the existing state of knowledge about sex as self-injury and what care is given to patients with self-injurious behaviour. This is to see how suffering is alleviated and health promoted in nurses daily care. Method: Cross-sectional study in which 70 registered nurses answered a questionnaire with a quantitative component which was reported with descriptive statistics and a qualitative part in which the accounts took the form of a content analysis according to Graneheim and Lundman (2004) . Results: Most of the nurses thought they knew what sex as self-injury involves. However, 77% (n = 54) experienced that their knowledge was not sufficient. Fully half of the nurses (60%) had experience of sex as self-harm and factors that could be linked to the sexual self-injury were other psychiatric diagnoses, and low self-esteem. The nursing interventions which were mainly used in contact with persons with a self- injurious behaviour were recommendations on sleep, nutrition and physical activity, and support-conversations. Conclusion: The knowledge of the subject among the nurses exists but more knowledge is needed in the field in order to improve the care of patients with sexual self-injurious behaviour.

The immediate and subsequent effects of different durations of response restriction were evaluated in a multiple schedule design. Response restriction components of 15, 30, and 60 minutes were conducted between 15 minute alone components. Levels of responding subsequent to the termination of response restriction procedures were compared to free operant levels prior to the implementation of response restriction. Responding during response restriction components reduced to near zero levels. Subsequent levels of responding were similar to or exceeded free operant baseline levels. Results are discussed in terms of potential operant mechanisms responsible for levels of responding subsequent to response restriction.

This study examined the effects of response restriction (blocking and protective equipment) on subsequent durations of self-injury with two female participants with developmental disabilities. First, a functional analysis was conducted with each participant to identify potential maintaining variables of the self-injury. Second, access to the response was systematically restricted in a multiple schedule restriction paradigm. A baseline extended alone was conducted without the restriction component in place as a control condition. For one participant the results suggested that response restriction may have increased subsequent durations of responding once the restriction element was removed. For a second participant responding did not appear to be affected by the restriction component.

I Sverige och globalt har det de senaste decennierna rapporterats en ökning av icke suicidalt självskadebeteende. Icke suicidalt självskadebeteende har definierats som skada en person medvetet tillfogar sin kropp. Forskning inom området har visat på att personer med icke suicidalt självskadebeteende känt sig stigmatiserade och upplevt dåligt bemötande inom vården. Syftet i denna studie var att beskriva hur det är att leva med icke suicidalt självskadebeteende (NSSI), genom att studera bloggar. En kvalitativ innehållsanalys på sex bloggar gjordes. En induktiv ansats användes för att fånga olika perspektiv angående hur det är att leva med NSSI. Analysen av innehållet resulterade i två kategorier som genomgående kunde återfinnas i alla studerade bloggar. En evig kamp med subkategorierna Att leva med ett beroende, Att sluta skada sig, Att känna sig utanför och Att dömas av vården, Att finna hopp och mening med subkategorierna Att känna stöd från andra och Att ha framtidstro. Personer med NSSI upplever ofta stigmatisering från samhället, vilket skapar lidande. Genom att, som sjuksköterska, möta dessa personer där de befinner sig i sitt lidande kan en trygg och respektfull relation skapas med vårdsökande person. / The recent decades, the number of Non-suicidal Self-injury (NSSI), has increased in Sweden and globally. NSSI has been defined as a conscious self-inflicted physical injury. Research within this field has shown that individuals with NSSI have been stigmatised and has received poor treatment by the healthcare. The purpose with this study is to describe what it is like to live with Non-Suicidal Self-Injury (NSSI) through the study of blogs. Qualitative content analysis of six blogs has been done, and an inductive approach was chosen to capture different perspectives of what it is like living with NSSI. The analysis of the content resulted in two categories that could consistently be found in all the studied blogs. An eternal struggle with the subcategories To live with addiction, To end self-harming, To feel left out, and To be judged by the care system, To find hope and meaning with the subcategories, To feel support from others and To have hope for the future. Individuals with NSSI often experience stigmatisation from the society, which causes further suffering. As a nurse, by meeting these care seekers at where they are in their suffering could help to create a safe and respectful relationship.

Results of a functional analysis indicated that the self-injurious behavior (SIB) of an adult female with profound mental retardation occurred primarily in the alone and demand conditions. Graphs of the separate topographies (head slaps and head bangs) showed that head banging occurred in the alone condition and that both head banging and head slapping occurred in the demand condition. A data analysis procedure to identify within-session trends across sessions and fluctuations in rates of SIB by topography revealed that most of the demands escaped were escaped by head slaps and that over 80% of all head slaps were associated with escape, compared to less than 1%of all head bangs, indicating that head banging and head slapping were members of separate functional response classes. Treatment consisted of noncontingent availability of preferred leisure materials, and produced substantial decreases of both head banging and head slapping. Interpretation of the results are discussed, as well as some implications and limitations of the study.