Search

Objective: Adolescents and young adults are at risk for non-suicidal self-injury (NSSI) and suicidal behavior. This study examined intrapersonal (depressive symptoms, self-criticism) and family (perceived family functioning, parenting style, parental attachment) factors associated with reported history of NSSI in a college sample. Method: Participants included 111 undergraduate students (Mage = 20.2) from a private, nonprofit university. Data were collected via online survey. Hierarchical logistic regression analysis was conducted. Results: The final model was statically significant, Nagelkerke R2 =.40, suggesting a robust association between the predictors and history of NSSI. Self-criticism and unhealthy family functioning were significant predictors of NSSI behaviors after controlling for study variables and demographic characteristics. Reported history of engaging in NSSI was positively correlated with parent alienation, unhealthy family functioning, self-criticizing behaviors, and depressive symptoms. Conclusion: College mental health providers should be familiar with risk factors of NSSI as well as strategies to address self-criticism. [ABSTRACT FROM AUTHOR]

Background: Historically, the research and treatment of self-injury has been disciplinarily siloed. As a result, the behaviour is understood and treated differently among individuals with and without intellectual and developmental disabilities. We explore the potential for an interdisciplinary research and practice agenda in self-injury. Method: We conducted 10 focus groups with experts in self-injury and analysed discussions that resulted from the question: "What is the role of interdisciplinarity in the study and treatment of self-injury?" Results: Through a reflexive thematic analysis we came up with actionable and positively-oriented themes: Interdisciplinarity at the Individual Level, Context of Needed Systems-Level Change, Highlighting Workforce Support, Strategic Use of Implementation and Dissemination Science, and The Pursuit of Integration. Each theme includes several subthemes that describe specific strategies. Conclusions: An interdisciplinary approach is not only possible but worthwhile and would be particularly beneficial to supporting individuals with intellectual and developmental disabilities engaging in self-injurious behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Interpretative phenomenological analysis (IPA) is used to explore how people make sense of their personal and social world, although a search of recent literature suggests that it has not been applied to better understand self‐injury (SI). The goal of this paper was to employ an IPA methodology to gain a deeper understanding of the impact witnessing the physical manifestations of SI has on therapists. Method: The study recruited a purposive sample of nine English‐speaking psychotherapists. Questions designed to relate to the participant's experience of witnessing the physical manifestations of SI were piloted with non‐participating psychotherapists whose experience matched those of the sample. Individual interviews were conducted by the primary researcher. Data Analysis: Analysis involved the hermeneutic circle, moving between the part and the whole to capture and record the unique experience of the individual participants. This entailed the following: reading and re‐reading the transcripts; initial noting; developing emergent themes; connecting emergent themes; and pattern identification across cases. Results: Two superordinate themes were identified that encapsulated how participants experienced, perceived and understood their own reactions to clients' SI presentation. The first, Shock, included the subordinate themes of Controlling reactions, Managing physical revulsion, Therapeutic holding and Revisiting and ruminating. The second, Responsibility, included the subordinate themes of Client responsibility, Professional responsibility, Personal responsibility and Responsibility for hope. Implications: Implications relate to core training for psychotherapists, the focus on continuing professional development, and the policies and procedures needed to support psychotherapists. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a behaviour many counselling psychologists encounter in practice, and the way clinician's respond can have an important impact on the individual's experience of recovery. The person-centred NSSI recovery framework incorporates the voices of lived experience in understanding the multi-faceted nature of recovery. Objectives: This paper outlines important considerations for how the recovery framework can guide clinicians with respect to both therapeutic stance and intervention targets in order to support clients in navigating their experience of NSSI and recovery. Implications: Clinicians should adopt a strengths-based approach and foster self-efficacy and self-compassion with persons with lived experience. This paper provides specific recommendations for counselling psychologists and their clients, including encouraging clinicians to avoid making assumptions about the causes, meanings, and outcomes of self-injury, and to be cognizant of the non-linear nature of the recovery process. [ABSTRACT FROM AUTHOR]

Objective: This current study aimed to validate the Indonesian version of the Inventory of Statements About Self-Injury (ISAS) questionnaire, which provides a better understanding of Non-Suicidal Self-Injury (NSSI) disorders. Method: The study used a cross-sectional design and involved 314 adolescents and young adults in high school or university. A stratified sampling method was used. All participants filled out the ISAS questionnaire. Data were analyzed for content validity, construct validity, item discrimination value, and internal consistency (Croncbach's α). The translation process was carried out using forward and back-translation methods. Results: The ISAS questionnaire consists of section I, the behavioral scale, and section II, the functional scale. For content validity, Aiken's V coefficient obtained for both scale sections I and II is in the range of 0.917 -- 1. This result shows that all items on the scale have very good validity. Confirmatory Factor Analyses were carried out using Lisrel 8.80 software on section II, resulting in several goodness of fit values that were not good enough (χ2 = 457.68; P < 0.000; df = 64; χ2 / df = 7.151, RMSEA = 0.130) and several other values that are quite acceptable (CFI = 0.95; SRMS = 0.057; NFI = 0.95; GFI = 0.83). The factor loading from section II ranges from 0.43 - 0.91. The item discrimination value using the corrected item-total correlation of section I is in the range of 0.031 - 0.837 and section II ranges from 0.290 -- 0.854. The reliability analysis values in section I and II of the ISAS are α = 0.527 and α = 0.966, respectively. Conclusion: This is the first study to have validated the Indonesian version of the ISAS questionnaire. The Indonesian version of the ISAS questionnaire is considered a valid and reliable instrument to assess NSSI disorders. [ABSTRACT FROM AUTHOR]

Introduction: Self-injury encompasses not just physical sensations but also includes psychological, emotional, and social dimensions. The present study aimed to compare behavioral inhibition and metacognitive thinking and cognitive fusion in self-injured and normal people. Method: This study is a causal-comparative research. The statistical population for the study consisted of individuals with a history of self-injurious behaviors who sought treatment at psychological clinics in Shiraz from July to September 2023. The research employed purposive sampling as the sampling method. At the end, the data of 53 participants was analyzed. The data collection tools utilized in this study were the Measure of Behavioral Inhibition (2005), Cognitive Fusion Scale (2014), and Meta- Cognition Questionnaire (2004). Data analysis was conducted using the MANOVA and Independent Samples T-Test and Welch's t-test through SPSS version 27 software. Results: According to findings, the observed difference in the mean of behavioral inhibition, positive beliefs about worry, negative beliefs about the controllability of thoughts, and cognitive uncertainty in two groups with self-injury and without self-injury was significant (p<0.05). Conclusion: The findings of this research suggest that individuals who engage in self-harm display notable disparities in terms of behavioral inhibition and metacognitive thinking in comparison to those who do not self-harm. However, there is no significant divergence observed in cognitive fusion between the two groups. The study reveals that individuals with self-injury exhibit higher levels of behavioral inhibition harbor negative beliefs about their ability to control thoughts, and experience cognitive uncertainty more frequently than individuals without self-injury. Conversely, individuals without selfinjury tend to possess stronger positive beliefs about worry compared to those with self-injury [ABSTRACT FROM AUTHOR]

