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We examined the effects of an individualized schedule on levels of engagement and self-injury for a student with severe autism. We first conducted a series of functional analyses to identify [...]

Since the early 1990s, research, largely from a feminist perspective, has been devoted to identifying the 'gender-specific needs' of delinquent girls. This article explores racial differences between girls and how these differences may affect the commission of violent behavior and self-injurious behavior. Self-report data were collected from 163 girls incarcerated in Ohio in 1998. Data were collected on a wide range of variables, including potentially criminogenic areas such as abuse, antisocial attitudes, drug use, type of parenting received, self-esteem, family experiences, and mental health. The findings indicate that some of these variables differ significantly by race. Furthermore, these criminogenic areas are investigated in order to test their relationship to self-reports of violence, self-injurious behavior, suicide attempts, and overall delinquency. These models are then examined by race with findings that demonstrate the fallacy of representing girls as a homogeneous group. Of particular interest is how differently girls respond to abuse, based on race. Keywords: racial differences; abuse

Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were identified by searching electronic databases and reference lists, and by consulting international experts. Fourteen studies met the eligibility criteria. Of the 29 variables examined by two or more studies, five (past or recent suicidal ideation, previous DSH, past depressive episode, drug abuse or dependence, and higher mean number of psychiatric admissions) were associated with an increased risk of DSH, and one (unemployment) was associated with a reduced risk. Schizophrenic patients with these risk factors need careful follow-up and monitoring, with treatment of any associated comorbid depression or drug abuse. Large, prospective studies of DSH in schizophrenia are needed to further define risk factors and to build on the findings of this review.

A large (n = 14,892) consecutive sample of deliberate self-harm (attempted suicide) patients who presented to a general hospital in the United Kingdom during a 23-year study period was examined (over two consecutive time periods) in order to compare the characteristics of those who used self-cutting (n = 428) and those who self-poisoned (n = 11,065). Patients who used different methods on other occasions, or were not assessed by the psychiatric service, were excluded. In the first time period (January 1976--June 1988), the self-cutters were distinguished from the self-poisoners by more often being male, single, not employed, and having a history of previous deliberate self-harm. In the second time period (July 1988--December 1998) the self-cutters were again distinguished by more often being male and having a history of previous deliberate self-harm, but also by being more likely to live alone, misuse alcohol, and have low suicidal intent scores. The finding of an excess of males among the self-cutters is contrary to the impression in the literature that self-cutting presentations to general hospitals more often involve females. It also indicates that the treatment needs of those who deliberately cut themselves are likely to differ from those of self-poisoners.

Little is known about the extent to which minor self-harm in the general population is associated with psychiatric disorder. A population-based sample of 980 young adults was interviewed independently about past-year suicidal and self-harm behavior and thoughts, and psychiatric disorders. Self-harm included self-harmful behaviors such as self-battery, as well as traditional methods of suicide (ICD [International Classification of Diseases] self-harm). All with ICD self-harm and most with other self-harmful behavior met the criteria for DSM-IV disorder. Suicidal/self-harmful thoughts increased the odds for self-harm, even in men without psychiatric disorder (odds ratio 4.9, 95% confidence interval 1.3-17.9). Young adults engaging in even minor self-harm warrant screening for psychiatric disorder.

Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated with health complaints, PTSD arousal, and three measures of sexual abuse severity: age of onset for sexual abuse, injury experienced during the sexual abuse, and perceived life threat. Tests of mediation revealed that symptoms of PTSD arousal mediated the relationship between earlier age of onset for sexual abuse and SIB. PTSD arousal moderated the relationship between sexual-abuse-related injury and SIB. SIB was a unique predictor of health complaints, even after controlling for sexual abuse severity and PTSD arousal. Keywords: self-injurious behaviors; health; sexual abuse; PTSD arousal

Objective: The aim of this study was to test whether alexithymia mediates the relationship between childhood maltreatment and self-injurious behaviors (SIB) in college women. Method: The sample was comprised of 100 female undergraduate students. Measures were the Childhood Trauma Questionnaire [D. Bernstein, L. Fink, Manual for the Childhood Trauma Questionnaire, The Psychological Corporation, New York, 1998], the Toronto Alexithymia Scale-20 [Journal of Psychosomatic Research 38 (1994) 23; Journal of Psychosomatic Research 38 (1994) 33], and the Self-Injurious Behaviors Questionnaire which assessed the lifetime frequency of six methods of superficial self-injury (hair pulling, head banging, punching, scratching, cutting, and burning). Regression analyses were used to test the proposed mediational model. Results: Forty-one percent of respondents reported having engaged in SIB; most engaged in multiple methods, and self-cutting was the most frequently endorsed method. Results of regression analyses supported the proposed mediational model for all types of maltreatment except sexual abuse. Sexual abuse, considered alone, was not significantly associated with alexithymia which precluded testing for mediational effects. Conclusions: Results support a link between a history of childhood maltreatment and SIB among college women and the hypothesis that alexithymia mediates this relationship. Keywords: Alexithymia; Childhood trauma; Self-injurious behaviors

As a warden and a psychologist at a maximum-security female correctional facility housing a psychiatric unit, we know the story well. As we enter the correctional facility, staff tell us [...]

The RCN maintains a fairly positive media profile, but mental health nurses usually only hit the headlines when someone is finding fault. So, when both made the front page of [...]

The topic of self-harm has been poorly conceived, inadequately described and, in consequence, is widely misunderstood. The three major questions facing professionals and service users alike are: * What do [...]

It is vital to examine the 'emotional meaning' behind acts of self-injurious behaviour, according to an expert who has pioneered the use of psychotherapy with people who have learning disabilities, [...]

Understanding the 'pain gate' theory could aid researchers and practitioners seeking to help people who injure themselves, according to Chris Oliver, professor of clinical psychology at the University of Birmingham. [...]