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Crawford, Michael Joeph. "The psychosocial management of deliberate self harm." Thesis, Imperial College London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313055.
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McAlaney, John, M. Fyfe, and M. Dale. "A specialist adolescent deliberate self harm service." Royal College of Nursing, 2009. http://hdl.handle.net/10454/2820.
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Griffiths, Jade. "Deliberate self-harm in adolescence : parenting and stigma." Thesis, University of Hull, 2011. http://hydra.hull.ac.uk/resources/hull:4922.
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The portfolio has three parts: a systematic literature review, an empirical study and a set of Appendixes. Part one is a systematic literature review in which empirical literature relating to the experiences of parenting a young person that engages in self-harm is reviewed and critically evaluated. It aims to present an understanding of parents' perceptions of self-harm, how it impacts themselves and others and the support available. Part two is an empirical paper which used qualitative methodologies to explore how young people that self-harm perceive stigma, how stigma impacts on them, and how they manage it. To achieve this, young people aged 14-17 attended a semi-structured interview with the main researcher which was analysed using Interpretive Phenomenological Analysis (IPA). The emerging themes are discussed at length and linked to previous research to identify theoretical implications. The clinical implications and methodological limitations are also discussed and areas requiring further research are identified. Part three comprises the Appendices to support the work in the first two parts and a reflective account of the research process.
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Payne, Hannah Austin. "Deliberate self-harm in mental health inpatient settings." Thesis, University of Warwick, 2008. http://wrap.warwick.ac.uk/2992/.
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Deliberate self-harm is a significant phenomenon amongst people in the general community, and is particularly prevalent amongst patients being treated in mental health inpatient settings. Views that staff hold towards patients who self-harm could have an impact upon the care and interventions that are delivered. The focus of this thesis was deliberate self-harm within inpatient mental health settings. The literature review presented in Chapter I provides an overview of previous reviews of studies that have evaluated psychological interventions for deliberate self-harm. All recent relevant evaluative studies of psychological interventions predominantly aimed at reducing deliberate self-harm, or treating self-harm as part of the symptomatology of Borderline Personality Disorder, arnongst inpatient enviromnents are then critically reviewed. The results of this are discussed along with clinical implications for practitioners working in mental health inpatient settings and recommendations for future research. The focus moves to staff attributions towards deliberate self-hann in inpatient settings in Chapter 2. This chapter presents empirical findings, reporting on adaptations of attributional and knowledge measures, and analyses of responses to these measures provided by qualified and unqualified nursing staff participants working in an inpatient setting. Questions regarding training needs were also posed, and participants were given the opportunity to comment on working with people who self-harm. Chapter 3 presents a reflective paper, incorporating references from literature, poetry and music, providing reflections on producing the first two chapters of the thesis, and on the overall experience of completing research for the clinical psychology doctorate course.
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Goodman, David. "The phenomenology and causal attributions of deliberate self-harm." Thesis, University of Birmingham, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422771.
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Wyder, Marianne, University of Western Sydney, College of Social and Health Sciences, and School of Applied Social and Human Sciences. "Understanding deliberate self harm : an enquiry into attempted suicide." THESIS_CSHS_ASH_Wyder_M.xml, 2004. http://handle.uws.edu.au:8081/1959.7/644.
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This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm.Doctor of Philosophy (PhD)
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Wyder, Marianne. "Understanding deliberate self harm an enquiry into attempted suicide /." View thesis, 2004. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20050831.165416/index.html.
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Thesis (Ph.D.) -- University of Western Sydney, 2004."A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy, School of Applied and Human Sciences, University of Western Sydney" Includes bibliography.
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Jones, Kellie. "The impact of assessment on repeat deliberate self-harm." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2011. https://ro.ecu.edu.au/theses/384.
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Deliberate self-harm is a pervasive issue that is the topic of worldwide clinical and research focus. Among the extensive research findings two salient issues emerge that provide the foundation for this study. The first is that a deliberate self-harm attempt is a significant risk factor for future attempts. The second is that a comprehensive assessment of a person presenting with an incident of deliberate self-harm can reduce further deliberate self-harming behaviour. A limitation of existing research is that no study has clearly identified the nature of assessments that impact on the likelihood of future self-harm attempts. The initial aim of this study was to replicate studies that explored the impact of an assessment after a deliberate self-harm episode, using Western Australian data. It was anticipated that the risk of a re-presentation will be reduced by increasing the likelihood that representation would take longer if an assessment was undertaken. It was also anticipated that some types of assessment would be more beneficial than others. A further aim of this study was to determine what the relevant health professionals believed led to this outcome, in particular, if one type of assessment was more beneficial than the others. In order to achieve these aims the research team examined data of patients who presented to the emergency departments of three teaching hospitals in Perth, Western Australia between 1995 and 2004 and had reported a deliberate self-harm attempt. A total of 8656 files were examined, from a total of 13,500 presentations during this period. Cox proportional hazards regression showed that compared to patients who had no assessment, the time between initial presentation and any further presentation for a self harm episode at one of the participating hospitals was significantly longer for those who received an assessment. Those who received either a social work assessment, or both a social work and mental health assessment, were significantly more likely to take longer to re-present. In an attempt to identify the content of the social work assessment that may have impacted on these findings the researcher interviewed six practitioners who undertook these assessments. These interviewees reported the relationship they established with patients; their exploration of the psychosocial context of the patient; and their conviction that the assessment is in itself an intervention, as the distinguishing factors of these assessments. Based on these findings, it is hypothesized that a psychosocial approach may be influential when conducting assessments of deliberate self harm. These assessments may benefit from a focus on developing a relationship with the client, combined with an attempt to resolve identified needs and should this occur during the assessment it may impact on future self harming behaviours.
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Padoa, Carryn. "Deliberate self-harm a search for self or a cry for help? /." Access electronically, 2008. http://ro.uow.edu.au/theses/146.
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Hepworth, Claire Rachel. "Cue reactivity to self-harm cues : the development of a systematic treatment intervention for deliberate self-harm." Thesis, University of Southampton, 2009. https://eprints.soton.ac.uk/71789/.
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There is increasing awareness of the prevalence of deliberate self-harm (DSH) although the phenomenon is still poorly understood. Those who self-harm often have a poor long-term prognosis, yet systematic focused treatment interventions are scarce. DSH appears to share fundamental characteristics with addictive behaviour, including; impulsive or compulsive urges to act in the presence of triggers, positive and negative reinforcing consequences and endorsement of the diagnostic criteria for clinical dependence. Given this fact, a behavioural mode of DSH may be appropriate. A range of events are anecdotally reported to trigger DSH. This thesis was designed to identify these cues, to develop an understanding of how those who self-harm respond to these cues and the processes by which these cues may operate to maintain DSH. An intervention based on the management of urges to self-harm in the presence of these cues was developed. Study I identified that triggers for DSH (interpersonal, intrapersonal and environmental) were similar to those that reliably predict addictive behaviour. Respondents endorsed the diagnostic criteria for dependency and reported that the act of DSH reduced negative emotions. The second two studies identified self-reported cue reactivity, and generalised hyperarousal to both DSH and neutral stimuli in those who self-harm but no evidence of psychophysiological cue reactivity. Study IV used ERP methodology to evaluate cue reactivity at the CNS level and to evaluate two mechanisms by which cues might operate to maintain DSH. There was some preliminary support for enhanced preconscious attentional bias towards emotional, but not environmental DSH cues, and no support for emotional interference. Study V identified that those who self-harm exhibited enhanced tolerance to physical and psychological stressors, and that priming with interpersonal distress did not impact on this tolerance. Finally, a single case intervention study identified a reduction in DSH, reduced psychophysiological arousal and urges to self-harm and improved clinical symptomatology. However, clinical improvements were not time-locked to targeted exposure intervention phases. The clinical and theoretical implications for these findings are discussed.
