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Deliberate self-harm and state dissociation: an experimental investigation
- Authors:
- BRACKEN Katherine L., et al
- Journal article citation:
- Journal of Aggression Maltreatment and Trauma, 17(4), 2008, pp.520-532.
- Publisher:
- Taylor and Francis
In this study 85 undergraduate student participants were randomly assigned to self-administer either a very mild electric shock below their pain threshold (i.e. a no self-harm control condition) or an electric shock that they were told could cause minor but reversible tissue damage (i.e. a self-harm condition). Shocks were preceded and followed by 90-second waiting periods, and after administration about half the participants rated their subjective level of state dissociation before the shock, and about half after the shock. The results show that women in the self-harm group experienced more dissociation compared to men, but only after the shock. Potential reasons for this gender effect are discussed.
Understanding self-harm
- Authors:
- CSIPKE Emese, et al
- Publisher:
- SANE
- Publication year:
- 2008
- Place of publication:
- London
Non-accidental self-harm without suicidal intent by cutting, scratching or burning the skin and other tissue, by taking overdoses of prescription and over-the-counter medications, by bruising, by ingesting harmful substances or objects and by other methods is finally being discussed in the media and researched by academics. Little by little, its meanings and functions are uncovered in writings by survivors and reports based on clinical experience and academic studies. SANE wanted to add to this research effort and in 2005 a web based questionnaire was launchedcharting the journey from first acts of self-harm through to the time when self-harm can be left behind, with a special focus on the social context in which self-harm takes place. This report is intended as a source of information and most importantly, a discussion point for people who self-harm, their families, treatment professionals who work with people who self-harm and research professionals and students who work on the subject.
Talk to me: a national action plan to reduce suicide and self harm in Wales: 2008-2013
- Author:
- WALES. Welsh Assembly Government
- Publisher:
- Wales. Welsh Assembly Government
- Publication year:
- 2008
- Pagination:
- 14p.
- Place of publication:
- Cardiff
The key aims of the action plan include raising awareness of mental health issues across wider society and delivering earlier help for those most at risk. Every suicide is a tragedy, a life and family member lost. For those left behind suicide leaves a wound that does not easily heal.
Relationship between service ecology, special observation and self-harm during acute in-patient care: City-128 study
- Authors:
- BOWERS Len, et al
- Journal article citation:
- British Journal of Psychiatry, 193(11), November 2008, pp.395-401.
- Publisher:
- Cambridge University Press
Special observation (the allocation of nurses to watch over nominated patients) is one means by which psychiatric services endeavour to keep in-patients safe from harm. The practice is both contentious and of unknown efficacy. The aim was to assess the relationship between special observation and self-harm rates, by ward, while controlling for potential confounding variables A multivariate cross-sectional study collecting data on self-harm, special observation, other conflict and containment, physical environment, patient and staff factors for a 6-month period on 136 acute-admission psychiatric wards. Constant special observation was not associated with self-harm rates, but intermittent observation was associated with reduced self-harm, as were levels of qualified nursing staff and more intense
Therapeutic assessment based on cognitive-analytic therapy for young people presenting with self-harm: pilot study
- Authors:
- OUGRIN Dennis, NG Audrey V., LOW James
- Journal article citation:
- Psychiatric Bulletin, 33(11), November 2008, pp.423-426.
- Publisher:
- Royal College of Psychiatrists
Adolescents presenting with self-harm have poor adherence to community follow-up. Poor adherence is a principal obstacle to treatment delivery and is associated with poor psychosocial outcomes. Therapeutic assessment is a novel method of assessing adolescents with self-harm. We compared therapeutic assessment with assessment as usual in a pilot study of 38 adolescents referred for psychosocial assessment following self-harm. Significantly more adolescents assessed with therapeutic assessment than with usual assessment attended the first community follow-up appointment and engaged with services. Young people assessed using therapeutic assessment may be more likely to engage with community follow-up. A therapeutic intervention at the time of the initial assessment might be necessary to enable
The behavioural phenotype of Smith–Magenis syndrome: evidence for a gene–environment interaction
- Authors:
- TAYLOR L., OLIVER C.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(10), October 2008, pp.830-841.
- Publisher:
- Wiley
Behaviour problems and a preference for adult contact are reported to be prominent in the phenotype of Smith–Magenis syndrome. This UK study examined the relationship between social interactions and self-injurious and aggressive/disruptive behaviour in Smith–Magenis syndrome to explore potential operant reinforcement of problem behaviours and thus a gene–environment interaction. Observational data were collected on five children with Smith–Magenis syndrome (age range 3 to 13 years) . The associations between purported phenotypic behaviours and two environmental events (adult attention and demands) were examined using descriptive analysis. All participants engaged in self-injurious behaviour and aggressive/disruptive outbursts. Sequential analyses of aggressive/disruptive outbursts and self-injury revealed that these behaviours were evoked by low levels of adult attention and led to increased levels of attention following the behaviours in three and two participants respectively out of the four for whom this analysis was possible. Problem behaviour in Smith–Magenis syndrome was evoked by decreased social contact in three out of four children. These data, considered alongside the preference for adult contact and the significantly increased prevalence of these behaviours in Smith–Magenis syndrome, illustrate a potential gene–environment interaction for problem behaviour in this syndrome.