Objective: The Interpersonal Theory of Suicide (ITS) could help identify differences in groups of suicidal adolescents and inform treatment. Method: Latent Profile Analysis (LPA) using thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, and capability was conducted on data from an at‐risk clinical sample (N = 500). The ITS prediction that changes in TB and PB are associated with changes in suicidal ideation was tested using admission and discharge data. Results: Latent Profile Analysis identified three profiles with increasing complexity and severity on ITS factors. The profiles were labelled low‐severity (7.6% of participants), moderate‐severity (45.2%), and high‐severity (47.2%). ITS predictions were partially supported for the full sample and only for the high‐severity and moderate‐severity subgroups, whereby changes in TB were significantly associated with changes in suicidal ideation over the course of treatment. However, changes in PB were only significant in the moderate‐severity subgroup, and none of the ITS predictions were supported in the low‐severity subgroup. Additionally, effect sizes for changes in TB and PB were modest in all analyses. Conclusions: Our findings highlight the importance reducing low belongingness in youth, which is a component of all supported interventions of youth suicide prevention. However, given the modest association of changes in ITS variables had with changes in suicidal ideation, it may be fruitful to elaborate on the relative importance on types of low belongingness or include other non‐ITS variables. [ABSTRACT FROM AUTHOR]

Background: Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. Methods: We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. Results: A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). Conclusions: Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend. [ABSTRACT FROM AUTHOR]

Emotional distress has received less attention as an explanatory factor for self-injury in people with intellectual disabilities, with research and practice primarily focusing on biobehavioural factors. This systematic review examines the self-reported explanations for self-injury by people with mild or moderate intellectual disabilities, and discusses how the findings contrast with those from self-reported studies of people within the general population who self-harm. Five databases (PsychINFO, IBSS, CINAHL, Web of Science and Medline) were systematically searched to find qualitative, empirical research since 2000 about self-reported reasons for self-injury. Four studies were found which conducted research with people with intellectual disabilities. Three primary themes are discussed: relief from overwhelming emotions; trauma and loss; and difficulty in articulating emotions. This review found a paucity of research asking people with intellectual disabilities about their own self-injury. However, the research available suggests that explanatory factors for self-injury typically reported in the general population should be considered for those with mild or moderate intellectual disabilities. [ABSTRACT FROM AUTHOR]

Suicidal risk has been a significant mental health problem. However, the predictive ability for repeated self-harm (SH) has not improved over the past decades. This study thus aimed to explore a potential tool with theoretical accommodation and clinical application by employing traditional logistic regression (LR) and newly developed machine learning, random forest algorithm (RF). Starting with 89 items from six commonly used scales (i.e., proximal suicide risk factors) as preliminary predictors, both LR and RF resulted in a better solution with much fewer items in two phases of item selections and analyses, with prediction accuracy 88.6% and 79.8%, respectively. A combination with 12 selected items, named LR-12, well predicted repeated self-harm in 6-month follow-up with satisfactory performance (AUC = 0.84, 95% CI: 0.76–0.92; cut-off point by 1/2 with sensitivity 81.1% and specificity 74.0%). The psychometrically appealing LR-12 could be used as a screening scale for suicide risk assessment. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to quantify the prevalence of non‐suicidal self‐injury across eating disorders (EDs) and within diagnostic categories through systematic review and proportional, or so‐called prevalence, meta‐analysis. Method: Included studies had to contain individuals with a verified diagnosis of an ED. The last literature search was conducted on September 11, 2023, for studies published on or before September 2023 without a restriction on earliest publication year. Results were synthesized and analyzed using the "metaprop" package in R and presented using forest plots. Bias was assessed by a Peters' regression test and funnel plot. Results: 79 studies published between 1985 and 2023 were included encompassing 32,334 individuals with an ED. Importantly, 42 studies were not included in any other meta‐analyses on self‐injury in EDs to date. Overall prevalence of non‐suicidal self‐injury was 34.59% (95%CI = 30.49–38.81). Prevalence in anorexia nervosa restrictive type, binge/purge type, bulimia nervosa, binge eating disorder and other specified feeding/eating disorder were 23.19% (95%CI = 16.96–30.03%), 41.98% (95%CI = 32.35–51.91%), 36.97% (95%CI = 30.69–43.46%), 21.21% (95%CI = 14.93–28.12%) and 37.65% (95%CI = 28.59–47.09%), respectively. Prevalence estimations could not be estimated for other ED categories due to lack of a sufficient number of studies. Discussion: Non‐suicidal self‐injury is prevalent across both binge/purge and restrictive EDs. Considering the transdiagnostic nature of self‐injurious behaviors in ED, the results highlight the importance of assessment and monitoring of self‐injury in people with ED, irrespective of specific diagnoses. The method of determining self‐injury varied across studies and may limit this study. Public Significance: This study highlights the prevalence of self‐injury across eating disorders irrespective of diagnosis and within specific EDs. While diagnoses known to exhibit self‐injurious behaviors (e.g., bulimia nervosa, anorexia nervosa binge/purge subtype) demonstrated the highest prevalence of self‐injury, all diagnoses were found to have a prevalence greater than 20%. These findings suggest the importance of assessing and monitoring all individuals with an eating disorder for the presence of self‐injury. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ. [ABSTRACT FROM AUTHOR]

Background: Suicide is a leading cause of death amongst young people and a major public health concern. Although increasing research has identified contributory and protective factors affecting youth suicide, less is known about how young people make sense of suicidal distress themselves. Methods: Using semi‐structured interview methods and reflexive thematic analysis, this study explores how 24 young people aged 16–24 in Scotland, UK made sense of their lived experiences of suicidal thoughts and feelings, self‐harm, and suicide attempts. Results: Intentionality, rationality, and authenticity formed our central themes. Suicidal thoughts were categorised by participants dependent on their intention to act on them; a distinction often used to downplay the significance of early suicidal thoughts. Escalating suicidal feelings were then described as almost rational responses to adversities; whereas suicide attempts appeared to be described as more impulsive. These narratives seemed to be somewhat shaped by dismissive attitudes participants experienced in response to their suicidal distress, both from professionals and within their close networks. This impacted how participants articulated distress and asked for support. Conclusion: Suicidal thoughts that participants articulated as lacking the intention to act could represent key opportunities for early clinical intervention to prevent suicide. In contrast, stigma, difficulties communicating suicidal distress and dismissive attitudes could serve as barriers to seeking help, and, therefore, additional efforts should be made to ensure young people feel comfortable seeking help. [ABSTRACT FROM AUTHOR]