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Kinyanda, Eugene. "Deliberate self-harm in urban Uganda – a case-control study." Doctoral thesis, Norwegian University of Science and Technology, Department of Psychology, 2006. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-978.
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Background: Deliberate self-harm (DSH) is both a personal problem and a public health problem not only in the West but also in sub-Saharan Africa including Uganda. Generally however, there is an absence of suicide interventions on the continent and linked to this problem an absence of recent studies on suicidal behaviour from Africa. To partly address these shortcomings, this present project examined the demographic, social and psychological characteristics of deliberate self-harm in the urban environment of Uganda.
Methods of the study: One hundred cases of deliberate self-harm attending three general hospitals in the Ugandan capital of Kampala were compared with 300 non-DSH in-patient controls from the participating hospitals. Both the cases and controls were interviewed using a Luganda translated version of the modified European Parasuicide Interview Schedule I (EPSIS I; Kerkhof et al. 1989). Two study samples were constituted where sample 1 were the cases and sample 2 the controls. For purposes of DSH repetition part of the study, sample 1 was split into the ‘suicide repeaters’ and the ‘non-repeaters’. Data on; socio-demographics, methods of DSH, precipitating factors of present act of DSH, life events, psychological factors and DSH repetition was collected.
Analysis: The statistical package SPSS 8.0 was used both at data entry and analysis. Analysis involved the generation of frequencies, means and mean rank scores and cross-tabulations using Pearson’s Chi-square test, Fischer’s Exact test and the independent t-test. Multivariate analysis using logistical regression was used to determine the independent effect of various variables in suitably specified models. The level of significance was set at 0.05.
Results: Results revealed that DSH in urban Uganda in a hospital based population was predominantly a problem for male (63%), adolescents and young adults (50%). The predominant method of DSH used was by organophosphate poisoning (45%). The main psychiatric diagnoses associated with DSH in this population were; adjustment disorder (35%), acute stress reaction (18%) and depression (23%).
Disturbed interpersonal relationships (with a partner/lover, parent(s) or children) were a precipitant in 65% of the DSH cases. The number of negative life events in; Childhood (categories of parents, significant others, and personal), Later in life (category of partner), and Last year (category personal and the total number of life events) were significantly associated with DSH in this study. The psychological factors found to be associated with DSH were; global psychological distress, hopelessness and state anger but not depression, trait anger nor alcohol abuse. Suicidal intent was found to be independently correlated with both depression and hopelessness.
Twenty five percent of the DSH cases in this study were repeaters with the socio-demographic factors associated with repetition of DSH including; being single, having children and staying alone or with parents. Other factors found to be associated with DSH repetition were; the number of negative life events in childhood and in the last year, global psychological distress and trait anger but not depression, hopelessness nor state anger.
Conclusion: The picture of DSH in urban Uganda is similar to a great extent to that observed elsewhere on the African continent and in the West. There are however important differences particularly with the picture of DSH as seen in the West.
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Weinberg, Mark Robert. "The experience of deliberate self harm : a grounded theory study." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/31723.
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This study utilized grounded theory methodology to examine the experience of transition towards, living with, and recovery from, deliberate self-harm from the perspective of people who had lived with these behaviours. The study aimed to transcend the tendency to focus on professional and clinical perspectives and to build a theory based on the direct experiences of people who have lived with deliberate self-harm. The grounded theory methodology (Strauss & Corbin, 1998) was utilized and consisted of in-depth interviews with 13 people who had recovered from deliberate self-harm as well as a registered psychologist who worked with people living with deliberate self-harm and a tattoo artist who practiced skin cutting as an art form. Interviews were coded and analyzed and a theoretical model was developed describing a process whereby: (a) exclusive and/or intrusive experiences play a central role in precipitating the discovery of deliberate selfharm, (b) a sense of loss of control results from these exclusive/intrusive experiences, (c) self-harming behaviours occur in an attempt to manage the sense of loss of control, and (d) continued exclusionary/intrusive experiences act to maintain self-harming behaviours. Recovery occurs in the context of an environmental shift, leading to the experience of Inclusion, which facilitates a sense of control. The findings of this study contribute to the field of counselling psychology by providing a model focused on client experience, and by building on a body of knowledge concerning a population that counsellors are encountering in increasing numbers (Zila & Kisela, 2001).Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate
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Hewitt, Christopher J. "Depression, emotion and frustration tolerance in adolescent deliberate self-harm." Thesis, University of Edinburgh, 2001. http://hdl.handle.net/1842/26603.
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Adolescent deliberate self-harm (DSH) constitutes an important and growing problem for health and welfare services (Harrington & Dyer, 1993). Rates of DSH in 15-24 year olds in the UK between 1989-1992 were among the highest in Europe (WHO/EURO Multicentre Study on Parasuicide). As well as being at a high risk of making a successful suicide attempt, around 15-20% of those admitted to a general hospital following self-harm repeat DSH within a year of the event and approximately 50% have a history of previous DSH (Kreitman & Foster, 1991). Various psychological factors have been reported to be significant in the assessment of the seriousness and/or repetition of DSH. These have included depression, hopelessness, impulsiveness, premeditation, impulsivity, problem duration, problem solving and anger. Hawton et al (1999) found that adolescents with a history of previous overdoses differed from non-repeaters on a number of these factors, although these differences largely disappeared when the level of depression was controlled for. Dialectical Behaviour Therapy (DBT) has been used extensively in the treatment of self-harming behaviours. The theory holds that due to a complex interaction of environmental, physiological and familial factors, individuals who engage in DSH may have failed to learn how to tolerate or identify emotional states or feelings of frustration and distress. This theory, however, has not been empirically validated. This study, therefore, aims to investigate the role of emotions and the ability to tolerate feelings of distress and frustration amongst adolescents who have selfharmed. The project also aims to investigate whether these factors may be potential moderators in the repetition of DSH, after the level of depression has been controlled for. This study recruited 45 patients aged between 16-21 years of age who had been admitted to hospital following a deliberate drug overdose. They completed questionnaires measuring depression, their experience of various emotions and distress/frustration tolerance. An age matched, non-self-harming general clinical comparison group was recruited and assessed using the same measures. Interrelationships amongst these factors were examined both between the DSH and non-DSH group, and between first episode DSH and repeat DSH. Results of these comparisons shall be given and discussed with reference to clinical implications.
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Sinclair, Julia M. A. "Deliberate self-harm : outcome, health service use and parents' narratives." Thesis, University of Oxford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436953.
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Bryant, Tessa Louise. "Deliberate self-harm as an addictive behaviour : a systematic analysis." Thesis, University of Southampton, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433880.
