Search results

The purpose of this paper is to explore client‐reported functions of deliberate self‐injury for prisoners located within a dangerous and severe personality disorder site.

As interviews produced in‐depth data indicating a very idiosyncratic experience of the function of deliberate self‐injury, interpretative phenomenological analysis was used within a small‐scale case study design.

Identified functions mirrored current quantitative research but few emerging themes were identified across the sample. Participants presented with varying levels of insight into their deliberate self‐injury.

A small sample of young males was used within the study.

A “status‐seeking” function of deliberate self‐injury was also observed, which is not explicitly discussed within the current literature base. This study's findings can be of use to treatment providers for this population given their complex responsivity needs.

Non-suicidal self-injury (NSSI) is distinguishable from suicide attempts (SAs) on a number of psychological and motivational factors. However, in corrective services settings, NSSI and SA are not clearly distinguished in assessment impacting on intervention. The purpose of this paper is to examine if any attributes differentiate lifetime history of SA+NSSI, NSSI and SA presentations in inmates who had recently been assessed in custody by a risk intervention team.

A comprehensive clinical assessment and file review was conducted with 87 male inmates (including a no self-injury control group) in two large correctional centres in New South Wales, Australia, to determine if three self-injury groups differ from the control group and if the three self-injury groups differ from each other across a range of static, trait, environmental and clinical characteristics.

The SA+NSSI group was most different from the control group (27/59 variables), and from the SA group (10/59 variables), predominantly across trait and clinical correlates. The SA group was least different from the control group (2/59 variables: suicide ideation, childhood physical abuse).

It was found that the presence of SA+NSSI history is an indicator of increased psychopathology. A history of SA only appears not readily associated with psychopathology. The self-injury subgroups reflected different clinical profiles with implications for risk assessment and treatment planning.

Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients.

All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+).

In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients.

More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self.

Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of staff dealing with such women. The aim of this study was to evaluate the trauma and self injury (TASI) training programme on staff knowledge and skills.

A total of 135 nurses and nursing assistants participated in the TASI two‐day training course. Questionnaires allowing for quantitative and qualitative data collection were completed before and after the training. Training and confidence levels in dealing with women who self‐harm prior to the training were identified and the impact of the programme was assessed.

The majority of staff had not received any previous training on trauma and self injury. There was an increased level of confidence in working with trauma and self injury following training and staff reported an increased ability to ask for support. Self‐perceived competence improved to a greater extent in those who had not received previous training compared to those who had.

The authors' data is limited to self‐report. Future research should use objective measures to evaluate the impact of staff training.

A relatively short training programme focusing on trauma and self injury appears to improve staff confidence, understanding and competence in working with women patients in a high secure setting. Similar training programmes might also be beneficial in different patient groups with complex backgrounds and behaviours.

This is the first report on a training programme focussing on women in high secure care who self‐harm and have experienced trauma.

This article reports on support that people with learning disabilities who self‐injure say they have found, or would find, helpful in relation to their self‐injury. It is an important issue, because most interventions and approaches are based on past patterns of support or what professionals think is helpful or appropriate. Rarely has the voice of the person concerned been heard. The clear message from people with learning disabilities, including those who use little or no verbal communication, is that they want opportunities to communicate their feelings and to be listened to. Being open to listening and developing one's own communication skills is essential for supporters of people with learning disabilities who self‐injure.

Non-suicidal self-injury (NSSI) is associated with psychological disorders and suicidal thoughts and behaviours; disclosure of NSSI can serve as a catalyst for help-seeking and self-advocacy amongst people who have self-injured. This study aims to identify the socio-demographic, NSSI-related, socio-cognitive and socio-emotional correlates of NSSI disclosure. Given elevated rates of NSSI amongst university students, this study aimed to investigate these factors amongst this population.

Australian university students (n = 573) completed online surveys; 80.2% had previously disclosed self-injury.

NSSI disclosure was associated with having a mental illness diagnosis, intrapersonal NSSI functions, specifically marking distress and anti-dissociation, having physical scars from NSSI, greater perceived impact of NSSI, less expectation that NSSI would result in communication and greater social support from friends and significant others.