We analyzed the Healthcare Cost and Utilization State Emergency Department (ED) Databases and State Inpatient Databases for all individuals who were 2 years of age or older with at least one ED visit from 2011 to 2016 in New York to estimate the association between suicide and non-fatal injury-related ED visits and autism spectrum disorder (ASD). Our study included 14.4 million individuals with 43.5 million ED visits. Of those, 31,946 (0.2%) individuals had ASD accounting for 162,440 ED visits (0.4%). Compared to those without ASD, individuals with ASD had 2.1 more ED visits on average, higher shares of inpatient ED visits, more years of ED utilization, and higher prevalence of mental health-related comorbidities and diagnoses and self-injury-related ED visits. Among the ASD cohort, 6.1% had at least one self-injury-related ED visit compared to 2.2% among those without ASD. Using multivariable regressions adjusted for sociodemographic, clinical, contextual, and visit-level characteristics, we found that individuals with ASD were significantly more likely to have at least one self-injury-related ED visit compared to those without ASD. Our findings highlight the importance of raising awareness among caregivers and providers about the increased self-injury risk that individuals with ASD face and to tailor care delivery practices towards their needs. This study used data for 14.4 million individuals with 43.5 million emergency department visits from all hospitals in the state of New York to explore the association between suicide and non-fatal self-injury-related (self-injury) emergency department visits and autism spectrum disorder. Overall, we found that individuals with autism spectrum disorder had more emergency department visits and admissions through the emergency department, more years of emergency department utilization, and higher prevalence of mental health-related comorbidities. Individuals with autism spectrum disorder were also significantly more likely to have at least one self-injury-related emergency department visit compared to those without autism spectrum disorder. These results emphasize the need to raise awareness across both family caregivers and healthcare providers on the increased suicide and self-injury risks that individuals with autism spectrum disorder face and to improve care delivery practices. In addition, effort to promote and increase timely access to mental health care is an urgent priority for individuals with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Suicide and nonsuicidal self-injury (NSSI) often co-occur and have high prevalence rates in adolescence. Given these worrisome findings, there is still much work that is needed to identify correlates of these self-injurious thoughts and behaviors distinctly. Given that clear self-injurious thoughts and behaviors terms have been limited in suicide research, there is promising research to suggest examining NSSI functions in high-risk youth with self-injurious thoughts and behaviors outcomes. Additionally, it is essential to examine important developmental contributors, such as romantic relationship stress, when assessing NSSI functions and self-injurious thoughts and behaviors outcomes. Thus, the present study examined the relationship between NSSI functions, romantic stress, and suicidal risk among 70 self-injuring adolescents in a clinical sample that were categorized into: NSSI (no suicide attempts, SAs; n = 29) and NSSI + SA (a lifetime history of SAs; n = 41). ANCOVAs revealed that the NSSI + SA endorsed significantly more interpersonal NSSI functions, when controlling for romantic stress. Engaging in NSSI for interpersonal boundaries, in addition to the intrapersonal function of self-punishment, were higher for the NSSI + SA group. Romantic stress was significantly associated with suicide ideation, but not SAs and threats, in the total sample. Descriptive information on the most common romantic stressors endorsed in this self-injuring sample also revealed that break-ups were not in the top three stressors endorsed. This study suggests targeting these distinct interpersonal factors will help to identify high-risk youth who may go on to attempt suicide. [ABSTRACT FROM AUTHOR]

Background: Viewing self‐harm and suicide‐related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self‐harm‐related images on the internet and social media. Method: CINAHL, Cochrane Library, EMBASE, HMIC, MEDLINE, PsycArticles, PsycINFO, PubMed, Scopus, Sociological Abstracts and Web of Science Core Collection databases were searched for relevant studies from inception to 22 January 2022. Inclusion criteria were English language, peer‐reviewed, empirical studies with data related to impacts of viewing self‐harm images or videos on the internet or social media. Quality and risk of bias were assessed using Critical Appraisal Skills Programme tools. A narrative synthesis approach was used. Results: Of the 15 identified studies, all found harmful effects of viewing self‐harm‐related images online. These included escalation of self‐harm, reinforcement of engagement behaviours (e.g. commenting and sharing images), encouragement of social comparison (comparing own self‐harm with others), development of a self‐harm identity, social connection perpetuating or escalating self‐harm, and emotional, cognitive, and physiological impacts triggering self‐harm urges and acts. Nine studies found protective effects, including self‐harm mitigation or reduction, promotion of self‐harm recovery, encouraging social connection and help‐giving, and emotional, cognitive and physiological impacts mitigating or reducing self‐harm urges and acts. Causality of impact was not determined in any study. Most of the studies did not explicitly evaluate or discuss potential mechanisms. Conclusions: Viewing self‐harm images online may have both harmful and protective effects, but harmful effects predominated in the studies. Clinically, it is important to assess individual's access to images relating to self‐harm and suicide, and the associated impacts, alongside pre‐existing vulnerabilities and contextual factors. Higher quality longitudinal research with less reliance on retrospective self‐report is needed, as well as studies that test potential mechanisms. We have developed a conceptual model of the impact of viewing self‐harm images online to inform future research. [ABSTRACT FROM AUTHOR]