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Warm, Anna. "Attachment, emotional regulation and self-harm : the role of attachment experiences and emotional regulation in deliberate self-harm." Thesis, Lancaster University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.485254.
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Shobbrook, Luke. "Context and complexity : counselling psychology, deliberate self-harm and substance misuse." Thesis, City University London, 2008. http://openaccess.city.ac.uk/8610/.
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This study aimed to explore the lived experience of the hidden population of young adult males in managing their deliberate self-hann. Semi-structured inten"iews were conducted either face-to-face (n=5) or online (/1=3) with male participants aged between 18 and 26 years old recruited from self-harm message boards online and a newspaper advertisement. Transcripts of the interviews were subjected to an interpretative phenomenological analysis which revealed four superordinate themes reflecting a journey from negative self-evaluation to self-acceptance: the invalidated self, the struggle for control, validation of the selfby others and learning to live with a new self Participants' experiences reflected the use of deliberate self-harm as a means of emotional regulation, however the management of deliberate self-harm appeared problematic from the outset. Despite the behaviour's subjective benefits it also served to increase participants' emotional distress and increase the likelihood of further self-harm. While gender was not an explicit concern participants nevertheless appeared to make an effort to maintain an illusion of self-control to confonn to a male stereotype. Their struggle to manage their own behaviour met with limited success however and it was not until they were able to seek help and support from others that most were able to manage it more effectively. Despite the hidden nature of the behaviour empathic and validating relationships of support and especially reciprocal relationships were a core feature of all accounts. Even after abstinence from the behaviour was achievedparticipants appeared reluctant to abandon the behaviour altogether and keen to maintain self-harm as a last resort if necessary. Participants' experiences appear to reflect the tension between professional priorities and the needs of those who self-harm for autonomy and responsibility for their own behaviour. The study provides a unique insight into the lived experience of young men in managing self-harming behaviour that may help inform counselling psychologists who encounter male self-harm in their practice.
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Steere, Caroline J. "Nurses' management of deliberate self-harm in an acute residential setting." Thesis, University of Hull, 2001. http://hydra.hull.ac.uk/resources/hull:11283.
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The study aimed to address the question of what represents the most therapeutic response when a client self-harms on an acute inpatient mental health unit. The null hypothesis was that nurse response type would have no bearing on how long it was before a client went on to self-harm again. Pilot studies and qualitative analysis led to the development of questionnaires which sought to measure nurse-client interactions across four dimensions: 1) The content of what the nurse said to the client; 2) The length of time the nurse spent with the client; 3) The emotional tone of the response; and 4) The strength of emotion expressed by the nurse. The participants were 19 inpatients and 29 nurses who described incidents of self-harm. Nurses and clients completed questionnaires describing the nurse's response type the first time that a client self-harmed during a new admission. Most of the statistical analyses supported the null hypothesis that nurse response type has no bearing on how long it is before a client engages in self-harm again. There was no evidence that the content, duration or emotional tone of a nurse's response had any bearing on how long it was before the client self-harmed again. The only statistically significant finding was that nurses perceiving themselves to be more strongly emotional was correlated with a longer delay before self-harm was repeated. A finding not directly related to the hypotheses was that nurses and clients perceived behaviour differently. There was poor agreement in terms of their perceptions of the number of minutes that an interaction lasted, how strongly emotional the nurse was, and the severity of the clients' self-harm. The implications of these findings are discussed, together with suggestions for future research.
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Cameron, Dianne Jennifer. "Living with the urge : a study exploring the experiences of people who self-injure." Thesis, University of Stirling, 2004. http://hdl.handle.net/1893/2601.
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Increasing rates of self-injury in the United Kingdom coupled with the apparent lack of understanding, highlights a need for research to be conducted in this area. A dearth of research illuminating the experiences of self-cutting, together with increased awareness of the differences in perspective between people who self injure and professionals, also provides a rationale for this study. This study aims to explore the experiences of people who self-injure in order to identify and understand the processes involved in self-cutting, and develop a theory which aids this understanding. A grounded theory approach is used to meet the aim of the study, generating data through in-depth interviews with 10 people who engage in self-cutting. Participants shared their experiences of self-injury emphasising both the meaning and function of cutting for them, and the struggle they face living with the behaviour. Although the experiences of participants were unique to each individual, clear commonalities in experience emerged during data analysis and were explored with subsequent participants,in keeping with the grounded theory method. As data generation and analysis developed, the aim of the study became more focused, resulting in an exploration of the urge to self-injure and how people who engage in self-cutting respond to this urge. Findings relate to the core category, living with the urge and main categories of experience namely underlying urge, triggering the urge, satisfying the urge and resisting the urge. Discussion of the findings offers a substantive theory, asserting that people who self-injure face a paradox of finding it very difficult to live with self-cutting, while simultaneously facing the challenge of living without the behaviour. This paradox can be understood within the context of the core category, living with the urge, a process which begins before the participants start self injuring, continues while they are cutting, through to when they are trying to live without cutting. The discussion contributes knowledge relating to commonalties between self-cutting and the experience of addiction; issues for prevention; repetitive nature of cutting; the relationship between people who cut and their cutting tools; and ultimately highlights how difficult it is for the participants to break-free from the world of cutting. Implications of the findings for health and social care practitioners, and education and training are discussed, and recommendations for research are made.
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Mendiola, Casey Alexandra. "He koha aroha ki te whanau: deliberate self harm and Maori whanau." Thesis, University of Auckland, 2011. http://hdl.handle.net/2292/13627.
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Deliberate self-harm (DSH) is a significant social problem facing young Māori (the indigenous people of New Zealand) today. Whānau, a concept meaning family and including extended family, is an essential factor in the well-being of Māori. Little is known about family members‟ reactions to a child‟s DSH or their needs following DSH, especially with Māori. Some research with non-Māori suggests that both the impact of DSH and consequent needs of family members may be considerable, yet often neglected. This study examined the impact of their children‟s DSH on Māori whānau, beliefs about the motives for the young person‟s DSH, and needs following the event. The whānau of ten young people, aged 10-18 years, presenting to a Child and Adolescent Mental Health Service following DSH were interviewed about the impact of the DSH, perceived motives for DSH and their needs. Five Māori clinicians were also interviewed about these topics. Interviews were recorded, transcribed, and subsequently analyzed using thematic analysis. Seven themes were identified from whānau ideas regarding motives for DSH: to communicate distress and seek help, to punish someone, to get relief from a distressing emotional state, due to the influence of others, as a response to feeling overwhelmed by difficult circumstances, to die, and the cultural influence of matakite. Clinicians presented similar motives; however, they did not mention matakite and included DSH being precipitated by social isolation. When discussing impacts of DSH, whānau reported that DSH had affected the entire whānau as well as having an effect on parents; including an emotional impact, an impact on parenting, and the concept of mental health was described as being difficult for parents to come to terms with. On the other hand, participants reported improvement in relationships within their whānau following DSH. Whānau also reported that DSH had resulted in practical difficulties. Themes derived from clinicians were similar; however, they did not discuss the effect of DSH on relationships. Whānau and clinicians both reported the need for greater levels of support and information. Implications are presented for the delivery of mental health services for young Māori and their families.
