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1
Morris, Charlotte. "Emotion and self-harm." Thesis, Lancaster University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.587076.
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This narrative review draws upon a broad range of literature, including theory and empirical research, to argue that positive emotions are a useful adjunct to therapy when working with individuals who self-harm. The review highlights how self-harm is often employed as a method of emotion regulation and may be both negatively and positively reinforced. It is suggested that individuals who self-harm have potential difficulty in experiencing positive and negative emotions. The compatibility of an emotion focused approach to therapy for individuals who self harm is therefore deemed an appropriate one. , However, current therapeutic models predominantly focus on unpleasant or negative emotions and tend to neglect positive emotions, such as happiness. Broaden and build theory indicates that positive emotions can reduce the effects of negative emotions and aid recovery from intolerable negative emotions which may underpin self-harming behaviours. Therefore, the incorporation of positive emotions into therapy is likely to be salutary. In addition, if cultivated over time positive emotions, can help build resilience which may enable individuals to better cope with events which precipitate self-injurious behaviours. The review emphasises how positive emotions represent a valuable addition to therapeutic work but that the negatively valenced and painful emotions often experienced by those who self-injure must also be addressed.
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Geulayov, Galit. "The impact of parental self-harm on offspring's self-harm, mental health and educational performance." Thesis, University of Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683911.
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Studies have reported that offspring exposed to parental suicidal behaviours are at risk of a variety of problems, most notably, suicidal behaviours and affective disorders. Research to date has largely focussed on the impact of parental suicide and has been bas,ed on populations in contact with psychiatric services. Most studies have addressed offspring suicidal behaviour as an outcome; little is known about the impact of parental suicidal behaviours on other aspects of their children's wellbeing. This thesis aims to investigate the association of parental self-harm with selfharm, suicidal thoughts, depression, and academic performance in their offspring in a community-based prospective birth cohort - the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental suicide attempt was self-reported on 10 occasions from pregnancy until the children were 11 years old. Children self-reported lifetime self-harm and suicidal thoughts at age 16-17 years. Symptoms of depression we're self-reported at age 10, 13, and 16-17 years. Academic performance was based on results from two national assessment exercises conducted at age 11-16 years. The analytic sample varies according to the exposure and outcomes being assessed but as an example: 4,396 mother-child and 2,541 father-child pairs were included in the analysis of the association of parental suicide attempt and offspring self-harm. Controlling for relevant confounders, maternal suicide attempt was associated with a 3-fold increased odds of self-harm with suicidal intent in their offspring [Adjusted odds ratio (aOR) 2.94, 95% confidence interval (CI) 1.43-6.07] but not with self-harm without suicidal intent (aOR 0.83, 95% CI 0.35-1.99). Offspring whose mother had attempted suicide were at an increased risk of suicidal thoughts and plans (aOR 5.04, 95% ,CI 2.24-11.36; aOR 2.17,95% CI 1.07-4.38, respectively). Findings in relation to paternal suicide attempt were similar to those of maternal suicide attempt, but were somewhat weaker and consistent with chance. Offspring whose mother had attempted suicide had also 26% higher mean score of symptoms of depression in adolescence relative to unexposed offspring (P=1.26, 95% CI 1.05 to 1.51, p=O.01). Paternal suicide attempt was associated with somewhat elevated mean score of depression but the evidence was weak and mostly consistent with chance. Adolescents whose mother had attempted suicide were less likely than their peers to achieve level five or above in English, Maths and Science combined at age 14 years (aOR 0.65,95% CI 0.43-0.97) and less likely to obtain five or more qualifications (i.e. GCSEs/GNVQs) at a top grade by age 16 years (aOR 0.41,95% CIO.17-0.96). Paternal suicide attempt was inversely associated with their offspring's likelihood of obtaining at least five qualifications by age 16 years (aOR 0.16, 95% CI 0.06-0.46). This thesis demonstrates that non-fatal suicidal behaviours in parents represent a major risk of psychiatric morbidity and poorer academic performance in their offspring. It suggests that interventions aimed at individuals with suicidal behaviours should identify individuals with parenting responsibilities and assess the needs of their children as well.
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Jomar, K. "A measure of positive and negative self-harm beliefs : the Self-Harm Beliefs Scale (SHBS)." Thesis, University of Liverpool, 2016. http://livrepository.liverpool.ac.uk/3003371/.
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Objectives: The current study aimed to develop a measure of positive and negative beliefs in non-suicidal self-injury (NSSI), the Self-Harm Beliefs Scale (SHBS). A secondary aim was to explore the impact of these beliefs on NSSI behaviour. Design: The study adopted a cross-sectional design. Methods: Adults (n=98) with a history of NSSI were recruited from general and clinical populations across the North-West of England. The relationship between beliefs and NSSI behaviour (i.e. current NSSI, NSSI severity and future likelihood of NSSI) were assessed. The impact of NSSI beliefs on shame and mental well-being were also explored. Results: The SHBS demonstrated good reliability and convergent validity. Individuals with current and historic experience of self-harm endorsed positive and negative beliefs about NSSI. Increased endorsement of positive beliefs appeared to predict current NSSI behaviour as well as future likelihood of NSSI. Both positive and negative beliefs were significant predictors of shame however, only negative beliefs significantly predicted mentalwell-being. NSSI beliefs did not appear to significantly predict NSSI severity. Conclusions: The SHBS is a reliable and valid measure of beliefs about NSSI and presents as a useful clinical and research tool. Exploring NSSI beliefs appears important for better understanding the maintenance of NSSI and improving treatment approaches for this population.
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Forrester, R. "Me, myself and self-harm : an investigation of the influences of self-perceptions in self-harm and recovery." Thesis, University of Liverpool, 2016. http://livrepository.liverpool.ac.uk/3003513/.
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Non-suicidal self-injury (NSSI) is a destructive act to oneself that may be related to low self-esteem. However, little is known about the nature of this relationship in adulthood. Therefore, this review synthesized the available literature. Articles were independently identified and risk of bias assessed by two reviewers searching PsycINFO, CINAHL, Medline and Web of Science databases. Inclusion criteria were: (1) a mean sample age of eighteen years or over (2) full manuscripts available in English (3) assessment(s) of NSSI (4) assessment(s) of self-esteem. Nineteen studies were identified and indicated a significant relationship between low self-esteem and NSSI. Results suggested that although low self-esteem and NSSI are related, there are a number of factors which also influence this relationship. It will be important for clinicians to consider the impact of self-esteem in those seeking support for NSSI. Further research should undertake longitudinal research to better understand the self-esteem and NSSI relationship.