This article explores the proposed psychiatric diagnostic category of nonsuicidal self‐injury disorder (NSSID) through the lens of feminist psychiatric disability theory. Mobilising insights from labelling theory's accounts of stigma and recovery, in conjunction with critical and feminist disability theory's attention to emotional and physical pain, we suggest that a feminist psychiatric disability approach to NSSID can illuminate the limits of a fully demedicalised engagement with self‐injury. While remaining critical of psychiatrisation processes, we explore the implications of 'strategic (dis)identifications' with illness labels as mechanisms through which to manage and access care, treatment and recovery. Such a nuanced account engenders more deeply material considerations of pain, stigma, treatment and 'cure' at the site of NSSID, opening new avenues of engagement with self‐injury for sociologists and critical disability scholars alike. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is an area of growing concern for the health care community, as evidenced by its identification as a Healthy People 2030 objective and as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In the past, nurses may have identified patients who cut or harmed themselves as having suicidal intent, yet NSSI is increasingly recognized and investigated as a separate disorder. This article provides an overview of NSSI, including information about risk factors, clinical assessment, and preventive efforts. The author provides an overview of NSSI—a method of self-harm that is associated with damage to the body without suicidal intent—including information about risk factors, clinical assessment, and preventive efforts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disrupted the lives of adolescents worldwide, and research on the mental health effects are ongoing. Adolescents living in rural areas of the United States were already known to be at a disadvantage in terms of access to mental health services, as well as elevated rates of mental health concerns and self-harm risk. Research on how these factors may have changed since the pandemic began is needed to better understand which areas saw the biggest impact and where we can best direct resources to assist youth. Data from the current study were taken from a project examining adolescent mental health and self-harm risk. The pandemic disrupted the timeline for the study resulting in data being collected in two separate waves: before (n = 695) and after (n = 206) the pandemic began. Comparisons were made between these two samples on multiple factors including depression, anxiety, emotion dysregulation, alcohol and substance use, experiencing of bullying, overall impairment, mental health services access, and self-harm. Results indicated that adolescents in the pandemic sample were more likely to have seen a counselor and been hospitalized for a mental health reason, and were more likely to have experienced past-year suicide thoughts and plans than adolescents in the pre-pandemic sample. The pandemic sample also showed more depression and anxiety symptoms, greater emotion dysregulation, and greater intensity of recent suicide ideation. Implications for assisting youth through post-pandemic times are discussed. [ABSTRACT FROM AUTHOR]

Suicide is one of the main causes of death among the adolescent population, which is why it is considered an important mental-health problem. In addition to this situation, for each suicide, the group of people who survive it (known as suicide survivors) can present serious emotional affectations, becoming a population at risk for this problem. The purpose of this study was to analyze the effect of suicide-survivor status on risk factors and protective factors for suicide. A total of 440 adolescents with a mean age of 15.78 (SD = 1.74) participated, who were divided according to survivor status, identified as the SV group (79 cases), and non-survivors, identified as the NSV group—adolescents that did not have experience or contact with a suicide attempt (361 cases). A questionnaire of sociodemographic characterization and risk conditions, the Alexian Brother Urge to Self-Injure (ABUSI), the Plutchik Suicide Risk Scale, the Multidimensional Scale of Perceived Social Support, and the Cognitive and Affective Empathy Test (TECA) were applied. Descriptive statistics, mean difference for independent samples, contingency tables, X2 statistic, Fisher's exact statistic, and Cohen's d coefficient were used. The results show significant differences between SV and NSV participants in risk and protective factors regarding the presence of a greater adoption of perspective and emotional understanding. On the other hand, NSV adolescents presented higher scores of perceived social supports regarding risk factors, and there was a higher proportion of a history of suicide attempt, severity/hospitalization, impulse to self-harm, and level of suicidal risk in the SV group. The need to incorporate forms of suicide prevention with the survivor population is discussed, increasing the possibilities of postvention. [ABSTRACT FROM AUTHOR]

Less than half of all young people with mental health difficulties will seek professional treatment. Due to the private nature of self‐harm it is estimated that only 1:28 young males and 1:18 young females who self‐harm ever present to hospital. Self‐help supports improved coping strategies and life changes without reliance on a clinical intervention which could be used to reduce self‐harming behaviours. The study objective is to review self‐help alternatives to self‐harm on mental health websites that can be accessed by young people. Google, Bing, and Yahoo search engines were used to search for appropriate websites. Eighty‐two unique websites on mental health were identified, of which 55 met the inclusion criteria. A total of 1177 self‐help suggestions were found for those struggling with self‐harm urges. The average number of suggestions per site was 42 (Range 3–252). The main techniques suggested were: seeking social contact/help, physical activity, displacement/mimicking techniques, relaxing/comforting techniques, sensory techniques, fun/diverting techniques, aggressive techniques, creative/reflective techniques. This review found not all strategies were suitable for young people and that the large number of possible strategies could be challenging for a young person to navigate. However, mental health self‐help websites were generally of high quality and gave a range of potentially helpful strategies. The categories created from this review could be used as a guide to consider with the young person when making an individualized self‐help plan to manage self‐harm urges. Further research is required to assess if and how these techniques could be used individually or in combination to reduce self‐harm. [ABSTRACT FROM AUTHOR]

Background: Peer problems have emerged as important predictors of Non‐Suicidal Self‐Injury (NSSI) development during adolescence. However, the possibility that adolescents who engage in NSSI may, in turn, be at increased risk for experiencing difficulties with their peers has rarely been examined. This study investigated the reciprocal associations between peer problems (e.g. peer victimization, friendship stress and loneliness) and NSSI throughout adolescence, distinguishing between‐ and within‐person effects. Method: Participants were 866 adolescents (54.5% females; Mage = 13.12 years, SD = 0.78), who took part in six waves of data collection. Adolescents completed self‐report measures of NSSI, friendship stress and loneliness and they took part in a peer nomination procedure to assess peer victimization. Random Intercept Cross‐Lagged Panel Models (RI‐CLPMs) were used to estimate within‐person cross‐lagged effects between each peer problem and NSSI from Grade 7 to 12. Results: After accounting for between‐person associations between peer problems and NSSI, results indicated that higher‐than‐usual levels of NSSI predicted higher‐than‐usual levels of adolescents' own friendship stress, loneliness and peer victimization at the subsequent time point. Yet, sensitivity analyses revealed that most of these effects were strongly attenuated and explained by within‐person fluctuations in depressive symptoms. No within‐person cross‐lagged effects from peer problems to NSSI were found. Conclusions: Findings highlight that the associations between peer problems (i.e. friendship stress, loneliness) and NSSI may be largely explained by shared underlying factors; yet, some evidence also suggests that NSSI engagement may increase adolescents' risk to experience difficulties in the relationships with their peers, in part via increases in depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. Methods: Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. Results: Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. Conclusion: Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches. [ABSTRACT FROM AUTHOR]