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McIntee, Gill Mary Sophie. "Dissociative symptoms in a deliberate self-harm and comparison female adolescent sample." Thesis, Bangor University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367311.
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Basson, Dominic Robin. "An investigation into the role of worry and rumination in deliberate self harm." Thesis, Lancaster University, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.497225.
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Surveys estimate that between 4.6% and 13% of the population in the UK engaged in self harm (Meltzer et al, 2002; Hawton et al., 2002). Studies have generally indicated that anxiety, depression and childhood traumas are predictive of deliberate self harm (DSH). Furthermore, studies generally support the view that the functions of impulsive forms of DSH are related to avoiding or escaping aversive motions. Based on such findings, the experiential avoidance model (Chapman et al. 2006) suggests that DSH is used as a way to disrupt unwanted thoughts, feelings or memories. This study investigated the effect of processes of worry and rumination in elation to DSH.
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Bandalli, Peter K. "A phenomenological analysis of the expressive and communicative functions of deliberate self-harm." Thesis, University of Bath, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.548105.
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The notion that acts of deliberate self-harm serve an expressive or communicative function is the central premise upon which many of the main functional models of selfharm are based. However despite the importance of this notion, very little empirical evidence exists to support it. Within this project the notion that acts of DSH serve an expressive or communicative function was explored in detail. Four studies investigating the expressive and communicative qualities of acts of DSH, the content which such behaviours serve to express, and the dynamics by which several different modalities of DSH do this were performed utilising Internet methods of data collection. The use of online methods of data collection findings of this project only apply to the sub-group of individuals who engage in DSH and also participate in online discussion forums. Photographs of words and phrases engraved into the skin along with detailed first person narratives of past episodes of deliberate self-harm were used as data sources in this project. Due to their high frequency of occurrence, acts of skin-cutting, self-burning, self-hitting, and self-poisoning were the main modalities of deliberate self-harm investigated in the four studies. Acts of skin-cutting, self-burning, self-hitting, and self-poisoning were all reported to serve expressive functions which allowed emotions and issues to be released or discharged from the body. Conversely, acts of skin-cutting and self-poisoning were also reportedly used to communicate emotional distress and a need for support from others. The content expressed or communicated by such behaviours, and indeed the dynamics by which they did so depended largely upon the modality by which injuries were inflicted. However in general the content expressed and communicated by the acts of deliberate self-harm reported in this project typically related to the events which preceded such behaviours, how they were interpreted, the types of psychological experiences they represented, and the emotions which they evoked. Such events were overwhelmingly interpersonal in nature, and typically involved the dissolution or disruption of relationships with primary support group members. The dynamics by which acts of deliberate self-harm reportedly served these functions differed widely, however the concept of symbolism was central to all modalities. The data collected within this project relating to the expressive and communicative functions of acts of skin-cutting, self-burning, self-hitting, and selfpoisoning was finally collated with the existing literature on the subject.
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Volodko, Liubov. "Paauglių save žalojančio elgesio vidiniai veiksniai." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20140626_194133-85829.
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Tyrėjai vis dažniau skiria dvi save žalojančių paauglių grupes: mėginančius nusižudyti ir nesuicidiškai save žalojančius, kurie nesiekia mirties. Tačiau iki šiol buvo atlikta mažai populiacinių tyrimų, mėginančių šias dvi grupes tiesiogiai palyginti, todėl informacija apie šių grupių psichologinių ypatumų ir save žalojančio elgesio vidinių veiksnių skirtumus yra gana prieštaringa. Tyrime buvo naudojamas „Gyvenimo būdo ir prisitaikymo klausimynas“ (orig. Lifestyle and Coping Skills Questionnaire), kurį Lietuvoje adaptavo ir paauglių save žalojančio elgesio tyrimui pritaikė A. Laskytė ir N. Žemaitienė. Dalis jų surinktų duomenų analizuojama šiame darbe. Tikslas: ištirti bendros populiacijos paauglių suicidinio ir nesuicidinio save žalojančio elgesio vidinius veiksnius: motyvus, savižudiškus ketinimus, žalojančio elgesio ypatumus ir su šiais faktoriais galimai susijusius asmens psichologinius ypatumus. Taip pat atskleisti būdingus šių veiksnių skirtumus merginoms ir vaikinams. Tiriamieji: 15-17 metų amžiaus Lietuvos moksleiviai, kurie pildydami „Gyvenimo būdo ir prisitaikymo klausimyną“, atsakė, kad bent kartą gyvenime sąmoningai save žalojo. Klausimyno pildymo metu paaiškindami save žalojančio elgesio priežastis, prie teiginio „Aš norėjau numirti“ paaugliai galėjo atsakyti „Taip“ arba „Ne“. Pagal šį atsakymą jie buvo suskirstyti į dvi grupes: suicidiškai save žalojančių – norėjusiųjų numirti (n=163), ir nesuicidiškai save žalojančių – nenorėjusiųjų numirti (n=118). Rezultatai:... [toliau žr. visą tekstą]Researches often differentiate two groups of self-harming adolescents: those who attempters a suicide, and those who are harming themselves in a non-suicidal way, and they don‘t seek the death. However just a few community-based research, which would directly compare these groups, were done so far, and therefore information about the differences of the psychological peculiarity and self-harming behavior‘s internal factors between the groups is ambivalent. Lifestyle and Coping Skills Questionnaire (Hawton, 2006), adapted and adjusted for the research of adolescents self-harming behavior by A. Laskytė and N. Žemaitienė in 2006, was used in this work. A part of their collected data is also used in this work. The aim: to examine the intrapersonal factors of suicidal and non-suicidal self-harm in a community sample population: the motives, suicidal intentions, the peculiarities of harming self-harm and person‘s psychological traits that could be possibly related to those factors. It also aimed to reveal the typical differences of these factors between the genders. The sample: 15-17 year old Lithuanian pupils who, while answering into Lifestyle and Coping Skills Questionnaire, responded that they were harming themselves at least once in a life time. In the questionnaire while explaining the reasons of self-harming behavior, into the proposition “I wanted to die” they could write “Yes” or “No”- in this way they were separated into two groups: suicidal self-harmers – who wanted to... [to full text]
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Marshall, David. "Understanding the processes in assessing risk of deliberate self harm in systemic family therapy." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/16955/.