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Latina, Delia. "Self-harm : interpersonal and holistic perspectives." Doctoral thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-47312.
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Who are the adolescents who purposely cut or burn their wrists, arms, or some other parts of their body? The fundamental question I raise in this dissertation is whether or not the portrait of self-harming adolescents as being exposed to others’ hostility in their everyday life environments and experiencing internal adjustment problems, particularly depressive symptoms, correctly represents their symptomology. I want to answer three questions: 1) What can be done to interrupt the maladaptive link that leads adolescents who experience internalizing symptoms to perform self-harming behaviors? 2) Are adolescent self-harmers typically exposed to others’ hostility or are they also involved in hostile interactions with other people? and, 3) What are the critical interpersonal and adjustment features of adolescent selfharmers? The results show that: 1) Adolescent girls with high depressive symptoms who feel at ease communicating with their parents do not use selfharm as a coping strategy when facing negative emotional experiences to the same extent as girls with high depressive symptoms who do not experience communication with parents as easy; 2) Adolescents who are involved in mutually hostile relationships with people who they meet in their daily life express more self-harming behaviors than adolescents who are exposed to others’ hostility; and, 3) Living in mutually hostile interactions with other people and experiencing both internalizing and externalizing problems seem to be key features of adolescents who harm themselves. Taken together, the results of this dissertation go beyond the traditional representation of selfharmers, and offer a holistic way of identifying a problem scenario under which adolescents self-harm. Implications for theory and practice are discussed.
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Marriott, Lucy C. "Self-harm : virtual and educational environments." Thesis, Bangor University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.573118.
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The current thesis explores self-harm in educational and virtual environments. It consists of three papers 1) a literature review 'The Nature and Effects of Self-Harm Websites: a Review ofthe Literature'; 2) a research paper 'Secondary School Teachers' Perceptions of Pupils' Self-harm: A Foucauldian Discourse Analysis'; and 3) a discussion paper 'Contribution to Theory and Clinical Practice'. The literature review found that sites with self-harm content were easily accessible, and found across a variety of mediums including personal/peer driven sites, self-help resources, discussion forums, YouTube, and social networking sites. .,; Individuals using the sites found they provided support and a sense of community and identity. However, self-harm sites may inadvertently maintain self-harming behaviour through its normalisation, and some sites contained material that might trigger self-harm. It is recommended that professionals working with individuals who self-harm should have an awareness of the sites available, assess their client's on-line activities, and where appropriate, allow them to explore their online-experiences in sessions. Through semi-structured interviews, the research paper explores how six secondary school teachers conceptualise self-harm. Foucauldian Discourse Analysis illuminated four discourses: (1) Self-harm transgresses social norms; (2) Self-harm and explanatory discourses; (3) Surveillance and reporting; and (4) Problematising responding. Teachers positioned themselves as responsible for supporting pupils who self-harm. It is recommended that the results are used to develop teachers' support and training programmes. The discussion paper focuses on how educational environments can provide appropriate support to pupils who self-harm, incorporating findings from the literature review regarding the use of self-harm websites. It includes a reflective commentary exploring the author's experiences of preparing the thesis and its contribution to her learning. It is hoped that this thesis will contribute to achieving better outcomes for people who self-harm.
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Klineberg, Emily. "Self-harm in East London adolescents." Thesis, Queen Mary, University of London, 2010. http://qmro.qmul.ac.uk/xmlui/handle/123456789/521.
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The prevalence of adolescent self-harm is higher in the community compared with self-harm monitored through service use, as only a minority of young people seek help. There has been limited longitudinal community-based research on adolescent self-harm, particularly in ethnic minorities. This research aimed to explore self-harm in an ethnically diverse sample of adolescents, with particular focus on social and psychological factors. Two studies were conducted with a sample of East London adolescents to examine the prevalence, risk and protective factors for self-harm, and to explore how young people talk about self-harm. The first involved analysis of longitudinal data from Phases 2 and 3 of RELACHS, a school-based study on adolescent health. In Phase 3, 1023 participants aged15-16 completed self-report surveys. The second, qualitative study explored self-harm in the context of East London adolescent life. Thirty interviews were conducted with 15-16 year olds, 20 of whom had self-harmed. The 12 month prevalence of self-harm was 10.6% for girls and 3.4% for boys (7.3% in total). Regression analysis showed self-harm was strongly associated with current and previous depressive symptoms, conduct problems, low support from family, low parental warmth and high maternal strictness. Relationships with borderline psychological distress indicate that self-harm is not limited to those with serious mental health problems. The qualitative study showed that definitions and experiences of self-harm varied. It was viewed as difficult to comprehend by those who had never done it, and also some who had. Many participants were hesitant to identify themselves as having self-harmed and explained reluctance to disclose self-harm to others. The qualitative study showed no evidence that self-harm was more acceptable in any ethnic group. However, for some, family and cultural restrictions exacerbated other stressors. The results of these two studies complement each other, providing further insight into self-harm in East London adolescents. Findings could inform the development of an intervention about self-harm and emotional well being for adolescents.
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Harrison, Poppy. "Assessing the harm inside : a study contextualising boys' self-harm in custody." Thesis, University of Bedfordshire, 2016. http://hdl.handle.net/10547/622024.