Objective: Patients with borderline personality disorder (BPD) are likely to attend the ED while experiencing crises and associated self‐injury and suicidality. Our study describes the prevalence, features, and outcomes associated with ED presentations by patients diagnosed with BPD in Outer Eastern Melbourne, Australia. Methods: A retrospective electronic audit of 157 364 ED attendances identified 700 unique BPD‐related ED presentations between May 2015 and April 2016. For the purpose of comparison, 583 (81% female) of these 700 cases were matched with 'depression only' cases. ED re‐presentation data were also extracted. Results: The 583 matched BPD patients attended ED a total of 2807 times during the audit year compared with 1092 attendances for matched depression‐only patients. BPD patients were more likely to: arrive by ambulance (50%); have comorbid substance abuse (44%); have a psychotic (15%) or bipolar disorder (17%); be under the care of a psychiatrist (31%); be case‐managed (42%); and be admitted to an inpatient unit (21%). ED doctors saw 38% of BPD or depression patients within the recommended time according to their triage category. The majority (73%) of BPD patients attended ED more than once during the audit year (average 4.81 ± 6.63 times; range 2–78). Conclusion: Repeated ED attendance of a subset of patients diagnosed with BPD highlights both the severity of their presentation and the inadequacy of community mental health services for meeting their complex needs. Development of effective ED referral pathways with follow‐up to engage patients in BPD‐appropriate treatment will reduce the likelihood of crises and reliance on hospital EDs for acute episodic care. [ABSTRACT FROM AUTHOR]

The main aim of this article is to compare the prevalence of four forms of physically self-destructive behavior in the offspring of parents with borderline personality disorder (BPD) and compare them to the offspring of parents with other personality disorders (OPD). At the 4- and 6-year waves in a prospective study of the long-term course of BPD, participants were asked to report on the self-destructive behaviors of their children using the Childhood Self-Destructiveness Scale. A total of 68 parents were interviewed regarding 131 children, 104 of whom were offspring of parents with BPD (n = 55) and 27 were offspring of parents with OPD (n = 13). BPD parents reported significantly more self-injury and substance abuse in their children than OPD parents. The results from this study suggest that both direct and indirect forms of self-destructive behavior are both more common and quite specific for the children of parents with BPD. [ABSTRACT FROM AUTHOR]

Background: Shame can be a powerfully aversive emotion that is associated with a wide variety of mental health difficulties including non‐suicidal self‐injury (NSSI). This study used a novel mixed‐methods design (Qualitative Experiential Sequence Tracking; QUEST) to investigate the experiences of shame in a sample of individuals who self‐injure. Methods: Six participants received prompts to complete brief online diaries three times per day over a period of 2 weeks. These diaries captured information about the experience of negative emotions, especially shame. Participants then underwent an individualised qualitative interview about their experiences over the previous 2 weeks. Results: Thematic analysis suggested that participants experienced shame as a social and relational emotion. Further themes included shame being associated with feelings of failure, being trapped, dangerous or contaminated, and hidden or exposed. The phenomenology of shame, and coping with shame, were also themes. NSSI could occur as a response to shame, but often shame was triggered or exacerbated by the responses of others to NSSI. Conclusions: Consistent with previous research, shame was described as an aversive emotion occurring within interpersonal and broader societal contexts and involving a negative self‐focus. A lack of compassion or understanding in response to NSSI, or anticipation of negative responses from others often triggered more intense shame than the NSSI itself. Future studies could use QUEST methodology with more diverse samples or different populations to further investigate experiences of shame. [ABSTRACT FROM AUTHOR]

Background: More knowledge about risks of clinical outcomes associated with nonsuicidal self‐injury (NSSI) and suicide attempts (SAs) is needed to inform risk assessment and intervention. Methods: Longitudinal cohort study based on 1,855 youths was clinically assessed for NSSI and SA, and followed up (from December, 2011 to December 2013) for the outcomes; diagnosed self‐injury, alcohol/substance use disorder, and psychiatric inpatient care data derived from Swedish registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) of the outcomes were estimated with Cox regressions, and additionally adjusted for the potential effect of sex and the number of clinical assessments. NSSI and SA were treated as time‐varying covariates. Results: Youths with NSSI had elevated risks of all outcomes, compared with youths without NSSI or SA; the HR was 2.3, 95% confidence interval [1.6, 3.4] for self‐injury, 1.4 [0.9, 2.1] for alcohol/substance use disorder, and 1.3 [1.0, 1.7] for psychiatric inpatient care. Youths with SA displayed higher risks for the outcomes than the NSSI group; the HR was 5.5 [2.4, 12.6] for self‐injury, 2.0 [0.9, 4.4] for alcohol/substance use disorder, and 2.6 [1.5, 4.5] for psychiatric inpatient care. Youths with both NSSI and SA showed similar risks as youths with SA; HR 4.1 [2.0, 8.3] for self‐injury, 2.0 [1.1, 4.1] for alcohol/substance use disorder, but a higher risk of psychiatric inpatient care; HR 5.0 [3.1, 7.9]. All results remained virtually unchanged in the adjusted analyses. Conclusions: Youths with NSSI and/or SA had higher risks for subsequent adverse clinical outcomes. These excess risks were more pronounced among youths with SA and youths with both NSSI and SA, and the risk for psychiatric inpatient care was particularly high in youths with both NSSI and SA. Our findings suggest that early interventions for youths with NSSI or SA should not exclusively focus on suicide prevention, but also consider the risk of subsequent alcohol/substance use disorder. [ABSTRACT FROM AUTHOR]

To explore nursing students' thoughts and feelings about self-injuring during their clinical practicums. Unfamiliar clinical environments pose challenges for nursing students, potentially leading to high levels of stress. When students find it difficult to cope with emotional triggers, some contemplate self-injury. Yet, it is rare to explore nursing students' thoughts and feelings related to self-injury during their clinical practicums. A phenomenological approach was used. Purposive sampling was used and the participants were drawn from nursing students who graduated from universities in Taiwan. In-depth, semi-structured interviews were conducted from August to November 2023. Data saturation was reached after interviewing 15 participants. Colaizzi's seven steps and NVivo software were used for data analysis. Four themes and 14 subthemes emerged. They were: (1) Sensing an emotional crescendo: participants experienced anxieties about clinical educators, assignments, homework and the clinical practicums and these intensified across time. (2) Physical and mental dysregulation: participants experienced physical discomfort, psychological distress and negative thoughts when subjected to overwhelming pressures during their clinical practicums. (3) Unwholesome self-protective behaviors: participants expressed thoughts of self-injury, engaged in self-injurious behaviors, experienced suicidal ideations and attempted suicide as measures of relieving stress. (4) Compassionate self-protective behaviors: participants coped with stress through emotional voicing, modifying situations to adjust stress, reaching out for help, self-compassion and self-care. Findings raise awareness of the need for clinical educators to demonstrate empathy with nursing students who have thoughts of self-injury during their clinical practicums. Further, it is crucial for them to offer timely guidance on the healing process while simultaneously creating nurturing clinical environments wherein students could flourish and grow. [ABSTRACT FROM AUTHOR]