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Introduction: The subject of self-harm in the adolescent population is a source for public concern likely grounded in the suicide rates for this age group and the perception that the risk of suicide is increased for individuals who regularly harm themselves. This leaves clinicians working with those who self-harm with the task of assessing the risk of those who access services. The literature base for risk assessment of suicide/self-harm is populated with studies which focus on the ‘whats’ of risk assessment, for example: what a clinician needs to cover to ensure safety or what service users think of their assessment. I argue the need to build on this knowledge base, and understand the ‘hows’ of risk assessment, e.g. how does a therapist complete an assessment and how does a therapist ensure engagement. The current study takes place within the context of a Systemic Family Therapy study and explores how a therapist completes their assessment with a family. Method: Grounded Theory was employed in order to analyse videotapes of Systemic Family Therapy sessions. A single case of a female adolescent was selected based on characteristics of her therapy. The key research questions address the processes the therapist employs to move between therapeutic and assessment tasks; how the therapist’s approach changes in the face of changing risk; and how the therapist maintains engagement throughout the therapy. Results: Themes emerging from the data revealed that the therapist employs a number of subtle processes in order to switch interchangeably between assessment and therapy tasks and that these foci are not mutually exclusive. These process occur within the context of a balanced, conversational relationship in which therapist and family has an equal footing. When the perceived level of risk changes, the therapist’s approach still fits within this framework, with a key difference being a more direct establishment of therapist goals. Engagement is maintained by the therapist’s negotiation of balance, collaboration and mutuality within the therapeutic relationship. Furthermore, the therapist moderates emotion in the room in a way that avoids re-traumatisation, and in a way that encourages the family and young person to continue to contribute to the discussions in safety. Discussion: The findings of the current study provides a preliminary model of risk assessment for this particular therapy which facilitates thinking about risk assessment in a wider sphere. The findings of the current study are then considered as part of a growing body of literature, with further recommendations made for future research.
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Fung, Shuk-ching Corina. "A case-control study of attachment style in deliberate self-harm patients : a systemic perspective." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3703053X.
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Fung, Shuk-ching Corina, and 馮淑貞. "A case-control study of attachment style in deliberate self-harm patients: a systemic perspective." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B3703053X.
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Smith, Rachael M. "The relationship between attachment style, perceived quality of life, and deliberate self harm in adolescence." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/25206.
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One in every seven adolescents may engage in deliberate self harm (DSH). Despite the significant prevalence of DSH in this population, research into the risk factors associated with DSH in adolescence is still at an early stage. Knowledge about the antecedents of adolescent DSH is vital for preventative purposes and to inform clinical assessment and management. Attachment theory has provided a valuable framework for understanding risk and protective factors in the development of psychopathology. The concept of quality of life (QOL) also provides an encompassing theoretical framework in which to embed explanatory models of psychopathology. The aim of this exploratory study was to investigate whether the theoretical frameworks of attachment and QOL are useful for understanding DSH in adolescence, by exploring the relationship between DSH, attachment style and perceived QOL in this population. A cross sectional between-groups design was adopted. Group A consisted of twenty adolescents currently attending a mental health clinic who had engaged in DSH in the last year. Group B (control group) consisted of eighteen adolescents currently attending a mental health clinic with no past or current history of DSH. Both groups completed measures assessing DSH, attachment style, perceived QOL and presence of depressive symptoms. DSH was found to be independently associated with an insecure attachment style and a lower perceived QOL. DSH was also associated with a higher level of depression. Perceived QOL was a significant predictor of risk of engaging in DSH, controlling for age, gender and attachment style. The results of this exploratory study provide preliminary evidence that an insecure attachment style appears to increase the risk of engaging in DSH in adolescence. This risk appears to be mediated by a young person’s perceived QOL and level of depressive symptoms; with adolescents with a lower perceived QOL and higher depressive symptoms being at greater risk of DSH.
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Chan, Carmen K. "Deliberate self-harm in adolescents : a way of coping with difficult interpersonal and intrapersonal relationships." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510416.
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Hargus, Emily Ann. "Toxic thoughts : Vulnerability factors and cognitive processes of thoughts or acts of deliberate self harm." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531819.
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Pooley, Edward Charles. "Genetic association studies of serotonergic gene polymorphisms with obsessive-compulsive disorder, deliberate self-harm and obesity." Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.670094.
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Pieterse, Deirdre. "Factors associated with deliberate self-harm method among patients in a tertiary hospital in South Africa." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29695.
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Background: Hospital-based research provides important insight into the burden of suicide behaviour and methods used in deliberate self-harm (DSH). The information on methods used in DSH may be useful to plan suicide-related intervention and prevention programmes. We aimed to investigate the socio-demographic and clinical factors associated with the methods used in DSH at a tertiary hospital in Cape Town, South Africa. Methods: Socio-demographic, clinical and treatment data were collected from 238 consecutive DSH patients who presented for emergency department treatment at the hospital. Univariate analyses and a logistic regression model were used to explore the associations between these variables and violent and non-violent method of DSH. Results: Self-poisoning was the most common method of self-harm (80.3%, n=191). Prescription medication was the most common form of self-poison (57.6%, n=137) while a large number of patients used the non-prescription medication paracetamol (40.9%, n=54). In the bivariate regression analysis, male gender, stating that the reason for DSH was to escape a situation and history of substance use were associated with violent method of DSH. Conclusion: This study contributes to emerging literature on methods used in DSH in South Africa. There is an urgent need to improve monitoring of prescription medication commonly used in DSH. More research on the source of prescription medication and its relationship to DSH is needed. Limiting the quantity and reviewing the packaging of paracetamol available in supermarkets may be effective strategies of means restriction that could be adopted in South Africa. This study underscores the need for increased collaboration between the Department of Social Development and the Department of Health in providing substance use interventions to high-risk population groups.
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Saldias, Amber. "Deliberate self-harm in a clinical sample : the impact of schema modes, parental bonding and perceived stress." Thesis, University of Edinburgh, 2012. http://hdl.handle.net/1842/7802.
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Introduction: Deliberate self-harm is being increasingly recognised as a behaviour with significant clinical importance. Yet, there remains uncertainty regarding which forms of psychological therapy are most effective for its treatment. Schema Therapy is an integrative psychotherapy blending elements of cognitive behaviour therapy, object relations and gestalt therapy into a unified approach for the treatment of individuals with complex and chronic psychological conditions. The current thesis aimed to provide a better understanding of the Schema Therapy model and its association with deliberate self-harm. Systematic Review: Despite the increasing evidence base for the efficacy of Schema Therapy, less is known about the evidence for its theoretical underpinnings. To address this gap in the literature a systematic review was undertaken to explore the following question: How empirically supported is the theoretical underpinning of Schema Therapy? In a systematic search of the literature conducted until 01 June 2012, studies based on cross-sectional, longitudinal, intervention, meditational and experimental designs were considered. These studies underwent detailed quality analysis culminating in 19 articles being included in the current review. Overall these studies indicate that many of the key theoretical assumptions in Schema Therapy are supported by the literature. Empirical Study: Schema Therapy has recently been expanded to include the ‘schema mode’ concept, with a number of researchers highlighting an association between particular schema modes and a number of chronic psychological conditions. Although the schema mode model allows a method for understanding moment-to-moment emotional states it has not previously been explored in relation to deliberate self-harm. The current project aimed to explore the relationship between these variables and their association with early experiences of parental bonding and current levels of perceived stress. 70 psychiatric outpatients with a history of deliberate self-harm completed a number of measures including the Deliberate Self-Harm Inventory, Schema Mode Inventory, Parental Bonding Instrument and Perceived Stress Scale. Results revealed significant associations between deliberate self-harm, maladaptive schema modes, perceived stress and patterns of parental care. Maladaptive schema modes significantly mediated the relationship between parental care and deliberate self-harm. The Punitive Parent and Angry Child modes were significant mediators in this relationship. Conclusion: Results from the systematic review support the notion that Schema Therapy has a good theoretical underpinning. The empirical study also supports Schema Therapy by highlighting the meditational role of maladaptive schema modes in the relationship between low parental care in childhood and deliberate self-harm in adulthood. These findings provide further support for the Schema Therapy model and suggest that individuals with deliberate self-harm may benefit from this treatment.