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Concerns about suicide and self-harm in English prisons are not new (Third report of the commissioners of prisons, 1880, cited in Liebling, 1992). However, a distinct system of intervention and custody for children (as established by the Crime and Disorder Act 1998) is relatively modern, and as such contextual studies about self-harm have largely, to date, overlooked children as a discrete group existing within a separate framework from adults. Similarly, large-scale research exploring self-harm among children in community settings has largely excluded the group of marginalised young people who come to the attention of youth justice services. This study presents a unique analysis of 181 youth justice assessments (‘Assets’) for boys who were remanded or sentenced to custody in under-18 Young Offender Institutions during 2014-15, tracing the subjects of the assessments from the communities they offended in through to a period in custody, using incident reports completed whilst they were there. What results is a contextual study examining the characteristics of the boys and their behaviour in custody. The study considers two central hypotheses: first, that to result in meaningful and supportive interventions, a definition of self-harm among the boys in the research sample often needs to include the harm they have done to their own lives (what the middle classes might call their ‘prospects’) through offending, and, second, that children who display the common traits of self-harming behaviour in custody may be identifiable by a different set of characteristics and needs from those who self-harm in the community. The author concludes that there is a previously undefined set of risk factors which can be applied to children who self-harm in custody for the first time, moving beyond the known risks associated with adolescent self-harm in the general population. Furthermore, it is found that boys who self-harm in custody are often oing so to exercise agency in an environment where they have very limited power, in circumstances defined not only by the restriction of liberty they are experiencing, but by the difficulties they experienced before coming to custody. Recommendations are made as to how policy-makers, through the current reforms to the youth justice system and a revised approach to assessments upon entry to custody, and practitioners, through increased awareness and improved recording of children’s views can more appropriately intervene in these boys’ lives to benefit them and society more widely.
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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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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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Suljevic, Selma, and Ida Marquardt. "Parental Attachment and Adolescent Self-harm: : A multidimensional approach examining patterns of attachment in relation to self-harm." Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52801.
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The study explored maternal and paternal attachment, taking a multidimensional approach, in relation to adolescent self-harm. Based on adolescents’ perception of their mothers and fathers availability, anger, and empathy, we examined what contribution of attachment was most predictive of self-harm separately and simultaneously. The sample included 564 Canadian high school students in grade 8 to 12. The quantitative survey was conducted on computers, and was from a three year longitudinal study, using the second and third annual assessments. Cross-sectionally, the results suggested low parental availability, anger toward mothers, and low empathy toward fathers to be related to self-harm. Longitudinal analysis did not support the hypotheses. In sum, attachment to mothers and fathers both contributed to the understanding of adolescent self-harm.
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Haughton, Rachel. "Self-harm in a youth offending population." Thesis, University of Nottingham, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.716484.
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The thesis investigates self-harm in a youth offending population, with particular focus on the coping strategies and levels of rumination utilised by these individuals. Chapter one provides an overview of the topic of self-harm, coping strategies and rumination in a youth offending population. Chapter two reviews the literature of coping strategies and levels of rumination in adolescents who self-harm following a systematic approach. The review highlighted there were inconsistencies in the definition used to describe self-harm, some studies included suicide attempts and included overdoses whereas other studies did not. A number of studies included behaviours irrespective of the intent to die, whereas others specified there should be no intent to die. These differences hinder the ability to make links between studies as well as ensuring that research is comparable throughout. Chapter two highlighted the limited research focusing on coping strategies and self-harm in youth offenders, with the majority of included studies using school based samples. Risk factors for self-harm were identified as psychological distress, rumination, poor problem solving, low self-esteem and limited social support. Chapter three investigated coping strategies and levels of rumination in a smaller subset of youth offenders. This highlighted that youth offenders who self-harmed utilised more emotion-focused coping styles such as: substance use, behavioural disengagement, denial and self-blame than youth offenders who did not self-harm. Difficulties identifying youth offenders who self-harmed was evident in the small sample size for the study. Chapter four involved a larger sample based on file information to aide identification of youth offenders who self-harmed. This research looked at identifying any differences between youth offenders who did and did not self-harm based on the ASSET (a risk and need assessment completed with all young people who come into contact with the youth offending team). These differences were utilised to inform a checklist of risk factors for males engaging in self-harm in a youth offending population which youth offending practitioners can use to identify those males at risk. The incidents of self-harm amongst male youth offenders was 4 cases in every 10 referrals (39.6%) and 69.5% of this group were correctly predicted (hits). The small number of female youth offenders who did not self-harm was evident in both chapter three and chapter four, highlighting that being a female youth offender in itself is a risk factor for self- harm. Chapter five described a single case study with a male youth offender who self-harmed and the difficulties in engaging this population in interventions. Chapter six is a critique of the ASSET used in chapter three, four and five. Chapter six describes the implications of the ASSET for practice and gives recommendations for future research in this area. Chapter seven gives a conclusion to the thesis, drawing together important implications for future research and practice.
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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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Patterson, William Paul. "Self harm : experiences and attitudes to care." Thesis, University of Liverpool, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399214.
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Health care professional's relationships with those who self harm have been found to be failing, characterised by negative staff attitudes leading to a phenomenon termed 'terminal malignant alienation' prior to client suicide (Morgan, 1979). Greater understanding of attitude and care experience is vital to enhancing care process and its outcomes. A mixed method approach was required to examine both meanings given to care experience and attitudes of a large group of qualified nurses attending post qualification courses. The phenomenology of the care experience of six participants, carer, clients and their nurses is the focus of Study 1. Four essential themes (van Mannen 1990) were derived; Trying Hard Getting No where (Past relating) Time Strain and Apprehension, Incongruent Relating and Acceptant Engagement. A transition in ways of relating is emergent in these themes and sub themes which is marked by movement from nurse/carer focus on control of self harm and the repeated experience of strain apprehension, avoidance and disempowerment, to greater acceptance of client experience. Shared responsibility and more authentic relationships are accompanied by diminished belief that self harm is a direct reflection of carer effort and competence. Study 2 describes both the development of a thirty item Self Harm Antipathy Scale (SHAS) and six attitude dimensions derived using exploratory factor analysis and a survey of attitudes to self harm (n=153). Between groups analysis using the Mann-Whitney test showed that; previous study of self harm and contact with self harming clients was associated with more positive attitudes (p<.05) and general nurses held more negative attitudes than participants with mental health qualifications. Gender and years of experience and age were not found to be related to attitudes to self harm (p>.05). Qualitative content analysis of written responses in the questionnaire informed by Carper (1978), revealed three main themes describing attitudes and perspectives on care; 'Need for knowledge understanding and skill; 'Care Strain; reactions and feelings '; 'Therapeutic Approach and Treatability '. Analysis revealed tension and contrast between awareness of professional care values, perceived competence and personal feelings. Study 3 investigated the effect on attitude of a post qualification course on self harm. In a quasi-experimental design utilising an intervention and comparison group, participant's attitudes were measured immediately on course commencement and twice following course completion. Analysis using within groups Wilcoxon test on post course scores (n=65) revealed less antipathy in the intervention group; scores were significantly lower on both the SHAS scale and 4 attitudes dimensions derived from factor analysis (p<.05); Care Futility; Client Intent; Rights and Responsibilities; Needs Function. The intervention group demonstrated more belief in the value of care, less critical motivational attributions and more recognition of client responsibility and need. In a comparison group (N=22), (no teaching on self harm), no significant difference was found between pre and post test SHAS on 5 of the 6 attitude dimensions (p>.05). It was concluded that attitude, perceived competence can be positively influenced by the educational intervention and optimise the potential to restore caring and therapeutic qualities to alienated relationships. Clinical supervision is recommended as a resource for enhancing practice and a means of promoting learning for those who cannot access formal courses on self harm.
