Gaining Clinical Perspective on Self-Injury

PsycCRITIQUES ◽  
2017 ◽  
Vol 62 (47) ◽  
Author(s):  
Andrew Nocita
Keyword(s):  
Clinical Perspective ◽  
Self Injury

scholarly journals Sometimes, not always, not never: a response to Pickard and Pearce

2017 ◽  
Vol 44 (3) ◽  
pp. 209-210 ◽  
Author(s):  
Patrick J Sullivan
Keyword(s):  
Healthcare Professionals ◽  
Clinical Perspective ◽  
Community Settings ◽  
Costs And Benefits ◽  
Ongoing Debate ◽  
Harm Minimisation ◽  
Self Injury

This paper provides a response to Hanna Pickard and Stephen Pearce’s paper ‘Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings.’ This paper responded to my article ‘Should healthcare professionals sometimes allow harm? The case of self-injury.’ There is much in the paper that I would agree with, but I feel it is important to respond to a number of the criticisms of my paper in order to clarify my position and to facilitate ongoing debate in relation to this important issue.

Kids and Self-Injury: ‘Pain Makes Them Feel Alive’

2007 ◽  
Vol 41 (4) ◽  
pp. 36
Author(s):  
TIMOTHY F. KIRN
Keyword(s):  
Self Injury

Suicidal Behavior and Non-Suicidal Self-Injury in Emergency Departments Underestimated by Administrative Claims Data

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 318-325 ◽  
Author(s):  
Barbara Stanley ◽  
Glenn W. Currier ◽  
Megan Chesin ◽  
Sadia Chaudhury ◽  
Shari Jager-Hyman ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Suicide Attempts ◽  
The United States ◽  
Administrative Claims ◽  
Suicide Attempters ◽  
Self Injury ◽  
Axis I ◽  
Ed Visits ◽  
External Causes ◽  
Severe Psychopathology

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.

Self-Injurious Behavior vs. Nonsuicidal Self-Injury

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Christopher M. Bloom ◽  
Shareen Holly ◽  
Adam M. P. Miller
Keyword(s):  
Positive Reinforcement ◽  
Empirical Investigation ◽  
High Stress ◽  
Animal Research ◽  
Stress Conditions ◽  
Human Populations ◽  
Pharmacological Interventions ◽  
Self Injury ◽  
Cns Stimulant ◽  
Nonsuicidal Self Injury

Background: Historically, the field of self-injury has distinguished between the behaviors exhibited among individuals with a developmental disability (self-injurious behaviors; SIB) and those present within a normative population (nonsuicidal self-injury; NSSI),which typically result as a response to perceived stress. More recently, however, conclusions about NSSI have been drawn from lines of animal research aimed at examining the neurobiological mechanisms of SIB. Despite some functional similarity between SIB and NSSI, no empirical investigation has provided precedent for the application of SIB-targeted animal research as justification for pharmacological interventions in populations demonstrating NSSI. Aims: The present study examined this question directly, by simulating an animal model of SIB in rodents injected with pemoline and systematically manipulating stress conditions in order to monitor rates of self-injury. Methods: Sham controls and experimental animals injected with pemoline (200 mg/kg) were assigned to either a low stress (discriminated positive reinforcement) or high stress (discriminated avoidance) group and compared on the dependent measures of self-inflicted injury prevalence and severity. Results: The manipulation of stress conditions did not impact the rate of self-injury demonstrated by the rats. The results do not support a model of stress-induced SIB in rodents. Conclusions: Current findings provide evidence for caution in the development of pharmacotherapies of NSSI in human populations based on CNS stimulant models. Theoretical implications are discussed with respect to antecedent factors such as preinjury arousal level and environmental stress.

Exploring Particular Facets of Cognitive Emotion Regulation and Their Relationships With Nonsuicidal Self-Injury Among Adolescents

Crisis ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Nir Madjar ◽  
Nicole Segal ◽  
Gilad Eger ◽  
Gal Shoval
Keyword(s):  
Emotion Regulation ◽  
High School Students ◽  
Analysis Of Covariance ◽  
Depression Symptoms ◽  
Emotion Regulation Strategies ◽  
Cognitive Emotion Regulation ◽  
School Students ◽  
Self Injury ◽  
Regulation Strategies ◽  
Nonsuicidal Self Injury

Abstract. Background: Nonsuicidal self-injury (NSSI) has been found to be associated with poor emotion regulation. Aims: The goal of this study was to examine the association of multidimensional cognitive emotion regulation strategies with NSSI among adolescents and compare the different patterns of NSSI. Method: A sample of 594 high-school students (54.4% boys; mean age = 14.96 years), from five regional schools across Israel, were assessed for five facets of cognitive emotion regulation strategies (acceptance, refocus on planning, positive refocusing, putting into perspective, and positive reappraisal) and NSSI behaviors using validated scales. Participants were allocated into three groups: repetitive NSSI (more than six occasions of NSSI; 7.1%), occasional NSSI (at least one incident but less than six; 8.3%), and no NSSI (84.6%). Results: Analysis of covariance, controlling for gender and depression symptoms, revealed that students with NSSI reported higher levels of acceptance, but lower levels of refocus on planning and putting into perspective. Limitations: The study used a cross-sectional design, which was a limitation. Conclusion: These findings demonstrate that particular cognitive emotion regulation strategies differ substantially in their relationship with NSSI. Adolescents who focus on planning and putting stressful situations into perspective may have increased resilience, whereas adolescents who are accepting of negative events that have happened may be more prone to maladaptive coping behaviors.

The Relation Between Illegal Risk Behaviors and the Acquired Capability for Suicide

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 368-377 ◽  
Author(s):  
Sean M. Mitchell ◽  
Danielle R. Jahn ◽  
Kelly C. Cukrowicz
Keyword(s):  
College Students ◽  
Risk Behaviors ◽  
Risky Behaviors ◽  
Interpersonal Theory ◽  
Interpersonal Theory Of Suicide ◽  
Acquired Capability ◽  
Self Injury ◽  
Partial Correlations ◽  
History Of ◽  
Explained Variance

Background: Suicide is the third leading cause of death among college students. The interpersonal theory of suicide may provide a way to conceptualize suicide risk in this population. Aims: We sought to examine relations between illegal behaviors that may act as risk factors for suicide and the acquired capability for suicide. Method: College students (N = 758) completed assessments of acquired capability and previous exposure to painful and provocative events, including illegal risk behaviors (IRBs). Linear regression, a nonparametric bootstrapping procedure, and two-tailed partial correlations were employed to test our hypotheses. Results: There was no significant relation between IRBs and acquired capability after controlling for legal painful and provocative experiences. A significant positive relation was identified between IRBs and fear/anxiety, contradicting the expected relation between increased painful and provocative experiences and lower fear/anxiety. Acquired capability explained variance in the relation between IRBs and history of suicide attempt or self-injury history. Conclusion: Further research is needed to examine links between IRBs and painful and provocative events, particularly to identify the point at which habituation begins to increase acquired capability, as our unexpected results may be due to a lack of habituation to risky behaviors or low variability of scores in the sample.

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