Background: To understand and care for men who self‐harm, it is important that healthcare professionals have understanding of how and why men self‐harm, men's experiences of self‐harm and what can be done to hinder or prevent self‐harm. Aims: The aim of this study was to synthesize the existing knowledge on men who self‐harm, with a special emphasis on background, self‐harming methods, experiences and reported therapeutic interventions and/or care approaches. Design: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Data sources: Systematic electronic database searches were conducted in CINAHL, MEDLINE (Ovid) and PsycINFO. From a total of 684 studies found, 24 studies met the inclusion criteria: full‐text, published in English, peer‐reviewed studies and grey literature including a focus on men who self‐harm, men aged between 18 and 65 years, and published between 2010 and 2019. Results: Men's self‐harm was understood as being related to mental disorders, a means of affect regulation, a loss of self‐control, and a means of interpersonal communication. Self‐harm can be a positive or negative experience, and there is a wide variety in the methods that men use to self‐harm: sharp objects, injection, ingestion, without aids or riskful behaviour. Few studies reported on therapeutic interventions and/or care approaches for men who self‐harm. Conclusion: Men's self‐harm should be understood as a complex, socially and culturally conditioned phenomenon and studied from a multitude of perspectives. Impact: This scoping review concludes that self‐harm among men should be understood as a complex, socially and culturally conditioned phenomenon. To empower men and support their recovery from self‐harm, a person‐centred approach should be incorporated into research on the subject and practice. [ABSTRACT FROM AUTHOR]

We present a case of a 29-year-old male night watchman complaining of sudden decreased vision, redness, and tearing of the left eye. On anamnesis, trauma was denied and personal past history was relevant for right eye enucleation due to an “eye injury” 8 years prior. At presentation, his visual acuity was 20/200 and intraocular pressure (IOP) was 10 mmHg. Slit lamp examination revealed a 1-mm inferonasal corneal wound and a localized lens opacity associated with extrusion and posterior extension of cortical material in the same quadrant. Echography confirmed posterior lens capsular bag puncture with hyperechogenic material in the anterior vitreous. Intraocular foreign body was ruled out. Topical anti-inflammatory and cycloplegic treatment was initiated with partial visual recovery, IOP rise, moderate anterior chamber inflammatory reaction, and an emergent posterior subcapsular cataract. A pars plana vitrectomy and lensectomy were performed. After surgery and recovery, best-corrected visual acuity with contact lens was 20/15. The patient was followed for 6 years, during which he returned 6 more times with a variety of new findings, such as new corneal leukoma, leaking corneal wounds, hypotony, choroidal folds, and choroidal detachments, each time with full visual acuity recovery. Some cases of ocular injury and self-mutilation have been described in the context of various psychiatric disorders. Self-inflicted injuries were suspected due to substance abuse, although the patient denied doing so. Referral to a psychiatrist was insisted on several occasions without success. However, potentially life-threatening complications may arise; therefore, psychiatric referral is imperative.

The knowledge and confidence of nursing staff can impact re-harming rates of patients with self-harm injury. This service improvement study sought to address the knowledge, confidence and practice issues for staff nurses and healthcare assistants (HCAs) caring for patients who had presented to the emergency department (ED) with self-harm injury. The knowledge and confidence of nursing staff was reported using Likert-style questionnaires in a longitudinal study, framed within one Plan, Do, Study, Act (PDSA) cycle. Attitudes and challenges to patient care were also sought to inform future practice. The findings, based on the responses of 10 nurses and 5 HCAs, showed an increase in knowledge and confidence among both staff groups following the education session. Of the 15 who participated, 5 provided feedback to a reflective questionnaire to assess their views 30 days after the intervention. Quantitative data revealed a perception in an increase in the standard of care. The study found that both knowledge and confidence in supporting individuals presenting with self-harm in the ED improved at 30 days post-educational intervention. The numbers in the study were small and challenge transferability, however, service improvement theory is concerned with identifying measures of success rather than statistical reliability. [ABSTRACT FROM AUTHOR]

Objective: To analyze the trend of mortality from intentional self-harm in adults in Brazil, from 2008 to 2018. Methods: This is an ecological, time-series study of deaths from suicide in adults in Brazil and its regions. The following variables were used: age group from 20 to 59 years, gender, education, Brazilian regions and ICD-10 code related to intentionally self-harm (X60-X84). Data were obtained from the Mortality Information System database, made available by the Ministry of Health, in November 2020. For trend analysis, the statistical program R version 3.4.3 was used and the polynomial regression model was used. Results: Of the 61,846 deaths by suicide, a growing and significant temporal trend (p<0.05) was observed in all regions of the country. The temporal evolution was also increasing in both sexes and among individuals with eight or more years of schooling. In cases of death by hanging/suffocation, they increased in all regions of the country. Conclusion: With the significant increase in suicide evidenced in the country, the importance of implementing suicide prevention actions is highlighted, taking into account the specificities of occurrences in each region of the country. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore service-user perspectives of sensory approaches introduced and promoted by the trauma and self-injury service within the National High Secure Healthcare Service for Women (NHSHSW) at Rampton Hospital. Design/methodology/approach: This cross-sectional descriptive study used a semi-structured questionnaire, which was devised for this evaluation and included both open and closed questions. The data collected were then analysed using descriptive statistics and thematic analysis. Findings: The paper evaluates the current use of sensory approaches within the NHSHSW. Sensory approaches were widely used across the service, with essential oils being the most commonly used sensory approach. The use of sensory approaches can be understood according to the following three themes: independence, accessibility and self-regulation. The self-regulation theme contained three sub-themes as follows: safety-seeking, relaxation and reducing distress. The evaluation also highlighted barriers to using sensory approaches and sought service-user feedback as to how these may be overcome. Practical implications: Participants' feedback informed changes to practice, such as introducing sensory approaches to service-users earlier in their care pathway and increasing the accessibility of sensory items. These approaches may be of relevance to service provision in other forensic or inpatient settings. Originality/value: This paper offers a unique contribution to the current literature with its focus on using sensory approaches to ameliorate trauma symptoms, in the context of a forensic setting. [ABSTRACT FROM AUTHOR]