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Tett, Holly. "Understanding how self-harm functions for individuals." Thesis, Canterbury Christ Church University, 2017. http://create.canterbury.ac.uk/16359/.
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The study aimed to develop a theory of the possible links between voice-hearing and self-harm. Twelve semi-structured interviews were conducted with participants living in the community and in a secure forensic setting. All participants had experience of both voice-hearing and self-harm. A grounded theory of possible links was developed from participants’ accounts of their experiences. All participants described self-harm as way of coping with negative voices and of regulating painful emotions. Some described it as a response to a fear of judgement from others, as a form of control or as a means of seeking help. The results suggest that there are numerous links between voice-hearing and self-harm. Predominantly, self-harm seems to function as a way to cope with individual voice-hearing experience. Help should focus on triggers to distress and ways to cope. Training for healthcare staff could usefully be provided by service users, focusing on the importance of being non-judgemental. Future research could examine tactile and visual experiences in relation to self-harm too, clinician perspectives on the links between voice-hearing and self-harm, and service user perspectives on the emotional availability of clinicians.
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Isbister, Chloe. "Young people, self-harm and help-seeking." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12505/.
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Given the high rates of completed suicide and poor help-seeking among young men, this research explored how young men, who had successfully sought help from a Child and Adolescent Mental Health Service (CAMHS), experienced help-seeking. This study focused on the factors that facilitated initial access and on-going engagement in services. Eight young men between the ages of 16-18, who had entered CAMHS following self-harm or suicidal ideation, and who were engaged in on-going therapy, were recruited. Each young man was interviewed to elicit his personal experiences of help-seeking and help-receiving. Interviews were transcribed and subjected to Interpretative Phenomenological Analysis. Five dominant themes, that overarched participant’s individual experiences, emerged from the data: Role of external adult in recognising, normalising and initiating help seeking; Influence of another;Challenging and renegotiating perception of need for help and meaning behind this need; Change in perspective; Maintaining an independent self; Mechanisms of engagement and Shared experience. Help-seeking was described as a journey of two stages; 1) initial access and 2) on-going engagement, during which the presence and timing of external influences (parents, teachers) and internal influences (personal beliefs and attitudes) were crucial. A model of help-seeking is presented. This study is the first of its kind to consider factors that facilitate the help-seeking journey of young men aged 16-18 following self-harm. It highlights the need for provision of information to parents and teachers about how to identify need and ways to facilitate access to services. Information and guidelines on how to adapt services to meet the complex developmental needs of young men, is highlighted for service developers, commissioners and clinicians.
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Jamieson, John Hill. "A critical 'insider' story of self-harm." Thesis, University of Newcastle upon Tyne, 2015. http://hdl.handle.net/10443/2858.
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This thesis is a qualitative study of self-harm employing a theoretical framework somewhere between social constructionist and critical realist. For some time I had been of the view that not enough was being done to successfully support and intervene in the lives of those who engaged in self-harming. There seemed to be a gap in the research literature and clinical practice which could possibly be filled by seeking answers to research questions such as: What meanings can be extracted from data on self-harm provided by individuals who considered that they had never self-harmed, had mildly or moderately self-harmed, or, who had seriously self-harmed? What is self-harm from a phenomenological and functional point of view? Has the phenomenon of self-harm been appropriately named and defined? What implications might there be for support and intervention, and staff training? The method of open, unstructured discussion rather than structured or semi-structured interviewing for collection of raw data was used, and the principal analytic tool was thematic analysis upon which were grafted parts of other qualitative methods such as narrative analysis and interpretative phenomenological analysis. Findings and conclusions included the following:- Piloting work produced 8 themes (addiction, control, coping, depression, emotion regulation, anti-suicide, suicide, and miscellaneous) and the main study added at least 11 more (purpose in life, pain, punishment, attention-seeking, unattractive/attractive, attacking to be attacked, communication, cry for help, dissociation/depersonalisation, someone to look after, and, manipulation). Four overarching themes were identified. First, what self-harm is – culturally unacceptable self-harming activities (CUSHAS) and culturally acceptable self-harming activities 5 (CASHAS); secondly, causes and functions; thirdly, support and intervention; and, fourthly, contradictions or dilemmas. From these overarching themes, and associated data extracts, synoptic stories on each of the six main study participants were assembled. A new name for self-harm was produced, namely, body self-harm or body self-harming (BSH) and a new definition: Body self-harming is behaviour which occurs when individuals, intentionally or unintentionally, give precedence to their mental health over their physical health by the process of damaging their own bodies. And, the beginnings of a new conceptual framework were put forward. Conclusions were reached about support and intervention which, I argued, could usefully take a form that was not necessarily different from what might be required by anyone in need of psychological assistance, irrespective of the presenting issues. Finally, some suggestions were made about staff training which would consider culturally acceptable and unacceptable Body self-harming activities (CABSHAS and CUBSHAS) as essentially similar phenomena.
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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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Lamb, Christina S. "Shame and self harm in Axis II disorders." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/24805.