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Shaverin, Lisa. "Written in scars : stories of recovery from self harm." Thesis, University of Hertfordshire, 2013. http://hdl.handle.net/2299/10309.
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This study sought to hear the narratives of individuals that have recovered from self-harming, with the intention of bearing witness to both the narratives and remaining scars in order to better understand and inform clinical practice. A purposive sample of seven individuals was recruited. Participants were asked to photograph their scars and bring them to an interview. Narratives were generated and explored through a relatively unstructured individual interview. Both the images and narratives were analysed using a narrative approach exploring content, performance and structural aspects, emphasising researcher reflexivity throughout. Findings were understood through psychoanalytic theory and highlighted a theme of validation and ‘being seen’, evidenced in stories of past invalidation that had been internalised into the self-structure and defended against by presenting a ‘defended’ self. Self-harm enabled this ‘unseen self’ to be expressed, validated and contained. Recovery was storied in terms of internalising experiences of validation, which enabled integration of the invalidated parts of the self. Many of the participants highlighted how their scars told a story of discovery; of becoming, coping and surviving. In the healing of scars this recovery is evident, but they may also continue to convey the unseen and unspoken experiences of pain, incoherence and invalidation. Self-harm and remaining scars may be understood as connecting, containing and re-embodying the internalised invalidation and ‘unseen’ aspects of the self. These findings are discussed with reference to the clinical implications, strengths and limitations of the methodology and directions for future research.
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Dennis, Michael S. "Suicide and deliberate self-harm in the elderly : an examination of risk factors with implications for prevention." Thesis, University of Leicester, 2002. http://hdl.handle.net/2381/29404.
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Methods. Descriptive and case-control studies were conducted. Data were collected on three groups: Successful Suicides - The Leicestershire Mortality list was examined for possible suicides and their psychiatric and general hospital notes scrutinised. 85 deaths were categorised as definite or probable suicide; DSH Group - 76 older adults who had deliberately harmed themselves were interviewed. Information obtained included Beck Suicide Intent score, and Hopelessness Scale. A psychiatric interview determined an ICD 10-diagnosis (70), social contacts and networks. The LEDS-2 interview identified recent life events and chronic difficulties; Depressed control Group - 50 depressed older adults referred to mental health services who had never self-harmed were interviewed in a similar manner. Results. 11(13%) of elderly suicides occurred within one month of contact with psychiatric services, and 11 within one month of discharge from a general hospital ward. The majority of elderly who self-harmed had high suicide intent, 70% were depressed, and 29% had seen their G.P. within one week of the episode. DSH subjects frequently were living alone with an isolated life style and poor physical health. Compared to depressed controls, DSH subjects were significantly more likely to have a poorly integrated social network, were less likely to receive visits from health/social/voluntary services, and were more hopeless. The proportions of DSH subjects and depressed controls experiencing a severe life event were similar. Conclusions. In 'high risk' patients known to services, careful planning of care and continual risk assessment may help to reduce suicides. After-care, including re-socialisation and addressing chronic physical health difficulties may also reduce risk. Improved mental health liaison services to general hospitals are required, as well as more assertive strategies to identify isolated and depressed older adults in the community.
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Chan, Tsz-King, and 陳梓敬. "The suicide behavior and deliberate self harm pattern of psychotic patients over 10 years in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206595.
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Background
Early interventions (EI) for psychosis are predicted to have an effect in reducing suicidal attempts and self harms for first episode psychosis (FEP) patients. However there is little evidence to reveal that early intervention has a long term effect in reducing suicidal behaviors. Also, the longitudinal patterns of suicidal behavior of patients under EI and standard care (SC) programme were remained unclear. Therefore, this study was performed to explore the longitudinal pattern of suicidal behaviors for EI and SC patients. The long term effect of EI in reducing suicidal attempts and self harms and possible predictors for suicide were also explored and analysed.
Method
A secondary analysis was performed with data retrieved from medical data in different hospitals. The data are matched up for SC patients and EI patients based on their demographic information. Data related to suicidal behaviors are collected. Longitudinal patterns of suicidal behaviors were analysis with generalized linear model (GENLIN) and descriptive analysis. Univariate regression was also performed to investigate predictors for suicide.
Results
EI has a significant effect in reducing the total number of suicidal attempts (X^2=5.779, p=0.016) and deliberate self harm (X2=7.817, 0.005) over 10 years but no effect on suicidal attempts in the first three year when effect was expected. However, data indicated EI has an effect of reducing the number of complete suicide. Patients do not receive EI is a significant predictor for increase in the suicidal attempts and younger age is a predictor for latter deliberate self harm behaviors.
Conclusion
The result demonstrated that EI has a long term effect in reducing suicidal behavior rather only short term and non-lasting effect as suggested by other researches. However, EI treatment might have a short term negative effect on suicidal ideations as suggested by the increase of suicidal attempts in the second and third years.
EI services do not only improve in symptoms and quality of life but a long term effects in reducing the number suicidal behaviors. Although, there is a possible negative effect on suicidal attempts, it might be beneficial if EI programme can be apply to all psychotic patients.published_or_final_version
Psychological Medicine
Master
Master of Psychological Medicine
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McMullan, Julie Clare. "Deliberate self-harm websites and social media platforms : an exploration of views from users and the voluntary sector." Thesis, Ulster University, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.720882.
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Aim: As a major public health issue deliberate self-harm (DSH) is more common than suicide. Set in such a context the aim of this study was to explore the use of related DSH websites and social media platforms, seeking to gain insight into the perceptions and experiences of those who use such online platforms as well as UK agencies working with those engaged in this behaviour. Theoretical Perspective: The model chosen for this study was Nock and Prinstein’s (2004) ‘The Four Factor Model ofNon-Suicidal Self-Injury’. Method: The study was conducted in three stages. Stage 1: Walker and Avant’s (2005) concept analysis approach was used as a framework to explore the meaning of the concept ‘DSH’. Stage 2: Ten semi-structured interviews were conducted with individuals in mental health voluntary agencies across the UK working with those who DSH. Stage 3: Fifteen interviews were completed with users of DSH websites and social media via face to face, telephone and desktop videoconferencing (typed chat). Findings: The concept analysis resulted in a new definition and understanding of DSH. Stage 2 and 3 interviews identified a significant difference between the knowledge of behaviour websites and social media of those working in voluntary agencies and that of the actual user’s. In addition participants acknowledged the inadequate support available to those over the age of forty. Conclusions: The study has provided an understanding of the motivation individuals have for accessing DSH websites and social media platforms. It has described how such sites support users in a manner which for them is not easily or readily found in the real world. The conclusions recommend improved training for health professional staff, for features to be included on DSH websites/social media appropriate for those aged 40 years plus and for the users themselves to be involved in the development of such sites.
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Armey, Michael F. "The influence of traumatic life events, affect, cognitions, emotion regulation processes, and coping on the occurrence of self-injurious behavior: An episodic experiential model." Kent State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=kent1248102470.
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Grobler, Kathryn. "Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33703.
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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.