Self-injury is deemed a pathology and a deviant practice that is not socially sanctioned and culturally accepted as soothing and healing the self. The marked female body is also pathologized and perceived as deviant; hence, having self-inflicted scars may easily lead to social stigma, shame, and the need to hide the scars. In this personal reflection I explore how self-inflicted scars can have the same meaning as self-injury to control the self and act as self-expression, and how the marked female body can be a resistance to the cultural idea of femininity. I draw upon my own personal experiences of self-inflicted scars and how these scars have become intertwined with my identity. I have carved or burnt my body in different situations and from different moods in the past, but they are all with me at the present and will be with me in the future. Without the scars, I am not the person that others see me as or I see myself as. I sometimes feel that I would be nothing without my scars. [ABSTRACT FROM AUTHOR]

Purpose: Non-suicidal self-injury (NSSI) is associated with psychological disorders and suicidal thoughts and behaviours; disclosure of NSSI can serve as a catalyst for help-seeking and self-advocacy amongst people who have self-injured. This study aims to identify the socio-demographic, NSSI-related, socio-cognitive and socio-emotional correlates of NSSI disclosure. Given elevated rates of NSSI amongst university students, this study aimed to investigate these factors amongst this population. Design/methodology/approach: Australian university students (n = 573) completed online surveys; 80.2% had previously disclosed self-injury. Findings: NSSI disclosure was associated with having a mental illness diagnosis, intrapersonal NSSI functions, specifically marking distress and anti-dissociation, having physical scars from NSSI, greater perceived impact of NSSI, less expectation that NSSI would result in communication and greater social support from friends and significant others. Originality/value: Expanding on previous works in the area, this study incorporated cognitions about NSSI. The ways in which individuals think about the noticeability and impact of their NSSI, and the potential to gain support, are associated with the decision to disclose self-injury. Addressing the way individuals with lived experience consolidate these considerations could facilitate their agency in whether to disclose their NSSI and highlight considerations for health-care professionals working with clients who have lived experience of NSSI. [ABSTRACT FROM AUTHOR]

A history of suicide attempt (SA) is a strong predictor of future suicide re-attempts or suicide. The aim of this systematic review is to evaluate the efficacy of psychotherapeutic interventions specifically designed for the prevention of suicide re-attempts. A systematic search from 1980 to June 2020 was performed via the databases PubMed and Google Scholar. Only randomized controlled trials were included which clearly differentiated suicidal self-harm from non-suicidal self-injury in terms of intent to die. Moreover, psychotherapeutic interventions had to be focused on suicidal behaviour and the numbers of suicide re-attempts had to be used as outcome variables. By this procedure, 18 studies were identified. Statistical comparison of all studies revealed that psychotherapeutic interventions in general were significantly more efficacious than control conditions in reducing the risk of future suicidal behaviour nearly by a third. Separate analyses revealed that cognitive-behavioural therapy as well as two different psychodynamic approaches were significantly more efficacious than control conditions. Dialectical behaviour therapy and elementary problem-solving therapy were not superior to control conditions in reducing the number of SAs. However, methodological reasons may explain to some extent these negative results. Considering the great significance of suicidal behaviour, there is unquestionably an urgent need for further development of psychotherapeutic techniques for the prevention of suicide re-attempts. Based on the encouraging results of this systematic review, it can be assumed that laying the focus on suicidal episodes might be the key intervention for preventing suicide re-attempts and suicides. [ABSTRACT FROM AUTHOR]

Background: The Benefits and Barriers Model proposes both benefits and barriers associated with nonsuicidal self‐injury (NSSI) and that a negative association with the self plays a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added benefit of targeting self‐criticism in the treatment of NSSI. Methods: Sample included 40 participants (30 females; Mage = 14.92) enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to decrease self‐criticism. Results: There was no evidence of an indirect effect of targeting self‐criticism upon NSSI at post‐treatment via post‐treatment self‐criticism (b = −0.98, p =.543); however, there was evidence of a significant interaction between treatment condition and self‐criticism at pretreatment in the prediction of NSSI at post‐treatment (b = 0.33, p =.030). Analyses of simple slopes indicated the conditional direct effect of targeting self‐criticism varied as a function of patient's level of self‐criticism at the onset of treatment, such that individuals −1 SD below the mean (b = −5.76, p=.037) and at average pretreatment levels of self‐criticism (b = −4.09, p=.042), but not + 1 SD above the mean (b = −2.42, p=.056), experienced fewer incidents of NSSI at post‐treatment. Conclusions: The results of this investigation support the added benefit of targeting self‐criticism in the treatment of NSSI for adolescents. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the experience of family relationships in an adult self‐harm population. Relationships are concerned with the connection between two or more individuals and therefore a multi‐perspective phenomenological design was employed to explore the perspectives of both adults who self‐harm and their family members. Semi‐structured interviews were conducted with twelve adults: six who attend a community mental health service and engage in self‐harm and six of their family members. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Four superordinate themes emerged within the data: family and societal culture, coping with traumatic relationships, inner conflict and the generational impact. Findings highlight the importance of considering family relationships in the treatment of self‐harm in adults. The impact of self‐harm on family members is also illuminated, in addition to the need to develop and assess interventions for family members. Practitioner points: Self‐harm in adults can impact family units as a whole, resulting in changes in family dynamics and conflicting emotions of fear, resentment and empathy in family membersPreliminary research suggests that interventions examining the role of family dynamics and their relationship with self‐harming behaviours may be beneficialEducation and interventions are needed for families of such adults to help build their awareness of self‐harmThis helps families address complex emotions such as guilt, shame and resentment which have been found to arise in this cohort [ABSTRACT FROM AUTHOR]