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Self harm is a challenging clinical problem within the health services. Although it has attracted a great deal of research attention, the majority of this research would appear to be descriptive in nature, with limited knowledge relating to the actual experience and function of self harm. It is suggested that one of the reasons that individuals engage in self harm is to be relieved of negative emotions (Brown, 2003). One emotion that is thought to play a significant role in self harm is shame (Wise, 1989). Further to this, self harm behaviour is found to be prevalent in the Axis II disorder (Personality Disorder) client group (Dulit et al., 1994). However, the fact that not all individuals engage in self harm behaviour, would suggest that certain mediating factors may exist. The hypotheses that were explored stated that individuals who have a personality disorder and who self harm, will experience higher levels of internal shame, and report more active shame schemas than those with a personality disorder who do not self harm. It was also hypothesised that in those who self harm, the frequency of self harm would be related to the levels of shame. The results of the study were analysed, and are discussed with reference to related theories and literature. Two case examples are also reported. The findings of this study suggested that there were no differences in shame between individuals with a personality disorder who self harm and those who do not self harm. The findings also indicated that there was no relationship between the frequency of self harm and shame. However, during the course of analysis, there was some evidence of a relationship between the recency of self harm and the level of shame. Methodological issues and conclusions are discussed.
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Precious, Yasmine. "The impact of the internet on self-harm." Thesis, University of Hertfordshire, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606826.
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This study aimed to investigate the qualitative nature of two different self-harm internet websites (professionally-led and user-led websites) using thematic content analysis (TCA). The second phase of the study posted questionnaires onto both websites to explore participants’ experiences of using self-harm websites and to investigate any relationships between the cultures of the websites and participants’ reports from the questionnaires. The second part of the questionnaire investigated individuals’ views regarding the type of professional support they would ideally like to receive for help with their self-harm. Particular interest was placed on respondents’ views on internet-based ‘professional’ help and whether they regarded it more or less beneficial than traditional face-to-face support (e.g. community mental health teams). The TCA revealed similar cultures between the professionally-led and user led self-harm websites and some subtle thematic differences. The majority of participants’ responses to the questionnaire revealed that they would favour internet based support for self-harm, moderated by both professionals and trained service-uses over face-to-face support. The limitations of the study were noted, with suggestions for future research. Finally, important implications of the research findings for service delivery were provided.
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Sambath, A. "'The inner scar' : women's experience of self-harm." Thesis, City, University of London, 2016. http://openaccess.city.ac.uk/16040/.
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South Asian women in the United Kingdom have shown higher rates of self-harm compared to their white counterparts and Asian men. However, only a few studies have attempted to use in-depth exploration on an individual level to understand the reasons behind this. The empirical study aimed to explore the subjective experience and meaning of self-harm from South Asian women’s perspectives. It sought to appraise how they understood and made sense of their experience and the factors contributing to their self-harm using a qualitative phenomenological methodology. Five South Asian women, representing a non-clinical sample, were interviewed and their accounts were analysed using Interpretative Phenomenological Analysis (IPA: Smith, 2008). Four master themes, highlighting the women’s experiences of self-harm, their understanding of the contributory factors, and their opinion of support services, emerged. In line with previous research, the study found self-harm to be a method of emotional regulation and a logical response to the distress these women faced in their lives. However, new meanings and understandings specific to South Asian women were also discovered. For instance, self-harm was perceived by these women as a friend; in other words, as a means of compensating for the loss of a visible companion in their lives. Self-harm’s covert style was acknowledged as a significant means of surviving within the context of South Asian culture. Most pertinent and embedded in the study’s findings was the concept of Family honour, otherwise understood as the South Asian cultural code of conduct and law of ‘Izzat’. The concept was recognised as a subtle yet pertinent and underlying influence behind why the women chose to self-harm. These findings have not been produced by previous research, bringing forth novelty to the field. Furthermore, self-harm was experienced as a double-edged sword; this was considered to maintain and perhaps explain the increased rate of suicide following self-harm in this population. Participants’ experiences and opinions of support services were also taken into account. Their suggestions and experience helped the study inform clinical practitioners working with South Asian women to approach interventions differently. Limitations to the study and recommendations for future research have also been outlined.
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Batey, Helen Elizabeth. "Intrusive thoughts, mindfulness and dissociation in self-harm." Thesis, University of Plymouth, 2011. http://hdl.handle.net/10026.1/484.
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This thesis presents four studies that examine the potential role that intrusive thoughts, dissociation and mindfulness in self-harming behaviours in young people and adults. A large online study was conducted with students and staff at a UK university. This examined a range of risk factors for self-harm derived from the literature, including dissociation, family background/trauma history and intrusive thoughts. This study was followed up with a qualitative study investigating triggers of self-harm, and the role of intrusive thoughts. A third study then looked at these factors in young people who were inpatients in an American psychiatric hospital, and who had all expressed intent to self- harm or commit suicide. This study also introduced a measure of trait mindfulness in order to investigate this potential way of dealing with intrusive thoughts. Finally, the risk factors identified in these studies were further investigated with an online survey with undergraduate students at a second UK university, dissociation, mindfulness and thought suppression. Intrusive thoughts were found to differ in content, frequency and effect between people with experience of self-harm and those without. A subgroup of potentially maladaptive behaviours were found to be associated with high scores on the predictors of self-harm, and therefore potentially predictive of self-harm. In the young people in hospital, the extent to which they reacted to their intrusive thoughts was inversely associated with the extent to which they were naturally mindful. Trait mindfulness scores were lower for those individuals with a history of childhood trauma, and for those meeting diagnostic criteria for Borderline Personality Disorder, in which self-harm is a key feature. These findings together suggest that mindfulness skills may play an important role in both dealing with intrusive thoughts and for protecting against self-harm. Overall, intrusive thoughts and dissociation were associated with experience of self- harming behaviours, while mindfulness skills were negatively associated with self-harm. Some potentially maladaptive behaviours (including smoking and eating pathology) represent risk factors for self-harm, and therefore may provide professionals with a way of identifying people for early intervention, if further longitudinal research shows evidence of progression. Alternatively, the differences in mindfulness between this group and the self-harmers may indicate that mindfulness training could benefit people who self-harm.
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Barber-Lomax, Lisa. "Attitudes and change in suicidality and self harm." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/3203/.