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Marchant, S. "An exploration of how secondary school staff take up a role in managing pupils who engage in deliberate self-harm." Thesis, University of Essex, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542359.
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Laskytė, Agnė. "Social and psychological characteristics of 15-17 year old Lithuanian pupils who deliberately cause self-harm." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2009. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2009~D_20090518_152241-70608.
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For over a decade, suicides of young people have been a very important public health concern. The number of suicides among the school-aged children varies from 20 to 33 per annum, whereas suicide as the cause of death is number three on the list of causes. Research carried out in various countries provide clear evidence that one of the most threatening signs of the possible suicidal behaviour is self-harm or attempted suicide at an early age. Therefore, in-depth knowledge of the risk factors for deliberate self-harm is very important not only for scientific reasons, but for the prevention of suicides of young people. The aim of dissertation is to research social and psychological peculiarities of deliberate self-harm of 15-17 year old Lithuanian pupils. In order to achieve the aim, the following objectives were set: 1. To assess distribution of pupils’ deliberate self-harm, types of self-harm, and socio-demographic irregularities. 2. To disclose subjective reasons for deliberate self-harm of pupils. 3. To analyse the relationship between stressful life experience and pupils’ deliberate self-harm. 4. To identify the importance of smoking, alcohol, and drug abuse to deliberate self-harm. 5. To investigate the relationship between the pupils’ deliberate self-harm and subjective indices of psychic health and general condition. 6. To assess the need for help to pupils who deliberately harm themselves.Jaunų žmonių savižudybės jau daugiau kaip dešimtmetį išlieka labai svarbia visuomenės sveikatos problema. Mokyklinio amžiaus vaikų savižudybių skaičius per metus svyruoja nuo 20 iki 33, o savižudybė pagal dažnį yra trečioje vietoje mirties priežasčių sąraše. Įvairiose šalyse atlikti tyrimai pateikia neabejotinų įrodymų, jog vienas grėsmingiausių galimo savižudiško elgesio rizikos ženklų yra sąmoningas savęs žalojimas ar bandymai žudytis jauname amžiuje. Todėl gilesnis sąmoningo savęs žalojimo rizikos veiksnių pažinimas yra labai svarbus ne tik mokslo, bet jaunų žmonių savižudybių prevencijos požiūriu. Disertacinio darbo tikslas — ištirti sąmoningai save žalojančių 15–17 metų Lietuvos moksleivių socialinius bei psichologinius ypatumus. Tikslui pasiekti iškelti šie uždaviniai: 1. Įvertinti moksleivių sąmoningo savęs žalojimo paplitimą, būdus bei jų sociodemografinius netolygumus. 2. Atskleisti subjektyvias moksleivių sąmoningo savęs žalojimo priežastis. 3. Išanalizuoti ryšius tarp stresą sukeliančios gyvenimo patirties ir moksleivių sąmoningo savęs žalojimo. 4. Nustatyti rūkymo, alkoholio bei narkotikų vartojimo reikšmę moksleivių sąmoningam savęs žalojimui. 5. Išnagrinėti moksleivių sąmoningo savęs žalojimo, subjektyvių psichikos sveikatos bei savijautos rodiklių sąsajas. 6. Įvertinti save žalojančių moksleivių pagalbos poreikius.
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Ahlström, Madeleine, and Hanna Puonti. "Att möta de osynliga : En kvalitativ studie om killar med självskadebeteende." Thesis, Linnéuniversitetet, Institutionen för socialt arbete, SA, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-19938.
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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.
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Rees, Joanna. "Factors associated with deliberate self-harm in people with mild intellectual disabilities, the role of social problem solving, depression and hopelessness." Thesis, University of East Anglia, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.514360.
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Colbert, Nigel. "A qualitative investigation into the experiences of clients and therapists engaged in psychodynamic interpersonal therapy following an episode of deliberate self-harm." Thesis, Lancaster University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413832.
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Haqqani, Sabahat. "Deliberate self-harm and attachment : mediating and moderating roles of depression, anxiety, social support and interpersonal problems among Pakistani school going adolescents." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/25818.
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Introduction: In Pakistan there is dearth of research on deliberate self-harm (DSH) and its predictors among adolescents. While the lack of research in Pakistan can be partly attributed to the sacrilegious status, criminalization and stigmatization attached to DSH, it is also an attribute of paucity of Urdu versions of the standardized psychological instruments. Previous research in developed countries has indicated that attachment theory can be used as a useful framework to understand the development of austere psychopathologies like DSH, as well as for studying pathways of interaction of interpersonal and intrapersonal factors of psychopathologies. In this study, standardized psychological instruments are translated into Urdu language as a first step. These instruments are then used to study pathways of interaction of interpersonal and intrapersonal factors of DSH, conceptualized within attachment framework. Method: The study was conducted in two steps. In step 1, Youth Health Risk Behavior Survey (YHRB), Inventory of Interpersonal Problems-32 (IIP-32) and Significant Others Scale (SOS), were translated into Urdu language. Along with these scales, Urdu translated versions of Hospital Anxiety and Depression Scale (HADS), Adolescent Relationship Scales Questionnaire (ARSQ), Life Events scale (LES) from CASE questionnaire and Family Affluence Scale-II (FAS-II) were reviewed for accuracy of translation through expert judgement and psychometric evaluation. Secondly, a cross sectional survey was conducted with 1290 adolescents (10 - 19 years age) using the translated Urdu versions of the instruments and demographic pro forma. Structural equation modelling was used to study the pathways of associations between predictors of DSH. Results: The extensive process of translation resulted in establishment of semantic, content, technical and construct equivalence of the translated instruments with the original English versions. Multiple imputation was performed to account for missing values in SPSS 20. Important structural adaptations were made in the scales based on factor analyses conducted in M plus. After modifications, all scales showed satisfactory CFI (≥ 0.90) and RMSEA (≤ 0.06). Results of the survey indicated that the prevalence of DSH (with, without and ambivalent suicidal intentions) was 7%. Two SEM models were constructed involving both mediation and moderation pathways. Results of Model 1 showed association of attachment with DSH was double mediated by social support, depression and anxiety. Model 2 also confirmed association of attachment with DSH with double mediation through relationship style problems, depression and anxiety. In order to understand the contextual picture of the concepts studied in this research both SEM models were also constructed by controlling for demographic factors. This resulted in confirming age, gender and family affluence as significant contributors but with very small effects. Discussion and conclusion: In the present study translation of the instruments helped in building a reservoir for future research. The results of translation and validation of instruments indicated that cultural differences, language needs and age must be accounted for while using standardized psychological instruments. Taking into consideration specific cultural and demographic background of Pakistan, this study also confirms the key role of attachment in influencing interaction of predictors of DSH. It is suggested that intrapersonal and interpersonal factors are influential points of intervention for designing clinical, school and community based awareness and prevention programs for DSH. The thesis also discusses the implications for policy guidelines along with recommendations for future research and other applications of the study.
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Stanbridge, Jessica A. "Epidemiology of substance use among service users admitted to hospital following a medically serious act of deliberate self-harm: a feasibility study." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30854.