Standards on the use of section 136 of the Mental Health Act 1983 (2007) (version for England)
- Author:
- ROYAL COLLEGE OF PSYCHIATRISTS
- Publisher:
- Royal College of Psychiatrists
- Publication year:
- 2008
- Pagination:
- 66p., bibliog.
- Place of publication:
- London
The Standards on the use of Section 136 of the Mental Health Act 1983 (2007) have been developed by a multi-agency group, led by the Royal College of Psychiatrists. Members include representatives from the Metropolitan Police, the Independent Police Complaints Commission, the Royal College of Nursing, the College of Emergency Medicine, the Faculty of Forensic and Legal Medicine, the Ambulance Association, the Healthcare Commission, Mental Health Act Commission, and the National Institute for Mental Health in England. Section 136 of the Mental Health Act 1983 gives the police powers to remove a person who appears to be suffering from mental disorder and who is “in immediate need of care or control” from a public place to a place of safety. Removal may take place if a police officer believes it is necessary in the interests of that person, or for the protection of others. The purpose of removing a person to a place of safety is to enable them to be assessed by a doctor or interviewed by an allied mental health professional, so that the necessary arrangements can be made for their care and treatment.
Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study
- Author:
- CHAMBERLAIN Samuel R.
- Journal article citation:
- British Journal of Psychiatry, 192(9), September 2008, pp.216-221.
- Publisher:
- Cambridge University Press
Trichotillomania (repetitive hair-pulling) is an Axis I psychiatric disorder whose neurobiological basis is incompletely understood. Whole-brain trichotillomania neuroimaging studies are lacking. The aim was to investigate grey and white matter abnormalities over the whole brain in patients with trichotillomania. Eighteen patients with DSM–IV trichotillomania and 19 healthy controls undertook structural magnetic resonance imaging after providing written informed consent. Differences in grey and white matter were investigated using computational morphometry. Patients with trichotillomania showed increased grey matter densities in the left striatum, left amygdalo-hippocampal formation, and multiple (including cingulate, supplementary motor, and frontal) cortical regions bilaterally. Trichotillomania was associated with structural grey matter changes in neural circuitry implicated in habit learning, cognition and affect regulation. These findings inform animal models of the disorder and highlight key regions of interest for future translational research.
Optional thinking ability among hospital-treated deliberate self-harm patients: a 1-year follow-up study
- Authors:
- McAULIFFE Carmel, et al
- Journal article citation:
- British Journal of Clinical Psychology, 47(1), March 2008, pp.43-58.
- Publisher:
- Wiley
A prospective study aimed to investigate the association between optional thinking in interpersonal problem solving and repeated deliberate self-harm (DSH) within 12 months. A non-consecutive sample (N=152) of DSH patients presenting to the Accident and Emergency department of an acute hospital in Cork city, Ireland, was assessed using a structured interview schedule including the Suicide Intent to their index episode. During follow-up 31 individuals (20.4%) repeated. History of self-harm was significantly associated with prospective repetition when considered alongside all the other predictor variables. Among first evers, low scores on the optional thinking test were significantly associated with the increased risk of repetition within 12 months. Among those with previous DSH, there was no evidence of an association between optional thinking and repetition within 12 months. Poor optional thinking is associated with increased risk of repeated deliberate self-harm in those who present with a first self-harm episode. Interventions to improve optional thinking skills, delivered soon after a first DSH presentation, may be useful in preventing repetition.
Nonsuicidal self-injury among nonclinical college women: lessons from Foucault
- Authors:
- KOKALIARI Efrosini, BERZOFF Joan
- Journal article citation:
- Affilia: Journal of Women and Social Work, 23(3), August 2008, pp.259-269.
- Publisher:
- Sage
This article presents a qualitative study that explored nonsuicidal self-injury among relatively psychologically healthy college women. It examines the phenomenon of self-injury through a social theoretical perspective using Foucault's concepts. Key arguments are that self-injury in women may be a reaction to an insidious form of social control and a reflection of the social pressures for productivity that are enacted on the body. Self-injury may regulate socially unacceptable affects and modify states of the ego so that women can regain their capacity to produce within a competitive and capitalist society. Implications for social work practice are discussed.