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This thesis comprises two volumes, representing the research and clinical components submitted to the University of Birmingham in partial fulfillment of the degree of Doctor of Clinical Psychology (D.ClinPsy). The first volume is the research component and contains three papers. The first paper is a literature review of research into healthcare professionals’ attitudes towards working with suicidality and people who self-harm. The review considers the presence and type of attitudes, followed by possible mediating factors. The second paper is an empirical study which describes the rationale, process and results of a Mindfulness based intervention on reducing vulnerability to suicidality in young adults. The study adopts a mixed methods approach, and analyses self-report questionnaire data using the reliable change index, and semi-structured interview data using template analysis. The third paper describes the literature review and empirical paper in language appropriate for dissemination to the general public. The second volume is the clinical component containing four Clinical Practice Reports. They include a paper which formulates a client’s case from two different psychological perspectives, a service evaluation, a single case experimental design and a case study. The fifth report is an abstract, describing a clinical presentation of a case study.
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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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Rowland, Chloe Margaret. "The experiences of stopping self-harm in adults." Thesis, University of Hull, 2014. http://hydra.hull.ac.uk/resources/hull:10893.
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The portfolio has three parts. Parts one and two are conceptually linked by their focus on self-harm and the cessation of the practice. Part one is a systematic literature review. Each individual’s self-harm experience is unique to them but there has been research that has shown that there are similarities between each experience. The systematic literature review examines the views and experiences of those who practice the behaviour with a view to identifying any similarities and discrepancies. Part two is an empirical paper. The therapies that have been studied for their effect on self-harm behaviours have failed to yield results that show that any one approach is consistent in decreasing the frequency and/or intensity of the behaviour. The empirical paper reports a study that explored the experiences of 8 adults who had previously self-harmed but no longer did so. It was hoped that the themes and any commonalities between the experiences would provide insight into what is poignant for the individuals when stopping the behaviour and that this would contribute to the on-going work helping people to no longer use the behaviour. Part three comprises the appendices.
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Mynhier, Christopher Ryan, and L. Lee Glenn. "Antipathy Towards Self-Harm Patients and Nurse Education." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7506.
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Chirico, Marie M. "Relationship Between Internal Homonegativity and Self-Harm Behaviors." Cleveland State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=csu1346624358.
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Punter, E. "The rejected self : young people's experiences of self-hatred, self-harm and finding acceptance." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/20261/.
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The aim of this study was to investigate how individuals with a history of adolescent self-harm perceive their experience of repetitive self-harm. This study explores the experiences of young people who engaged in repetitive self-harm during adolescence but have subsequently stopped. Due to the lack of qualitative research on this topic and the potential for stigma relating to self harm, it was considered pertinent to focus on individuals’ lived experience. Seven female participants (aged 22 to 30 years old) gave accounts of their experiences via face-to-face semi structured interviews. The interview transcripts were then analysed using interpretative phenomenological analysis (IPA). Five superordinate themes emerged from the data: ‘Isolation’, ‘Others don’t understand’, ‘Rejection and Acceptance”, ‘Relationship with the self’ and ‘Autonomy’. Situated within these themes were subthemes capturing specific different facets of the experience, including certain transformations related to the cessation of their self-harm. The findings revealed that participants began to stop self-harming towards late adolescence when factors in their lives began to shift, particularly in the areas of acceptance and autonomy. The findings shed light on resolution of the behaviour. The findings support existing theoretical models of self-harm and previous research, and are discussed in the context of the developmental stage of adolescence. This study offers concluding thoughts around the implications of the findings in relation to the practice of counselling psychology, specifically when working therapeutically with adolescents who self-harm.
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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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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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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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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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Long, Margaret-Ann. "Self-harm and help-seeking: client and helper perspectives." Thesis, Ulster University, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.591079.
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Aim: To understand the experiences of self-harm and the process of seeking and accessing help for self-harm from the perspectives of counselling clients, gatekeepers and counsellors. Method: A qualitative study which focuses on the ideas and experiences of (1) current counselling clients who have a history of selfharm, (2) community gatekeepers in a range of ro les who are often the fi rst point of contact for people who self-harm when they seek help, including community workers, youth workers, helpline supervisors, clergy and the partner of a person who selfharms, and (3) counsellors who have experience of working with people who selfharm. Semi-structured interviews were carried out with 10 participants from each sample group (tota l n = 30). Data analysis of the three sets of findings was conducted using Strauss and Corbin's (1 998) Grounded Theory and facilitated with NVivo 9.0. Findings: Each set of findings yielded six major categories, all of which inter-relate to form the core category, 'The journey through self-harm: Developing a healing reconnection with self and others". Discussion: The three perspectives were synthesised and areas of convergence and divergence with the existing evidence base were identified to provide a composite portrayal of the helping process for people who self-harm. Implications: Core and critical implications have been deduced from the find ings in relation to practice and research. A pertinent implication of the study is that it is possible to recover from self-harm, with the support of helpers who can relate with compassion and humanity and thus promote the individual's capacity for self-healing. Conclusion: There is a need for individual helpers and the organisations in which they work to seek to listen to, understand and respond to the individual life story communicated by every person who self-harms.
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McGuire, Conor. "Exploring self-harm in young people and university students." Thesis, University of Hull, 2018. http://hydra.hull.ac.uk/resources/hull:16583.
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This portfolio thesis consist of three parts; a systematic literature review, an empirical report and supporting appendices. Part one is a systematic literature review in which empirical papers that study the relationship between identity in adolescents and self-harm is reviewed. A systematic search of databases identified eight studies. A narrative synthesis of the findings was produced alongside the methodological quality of the articles. The implications of the review and directions for future research are discussed. Part two is an empirical paper which used a qualitative methodology to explore possible continua which exist in the narratives of university students who have experiences of self-harm. The paper used a categorical-content and holistic-form analysis to investigate the narratives. The findings are discussed and implications for future research proposed. Part three consists of the appendices which support the systematic literature review and the empirical paper. The appendices also include a reflective statement which focuses on the research process.
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Hughes, Mairead. "Is affiliation with alternative subcultures associated with self-harm?" Thesis, University of Liverpool, 2017. http://livrepository.liverpool.ac.uk/3009663/.