Full textAbstract:
Background: Suicidal behaviour is increasing internationally and in South Africa and is considered a national public health problem (1). Literature has shown that substance use is a potentially modifiable risk factor for both fatal and non-fatal suicidal behavior (2- 6). In South Africa, 43 percent of patients who present to emergency departments with intentional or unintentional injuries meet the criteria for a substance use disorder (SUD) (7). The association between substance use and suicidal behavior has been well established, however, the exact nature of this relationship awaits further investigation and clarification. Aims: The proposed study’s aims are; (i)to determine the patterns of substance abuse and the prevalence of SUDs (past and current) among patients admitted following an act of DSH, (ii) to compare patterns of substance use and the prevalence of SUDs (past and current) among those admitted following an episode of DSH, those admitted to the emergency psychiatric unit for reasons other than DSH and medical patients admitted for reasons other than DSH, (iii) to determine if patterns of substance use or the diagnosis of substance use or the diagnosis of SUDs predicts hospital admission for DSH. It concurrently analyzed preliminary data in order to determine if outcomes of the larger study would be meaningful and significant. Methods: Seventy-six patients were recruited over a period of 19 weeks. Twenty-seven consecutive patients with a medically serious act of DSH were recruited and were matched with a control group based on age range and gender. Demographic data and substance use history were collected using; (i) a self reported questionnaire, (ii) Alcohol Use Disorders Identification Tests (AUDIT), (iii) Drug Use Disorders Identification Test (DUDIT) and (iv) SUD module of the structured clinical interview of the DSM. Results: Findings of the feasibility study indicated low recruitment numbers and data collection challenges. Causes of low recruitment number were multifactorial, including low base rates for self-harm, length of recruitment time, consenting capacity, tight control criteria, exclusion of manic and psychotic patients and declining of patients to participate. Data collection faced challenges including difficult navigation of hospital premises, long data collection times, limited understanding of questions, language barriers and lack of privacy. Formal suicide risk assessment was a challenge for some data collectors. Preliminary data confirmed that substance use is a significant risk factor for DSH. Conclusions: This feasibility study demonstrated the existing protocol can be used to generate meaningful data and identified specific steps to be altered in a scaled-up study. These steps included; expansion of study sites to more institutions to increase recruitment numbers, a wider range in matching criteria for control groups and improved orientation and training of data collectors regarding use of the data collection tool, navigation of the hospital premises, maintaining confidentiality and formal suicide risk assessments. Formal translation of the research tool into other languages was recommended. Despite low recruitment numbers, data collected from this study was meaningful.
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Multra, Vidyah. "Pathways to episodes of deliberate self-harm among mentally ill men in a high-secure hospital : an exploratory study with conceptual development." Thesis, University of Lincoln, 2011. http://eprints.lincoln.ac.uk/22344/.
Full textAbstract:
There is a dearth of research exploring pathways to episodes of deliberate self-harm (DSH) as experienced by mentally ill men within high-secure hospital settings. The principal aim of this study was to explore the causal pathway(s) to episodes of self-harm experienced by mentally ill men within a high secure hospital. With a secondary aim of developing a conceptual understanding of the development and function of this phenomenon within this often ignored population. Seven men with a history of repetitive DSH participated in audiotaped semi-structured interviews in which they recalled antecedents and functions of typical episodes. Transcribed interviews were analysed and coded using grounded theory methods. Two pathways to episodes of DSH emerged and were subsequently termed, the Relief and the Response to Mental Health Problems Pathways. The Relief Pathway consisted of two inter-related functions; relief and an expression of self-hatred. Within the Response to Mental Health Problems Pathway, episodes of DSH were directly influenced by auditory hallucinations and delusional beliefs. Participation within a dyadic suicide pact emerged as a wholly unexpected theme. Further research is required to substantiate the two-pathway aetiology to episodes of DSH proposed within this study.
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Lippi, Carla. "An exploratory study of the relationship between deliberate self-harm and symptoms of depression and anxiety among a South African university population." Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/46113.
Full textAbstract:
This cross-sectional, exploratory study aimed to determine the prevalence and characteristics
of self-harming behaviours among a sample of South African university students (N = 603),
as well as the relationship between deliberate self-harm (DSH) and symptoms of depression
and anxiety. A battery of instruments, including the Beck Depression Inventory (BDI-II),
State-Trait Anxiety Inventory (STAI), and Deliberate Self-Harm Inventory (DSHI) was
administered to participants. Data were analysed by means of descriptive statistics, Chi
Square tests, t-tests, and logistic regression analyses. The findings suggest high rates of DSH
among the sample (46% lifetime prevalence; 36% 12-month prevalence). No significant
gender differences were found in the rates of DSH. Participants from the combined Asian
and Coloured racial group reported significantly higher rates of DSH than both White and
Black participants. Participants aged 20-21 were significantly more likely to report DSH than
those in other age groups. Overall, depression scores in the sample fell within the normal
range (M = 15.79), while anxiety scores were found to be exceptionally high (state anxiety:
M = 46.56; trait anxiety: M = 48.72). The findings suggest that participants with elevated
levels of depression are significantly more likely to report DSH. A significant, negative
relationship was found between DSH and state anxiety, while a positive yet insignificant
relationship was found between DSH and trait anxiety. The findings of this exploratory study
partially support the findings of international research investigating the relationship between
DSH and depression and anxiety, but warrant further exploration in order to better understand
the complexities of these relationships, particularly in the South African context.Mini-Dissertation (MA)--University of Pretoria, 2014.
tm2015
Psychology
MA
Unrestricted
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Jones, Kelly S. "The role of the educational psychologist in working with secondary school staff to increase their capacity to respond effectively to deliberate self-harm." Thesis, University of Manchester, 2009. https://www.research.manchester.ac.uk/portal/en/theses/the-role-of-the-educational-psychologist-in-working-with-secondary-school-staff-to-increase-their-capacity-to-respond-effectively-to-deliberate-selfharm(336fa179-2df3-4465-8af1-407aea544072).html.
Full textAbstract:
The aim of the study is to address the training needs of secondary school staff with a view to increasing their capacity to respond effectively to young people who engage in deliberate self-harm (DSH). The study aims to address the suggestion that current training and supervisory support for secondary school staff when working with young people that engage in DSH is unsatisfactory. The initial phase of the research was to use semi-structured interviews to gather the views and perceptions of secondary school staff, regarding their training needs in relation to DSH. In order to address the identified needs a six session training programme was set up based upon the needs identified during the interviews. Six training sessions were delivered to thirteen participants, from two secondary schools, on a monthly basis. At the first and sixth training session a structured questionnaire was administered to assess school staffs' knowledge and attitudes towards DSH. Data was analysed using SPSS. After the training sessions nine participants took part in semi-structured interview 2. All semi-structured interviews were recorded and transcribed verbatim and analysed using thematic analysis. The study provides promising evidence that a training programme drawing on a consultation approach and designed to meet participants' needs, increased participants' knowledge, gave them additional skills and made them feel more comfortable and confident when working with young people who engage in DSH. As a service working with schools Educational Psychologists (EPs) are ideally placed to tailor a training programme to meet the needs of staff and provide the training to school staff to enable them to ~ support those pupils that engage in deliberate self-harm.
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Donovan, Stuart. "A study to investigate if there is a potential link between the prescription of antidepressant drugs and the occurance of deliberate self harm." Thesis, University of Nottingham, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285772.
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