Expanding on previous works in the area, this study incorporated cognitions about NSSI. The ways in which individuals think about the noticeability and impact of their NSSI, and the potential to gain support, are associated with the decision to disclose self-injury. Addressing the way individuals with lived experience consolidate these considerations could facilitate their agency in whether to disclose their NSSI and highlight considerations for health-care professionals working with clients who have lived experience of NSSI.

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).

Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation.

The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.

This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.

The case report offers an important contribution to an area that requires much further research.

Non-suicidal self-injury (NSSI) is a growing public health concern. Continued NSSI is often associated with negative outcomes, yet the behaviour usually serves a purpose for individuals who self-injure (e.g. emotional relief). As such, individuals who self-injure often experience ambivalence about the behaviour. The purpose of this paper is to highlight the importance of recognising ambivalence as a natural and expected part of the recovery process.

This paper draws on literature regarding NSSI recovery, ambivalence towards stopping the behaviour and challenges for both clients and health professionals.

This paper argues that ambivalence towards self-injury can be challenging for both clients and health professionals. Clients may feel shame and sense of failure if they experience a setback; health professionals may experience frustration towards clients who continue to self-injure despite treatment.

Validation of the clients’ experience can have significant positive outcomes in treatment and help-seeking behaviours. Acknowledgement of client ambivalence during the recovery process will serve to validate clients’ experience and facilitate rapport. Health professionals who accept ambivalence as a natural part of the recovery process may experience less frustration with clients who continue to self-injure.

Needs of people following acquired brain injury vary over their life-course presenting challenges for community services, especially for those with “hidden” neuropsychological needs. Characterisation of subtypes of rehabilitation service user may help improve service design towards optimal targeting of resources. This paper aims to characterise a neuropsychologically complex group of service users.

Preliminary data from 35 participants accepted for a holistic neuropsychological rehabilitation day programme were subject to cluster analysis using self-ratings of mood, executive function and brain injury symptomatology.

Analysis identified three clusters significantly differentiated in terms of symptom severity (Cluster 1 least and Cluster 2 most severe), self-esteem (Clusters 2 and 3 low self-esteem) and mood (Cluster 2 more anxious and depressed). The three clusters were then compared on characteristics including age at injury, type of injury, chronicity of problems, presence of pre-injury problems and completion of rehabilitation. Cluster 2 were significantly younger at time of injury, and all had head injury.

Results suggest different subgroups of neuropsychological rehabilitation service user, highlighting the importance of early identification and provision of rehabilitation to prevent deterioration, especially for those injured when young. Implications for design of, and research into, community rehabilitation service design for those with “hidden disability” are considered.

The paper findings suggests that innovative conceptual frameworks for understanding potentially complex longer term outcomes are required to enable development of tools for triaging and efficient allocation of community service resources.

What is happening in the perceived world of young people who have non-suicidal self-injury? The answer to this question explains many quantitative research findings in the field of NSSI. The current qualitative research design is Husserl's descriptive phenomenology.

The participants included 17–29-year-old youths with self-injury and were selected with a targeted sampling approach and a conspicuous sampling method based on the theoretical saturation criterion of 21 people. Data were collected in a semi-structured interview and analyzed in the MAXQDA2022 software using the Attride-Stirling (2001) method. Validation of data was done by the method of simultaneous review of colleagues and simultaneous review of participants.

The themes emerging from the analysis of the findings are the three organizing themes of “vulnerable temperament” which includes height and head, high pain sensitivity threshold and desire for nothingness, “traumatic family” which includes disorganization, crisis and devaluation in the family and “developmental injuries” that are associated with physical, sexual and emotional abuse and neglect. The content of these themes seriously harms a person's self-perception through the emotions of fear, shame, anger and despair and is integrated into the overarching theme of “damaged self”.

“Damaged Self” provides causal explanations related to the formation of self-injurious behaviors and these behaviors are in harmony with the damage that a person observes in his perception of himself.