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This thesis focuses on the relationship between young people who affiliate with alternative subcultures and self-harm and/or suicide. Alternative subcultures can be described as groups that are distinct from 'mainstream' cultures. Affiliation with such groups can be broadly defined as having a strong collective identity to a group with specific values and tastes, typically centred around music preference, clothing, hairstyles, make-up, tattoos and piercings (Greater Manchester Police; GMP, 2013; Moore, 2005). Some alternative subcultures have also been associated with 'dark, sinister and morbid' themes, such as Goths, Emos, and Metallers (Young, Sproeber, Groschwitz, Preiss, & Plener, 2014). Self-harm can be defined as the deliberate act of harming oneself, with or without suicidal intent. This commonly involves cutting and self-poisoning (NICE, 2013). Other behaviours that can be described using this term include non-suicidal self-injury (NSSI; the intentional destruction of body tissue without suicidal intent) and suicidal behaviours such as suicidal ideation and attempts (self-harm with some intent to die; Klonsky & Muehlenkamp, 2007; Nock, Borges, Bromet, Cha, Kessler, & Lee, 2008). Some would argue that NSSI is distinct from self-harm, and as such it features as a disorder in the DSM-V as Non-Suicidal Self-Injury Disorder (NSSID; APA, 2013), however there remains some controversy over the latter (Kapur, Cooper, O'Connor, & Hawton, 2013). The associations between alternative subgroup affiliation and self-harm and/or suicide were explored through a systematic review and empirical research study using quantitative methodology. It is well documented in the literature that the prevalence of self-harm and suicide is particularly high in adolescents and young adults, with suicide being one of the leading causes of death in this population (Hawton, Saunders, & O'Connor, 2012; WHO, 2014). Self-harm has become a clinical and public health concern with up to 30,000 adolescents receiving hospital treatment each year (Hawton, Rodham, & Evans, 2006) and prevalence rates rising to between 7-14% for young people in the UK (Hawton & James, 2005; Skegg, 2005; Swannell, Martin, Page, Hasking, & St John, 2014). Minority groups are another population who appear to have elevated rates of self-harm, including Lesbian Gay Bisexual and Transgender (LGBT; Jackman, Honig, & Bockting, 2016), ethnic minorities (Bhui, McKnezie, & Rasul, 2007) and alternative subcultures (Young et al., 2014). However, there is a paucity of research into the latter population. This presented a gap to conduct a systematic review of the available literature in an attempt to understand the association between alternative subculture affiliation and self-harm and suicide. Chapter 1 describes the systematic process taken in an attempt to understand the links between alternative subculture affiliation and both self-harm and suicide. Ten studies were included which focused on self-harm and/or suicide and alternative identity through subculture affiliation (e.g. Goth) or music preference (e.g. Heavy Metal). The results indicated that there is an association between alternative subculture affiliation and self-harm and suicide, though the lack of research in the area and methodological limitations impact on the extent to which the underlying mechanisms can be understood. Leading on from the systematic review, Chapter 2 presents the empirical study which investigated the factors that might contribute to the increased risk of NSSI in alternative subcultures, specifically focusing on variables that have been found to be linked to NSSI in young people; emotion dysregulation, depression, identity confusion and exposure to self-harm. The aim of this study was to increase our understanding of the mechanisms involved that might explain this increased risk of NSSI. Alternative subcultures were found to be at a greater risk of NSSI in comparison to affiliations with other subcultures, though this association lessened when the other variables were accounted for. A key predictor of NSSI in this population was emotion dysregulation. The findings highlight the importance of raising awareness of the potential risk of self-harm/suicide in alternative subcultures in order to create a greater understanding and direct resources appropriately.
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Kirtley, Olivia Jane. "A psychophysiological investigation of self-harm ideation and enactment." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/7162/.
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Background: Many individuals have thoughts of self-harm, but only a proportion act upon them and engage in self-harm behaviour. Currently, our ability to differentiate which individuals who think about self-harm will translate those thoughts into actions, is limited, and is a critically important area for future research to inform suicide prevention efforts. This thesis presents three empirical studies underpinned by the recently proposed model of suicidal behaviour, the Integrated Motivational-Volitional model (IMV; O’Connor, 2011), which specifically makes predictions about factors which differentiate between suicidal thoughts and behaviours. Two putative variables within this model may be sensitivity to emotional and physical pain; indeed threshold and tolerance for physical pain have been found to be elevated in individuals who have engaged in self-harm, relative to healthy controls. Furthermore, previous research has suggested that elevated physical pain tolerance may be potentiated by an individual’s state of distress. Emotional pain sensitivity, however, has been demonstrated to be reduced in those who have engaged in self-harm. Whether changes in sensitivity to emotional and physical pain are a cause or a consequence of self-harm, is unknown, and could be an important target for treatment and intervention development. Methods: A systematic review of the literature around physical pain and self-harm (n = 25 studies) was conducted in order to assess the quality and extent of the existing knowledge in this area. Three empirical studies were then conducted investigating the relationship between emotional and physical pain in self-harm ideation and enactment. Two of these (n = 102; n = 88) were laboratory studies, employing a combination of self-report and behavioural measures of emotional and physical pain sensitivity, and one took the form of a large online self-report study (n = 351). Results: The studies within this thesis found no evidence to suggest that behavioural threshold or tolerance for physical pain is elevated in self-harm ideation or enactment. Furthermore, pain tolerance does not appear to differ as a function of stress. Self-reported sensitivity to emotional pain was highest in those who had engaged in self-harm, followed by those who had ideated about self-harm and was lowest in healthy controls. There were no significant associations between self-reported and behavioural measures of emotional and physical pain sensitivity. Negative mood decreased following administration of a painful stimulus for all groups (controls, self-harm ideation and self-harm enactment). As predicted, motivational phase variables within the IMV did not differ significantly between the ideation and enactment groups, however, volitional phase variables did exhibit a significant difference. Conclusions: The findings from this thesis provide some support for the IMV model of suicidal behaviour (O’Connor, 2011), demonstrating that the volitional phase variables impulsivity and exposure to social modelling of self-harm, differentiate between those with thoughts (only) of self-harm and those who have gone on to engage in the behaviour. This is an important finding with implications for intervention and treatment development. The similar pattern of elevated emotional pain sensitivity across self-harm ideation and enactment suggests that this could be a pre-motivational phase variable within the IMV. The lack of expected between-group differences in behavioural measures of emotional and physical pain call into question the findings of previous studies. Furthermore, as neither of the laboratory studies presented within this thesis found significant differences in pain threshold or tolerance between self-harm ideation, self-harm enactment and control groups, there is a clear need for more research in this area.
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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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Estefan, Andrew. "Harm, Interrupted: Self-Injury Narratives and Same Sex Attraction." Thesis, Griffith University, 2008. http://hdl.handle.net/10072/367391.