Introduction: The epidemiology of adolescent self-harming behaviors is important. One of the common concerns today is the prevalence and persistence of self-injurious behaviors among adolescents. Aim: The aim of this study was to determine the prevalence and functions of self-harming behaviors in adolescents. Method: The present study was a descriptive study. The statistical population of the study was all adolescents aged 15-18 in Sanandaj in the years 2018-2019. Sampling method was Cluster. Using the Klonsky and Glenn Self-Injurious Behaviors and Functions Scale, 1334 subjects (686 girls and 648 boys) were selected. Using Chi-square and Independent T-test statistical method, using SPSS software version 25. Results: The results showed that the prevalence rate of self-injurious behaviors among girls and boys was 9.6% and 7.1%. Girls self-injurious behaviors were more invisible (Χ²=6.37, P<0.009) and irregular (Χ²=14.36, P<0.001) than boys. The highest frequency of self-injurious behaviors included: self-inflicted cutting, hitting and annoying self-talk. Also, the function of girls and boys self-injurious behaviors was intrapersonal and interpersonal (T=2.18, P<0.05). Conclusion: The results of this study showed that the adolescent girls had more self-injurious behaviors than boys. And the prevalence of self-injurious behaviors in adolescents is increasing, which should be taken into account. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore whether depression symptoms mediate the relationships between perceptions of social support from three sources; namely parents, teachers, and peers, and non-suicidal self-injury (NSSI) and suicidal ideation. We also tested the interactions between the different sources of support. Focusing on the Arab-Israeli population is unique as it is an ethnic minority characterized with strong familial support, and less access to mental health services compared to the ethnic majority. Adolescents (N = 276; 65.6% girls; mean age 15.1 years) from the Arab minority in northern Israel were sampled (74% response rate). Participants were evaluated using validated scales assessing perceived social support, NSSI and suicidal ideation. Path analysis with Bayesian estimation supported the hypothesized model. Depression symptoms fully mediated the relationships between school-related social support (i.e., teachers and peers) and NSSI, and partially between parents' support and suicidal ideation. Interactions between the social support sources were not significant, and cluster analysis indicated that each source is independently essential to understand NSSI and suicide ideation. This model emphasizes the importance of school-related factors in adolescents' particular aspects of mental health, and suggests that one source of social support may not compensate for a lack of another. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the experience of living with scars from self-injury; how people who self-injure (SI) make meaning of their scars and how these scars are a part of the identity construction process. Design/methodology/approach: It is observed that 60 entries, from 25 online narrative blogs detailing the experience of living with self-injury scars, were analyzed using a contextualized thematic analysis informed by an embodied perspective. Findings: The analysis generated two dominant themes: temporal aspects of identity; and social stigma and scars. Originality/value: Far-reaching consequences of self-injury scars on the daily lives of people who SI was found. This included a person's posture, clothing, choices of career, inclusion in family life, leisure activities and relationships; all of which have corollaries in emotional and psychological well-being. Scars were found to be self-narrative with particular salience given to how scars represented healing. Novel findings included the central role scars played in the resistance of self-injury stigma. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trivium (2176-4891) is the property of Mestrado Profissional em Psicanalise, Saude e Sociedade da Universidade Veiga de Almeida and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare. Self-injury in males and sex differences are poorly understood. This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury. Data came from a Swiss prospective-longitudinal cohort study (N = 1482). Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20. Between ages 13–20, 27% of adolescents reported self-injury at least once. In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20). In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] < 3 to OR > 10); in females, recurrence was high from age 13 onwards (OR > 5). Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset. Typically, less than half of adolescents with self-injury used mental health services. Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization. Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization. There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use. Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury. Males are at particular risk of not receiving adequate treatment for self-injury. [ABSTRACT FROM AUTHOR]

According to Social Cognitive Theory, the anticipated consequences of a behavior (outcome expectancies), coupled with our belief in our ability to successfully perform the behavior (self-efficacy), determine the likelihood of engagement in a behavior. We explored whether the relationship between nonsuicidal self-injury outcome expectancies and self-injury was moderated by self-efficacy to resist nonsuicidal self-injury. Participants: Five hundred and sixteen college students aged 18–26 years (M = 20.60, SD = 1.86). Methods: Self-report measures were completed online. Results: The relationship between expecting self-injury would result in pain or emotion regulation and engaging in self-injury was moderated by a belief in the ability to resist self-injury. People who had never self-injured were more likely to believe that self-injury would cause physical pain and believe they could resist self-injury. A belief in the ability to resist self-injury countered expectations that self-injury would result in emotion regulation. Conclusion: Results may inform college-based prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Background: Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods: We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. Results: Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63). Conclusions: DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI. [ABSTRACT FROM AUTHOR]

We present a case of a 29-year-old male night watchman complaining of sudden decreased vision, redness, and tearing of the left eye. On anamnesis, trauma was denied and personal past history was relevant for right eye enucleation due to an "eye injury" 8 years prior. At presentation, his visual acuity was 20/200 and intraocular pressure (IOP) was 10 mmHg. Slit lamp examination revealed a 1-mm inferonasal corneal wound and a localized lens opacity associated with extrusion and posterior extension of cortical material in the same quadrant. Echography confirmed posterior lens capsular bag puncture with hyperechogenic material in the anterior vitreous. Intraocular foreign body was ruled out. Topical anti-inflammatory and cycloplegic treatment was initiated with partial visual recovery, IOP rise, moderate anterior chamber inflammatory reaction, and an emergent posterior subcapsular cataract. A pars plana vitrectomy and lensectomy were performed. After surgery and recovery, best-corrected visual acuity with contact lens was 20/15. The patient was followed for 6 years, during which he returned 6 more times with a variety of new findings, such as new corneal leukoma, leaking corneal wounds, hypotony, choroidal folds, and choroidal detachments, each time with full visual acuity recovery. Some cases of ocular injury and self-mutilation have been described in the context of various psychiatric disorders. Self-inflicted injuries were suspected due to substance abuse, although the patient denied doing so. Referral to a psychiatrist was insisted on several occasions without success. However, potentially life-threatening complications may arise; therefore, psychiatric referral is imperative. [ABSTRACT FROM AUTHOR]

Nonsuicidal self‐injury(NSSI) is a behavioural concern and can present in diverse ways, varying by method, frequency, severity, function and so forth. The possible combinations of these features of NSSI produce an array of profiles that makes evaluation and management of this behaviour challenging. The aim of this study was to build upon previous work that reduces the heterogeneity of NSSI patterns by using latent class analysis (LCA) to identify a typology of NSSI. Participants consisted of 235 outpatients aged 14–35 years attending a tertiary psychiatric hospital in Singapore who had reported at least one NSSI behaviour within the last year. Eight indicators captured using the Functional Assessment of Self‐Mutilation were used in the LCA: frequency of NSSI, length of contemplation before engaging in NSSI, usage of more than three NSSI methods, suicidal ideation and four psychological functions of NSSI, that is, social‐positive, social‐negative, automatic‐positive and automatic‐negative. The LCA revealed three distinct groups: Class 1—Experimental/Mild NSSI, Class 2—Multiple functions NSSI/Low Suicide Ideation and Class 3—Multiplefunctions NSSI/Possible Suicide Ideation. Multinomial logistic regression analyses were conducted to examine the associations between class membership and sociodemographic variables as well as measures of emotion dysregulation, childhood trauma, depression and quality of life. Females were overrepresented in Class 3. In general, Class 3 had the poorest scores followed by Class 2. Our analyses suggest that different NSSI subtypes require different treatment indications. Profiling patterns of NSSI may be a potentially useful step in guiding treatment plans and strategies. [ABSTRACT FROM AUTHOR]