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This study addresses a significant clinical and social issue: self-injury among gay men. Self-injury can be understood as any act undertaken by the self to cause physical damage to the body without the conscious intent to die.
The existing self-injury literature tends to focus on self-injury as a problem for women. That is to say, because more women than men self-injure, research focuses more strongly on their motivations and treatment needs. The literature that explores self-injury as it relates to gay men is not well developed and focuses strongly on suicidality and the risks associated with various self-injurious behaviours. This has produced useful information for some areas of practice such as risk management and public health suicide prevention strategies. What this literature has not done is explore the contexts and meanings of self-injury for this particular group.
This study is a narrative inquiry, which explores gay men’s self-injury through their experiences in context. This thesis therefore tells the stories of gay men who participated in the study and reveals their self-injury across a landscape of time, context, experiences and interactions. This study sought to address gaps in available knowledge by examining how gay men are self-injuring and what their self-injury means in the context of a life lived in relationship with self and others.
Self-injury for the gay men in this study was enacted, according to their stories, through similar methods to those reported for other populations. The men’s stories illustrated how self-injury also helped them to manage their distress and cope with a social world that can be invalidating. Through attending to the similarities and differences in experience, as they are told in the men’s stories, this thesis introduces two narratives that shape the way self-injury is known. The first, the harm narrative, is a conventional plotline derived from dominant explanations of the risk, pathology and irrationality of self-injury. This narrative has allowed stories of self-injury to be told and re-told in clinical and social contexts that foreclose alternative readings of an apparently destructive behaviour. The second narrative presented in this thesis is a moral narrative of self-injury. The moral narrative arises by holding the harm narrative to the margins, while allowing the stories of the men to emerge and be thought about narratively, that is to say their self-injury is viewed as part of a life story that is not simply reduced to harm. The moral narrative for the men in this study operates in two ways. The first is to show how, for some of the men, their self-injurious actions have moral value. The second way is to show how acts of self-injury create moral spaces in which the men are able to experience self-care and caring for others. This moral narrative represents a new way of thinking about self-injury as it occurs and is experienced in context.
The thesis concludes with ideas and suggestions for working with gay men and others who self-injure. The suggestions are that nurses defer immediate risk-based responses in order to allow clients to explore the contexts in which their self-injury occurs in order to prevent care from becoming a risk factor for further self-injury. Recommendations for further research are also made, which expand on the insights regarding self-injury and moral narratives, the health care experiences of gay men who self-injure and how self-injury exists in relationship with masculinity.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Phillips, Kristina T. "Applying the Relapse Model to Harm Reduction: The Development and Evaluation of the Harm Reduction Self-Efficacy Questionnaire." Connect to this title online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1131342662.
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Ramluggun, Prasundcoomar. "A critical exploration of the management of self-harm in a male custodial setting : a comparative analysis of prison staff views on self-harm." Thesis, University of East Anglia, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577567.
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There are a growing number of prisoners who self-harm in prisons in England and Wales. As the prisoners first means of support, prison staff play an important role in identifying and managing prisoners at risk of self-harm. In spite of the implementation of a prison self-harm pathway, self-harm continues to rise. The main purpose of this project was to identify and compare relevant attitudinal dimensions of custodial and health care staff who work with prisoners who self-harm in an Adult Male 'Local' Category B prison (referred to as the study prison). A case study methodology with a mixed method approach that includes a self-harm questionnaire (SHAS), semi-structured interviews and documentary evidence was used. Thirty-seven prison staff (14 nurses and 23 prison officers) completed the SHAS. Qualitative data were analysed using thematic analysis. Quantitative data were analysed using Windows Software Package for Social Sciences (SPSS) version 16. There were no significant differences between the SHAS scores of the nurses and prison officers. Nurses with a mental health registration, those with training in self-harm and non-uniform prison officers showed more empathy to prisoners who self-harm. Five themes were identified from the qualitative data. They were: understanding self-harm, building relationships, organisational issues, occupational issues and care management of self-harm. A high proportion of prison staff felt that they were poorly educated in self-harm and unsupported by management. There were also interdisciplinary conflicts amongst prison staff on how to manage self-harm and criticism of the current management framework. An effective prison management structure for prisoners at risk of self-harm was identified as one which encourages joint working and shared decision making amongst different agencies involved in the care of these prisoners and is supportive of all prison staff with regular access and updates to self-harm education.
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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.
Full textAbstract:
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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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.
Full textAbstract:
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.
Full textAbstract:
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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Caulfield, Anne. "What helps? : an exploration of protective factors and self-harm." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/16450.
Full textAbstract:
Background: Self-harm is important considering the demand it places on health services and its strong association as a risk factor for suicide. Research regarding protective factors for self-harm is limited, protective factors can be personal or social resources that reduce the impact of negative consequences, in the face of stressors. Identifying protective factors is important, provided they can be enhanced and utilised to inform intervention. Aims: This thesis had two aims; to systematically review the literature investigating the relationship between social support and suicidality, and to use Interpretative Phenomenological Analysis to explore the factors that support desistance from self-harm. Methods: Quantitative studies, exploring the relationship between social support and suicidality were reviewed systematically. The empirical study employed Interpretative Phenomenological Analysis to investigate self-harm behaviour in context, identify potential protective factors and explore what participants have found to be helpful to desist from selfharm behaviour. Semi structured interviews were conducted with nine participants (18- 61years) recruited from the Adult Community Mental Health Team. Results: Findings of the systematic review indicate that there is an association between poor social support and increased suicidality in adulthood. In the empirical study four main themes emerged from the data: Self-harm provided Relief from Psychological Distress, Difficulties Communicating, Social support and Gradual desistance. Conclusions: Social support may be an important factor that protects against suicidality; however further research is required to investigate this association. Findings from the empirical study suggest that treatment providers must be sensitive to the context and function of self-harm behaviour for the individual, and be willing to work to reduce the self-harm behaviour, while being cognisant that self-harm may be protective for the individual and prevent more severe self-harm or even suicide.
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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.
Full textAbstract:
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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McCarthy-Sweeney, Kelly. "The Impact of Adolescent Self-Harm on Parental Weil-Being." Thesis, Lancaster University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.524764.
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