Deliberate Self-harm Behavior Research Articles

Cognitive Constructs and Personality Profiles in Youth with Deliberate Self-Harm Behaviours: A Scoping Review

This scoping review explored the relationship between cognitive constructs and personality profiles in deliberate selfharm among youth, with the objective of proposing preventive and intervention strategies based on the findings. The review analysed the correlation between cognitive constructs and Deliberate Self-Harm behaviors in youth with diverse personality profiles. It investigated the role of cognitive distortions, emotional regulation, reasoning, and executive functioning in youth engaged in deliberate self-harm. A comprehensive search using the Scopus database yielded 72 relevant articles for analysis. The prevalence rates of deliberate self-harm among youth range from 7.5% to 46.5%, emphasizing the need for targeted interventions. Promising approaches include cognitive restructuring, mindfulnessbased therapies, and interventions focusing on challenging cognitive distortions to promote adaptive thinking patterns. Training interventions addressing executive functioning skills can effectively target impulsive and risky behaviors. Personality traits such as neuroticism, sensation seeking, borderline personality disorder, and perfectionism require interventions focused on emotional resilience, coping strategies, risk assessment, self-control, and impulse management

Associations between unintentional injuries and deliberate self-harm behaviors of children and adolescents: A school-based cross-sectional survey

While statistics from hospitals showed that the proportion of self-harm or attempted suicide kept growing among children and adolescents aged 6–17 attending the emergency department, cases of self-harm or attempted suicide dissimulated as accidents received scant attention or were neglected. This study aimed to examine associations between unintentional injuries subtypes and deliberate self-harm behaviors from a school-based large-scale survey. A school-based cross-sectional study was conducted in Anhui, China, between November 2022 to January 2023. A total of 28,013 students (aged 11–17, 5th–12th grade) from 35 primary schools, 27 middle schools, and 6 high schools were included for the present study. Unintentional injuries in the past year of children and adolescents reported by parents. Self-harm behaviors in the past year of children and adolescents was measured with one question reported by students. Children and adolescents whose parents reported their contacts with sharp instruments demonstrated the highest risk for self-harm behaviors, followed by poisoning, exposure to electric current, falls, vehicle and traffic injuries, accidental drowning and submersion, and eating foreign bodies. And these associations distributed differently among children and adolescents reporting different frequencies of self-harm behaviors. Thus, we urge attention from parents, child caregivers, and teachers on children and adolescents experiencing certain types of unintentional injuries.

Associations between problematic internet use, life satisfaction, and deliberate self-harm among Chinese adolescents: A multi-centered longitudinal study

IntroductionProblematic Internet use (PIU), which is associated with deliberate self-harm (DSH), has become a common problem among adolescents. Life satisfaction (LS) may be able to mitigate the negative influences of PIU and DSH. But the longitudinal associations among them are yet to be well-researched. MethodsA longitudinal study with three-wave data collection involving 6092 adolescents was carried out in China. PIU, LS, and DSH were assessed using the Young Internet Addiction Test, the Satisfaction with Life Scale, and the Deliberate Self-Harm Inventory Nine-Item Version, respectively. A cross-lagged model was used to analyze the longitudinal interactions between them. Generalized Estimating Equations were adopted to identify their influential factors. ResultsThe prevalence of single DSH behaviors from wave 1 to wave 3 was 5.04%, 5.00%, and 4.67%, and the repeated DHS from wave 1 to wave 3 was 2.9%, 3.2%, and 3.4%, respectively. Bidirectional longitudinal predictive associations were revealed between PIU and LS (p＜0.001), and LS and DSH (p＜0.001). DSH could longitudinally predict PIU (p＜0.001). Gender and age were associated with PIU, LS, and DSH (p＜0.001), and PIU was influenced by ethnicity (p＜0.001). ConclusionPIU and LS, LS and DSH were associated bidirectionally. Adolescents with more severe DSH behaviors were inclined to become addicted to the Internet, and adolescents with a history of DSH had a higher risk of recurring DSH. Parents, schools, and administrators need to improve the LS of adolescents, with a particular focus on older, female adolescents.

BDNF and stress/mood-related interactions on emotional disorder symptoms, executive functioning, and deliberate self-harm

Some prior research has suggested that the brain-derived neurotrophic factor (BDNF) gene may amplify responses related to life stress (e.g., depression and anxiety) or associated with negative moods (e.g., self-harm and diminished cognitive functioning). The purpose of this study was to investigate whether stress/mood-related associations with depressive and anxiety symptoms, deliberate self-harm, and executive functioning (EF) are moderated by genotypic variations in BDNF rs10835210 (a relatively understudied BDNF polymorphism) in a nonclinical sample. As part of a larger study, European American social drinkers (N = 132; 43.9% female; M age = 26.0, SD = 7.6) were genotyped for BDNF rs10835210 and were administered self-report measures of subjective life stress, depressive and anxiety symptoms, and history of non-suicidal self-injury (NSSI) and behavioral measures of EF and deliberate self-harm. Results indicated that BDNF significantly moderated the life stress associations with depressive symptoms and NSSI, the anxious mood association with EF, and the depressed mood association with deliberate self-harm behavior. Each of these BDNF × stress/mood interactions were characterized by stress/mood associations that were stronger in individuals with the AA genotype (homozygous for the minor allele) than in individuals possessing a genotype that included the major allele (AC or CC). The main limitations of the present study were use of a cross-sectional design, modest sample size, and investigating only one BDNF polymorphism. Despite these limitations and though preliminary, current findings suggest that variations in BDNF may confer vulnerability to stress or mood, which may result in more adverse emotional, cognitive, or behavioral outcomes.

Investigating the Effective Factors in the Formation of Deliberate Self-harm in Adolescence: Mental Health Professionals’ Viewpoints

Objective: This study aims to investigate the issues related to the formation and persistence of deliberate self-harm behavior in adolescents from Iranian mental health professionals’ viewpoints. Methods: The present qualitative study used semi-structured interviews to record the experiences of 9 mental health professionals with work experience in deliberate self-harm behavior in adolescence. The participants were selected via the purposive sampling method. The Sterling content analysis method was used to analyze the transcription of the interviews. Results: The semantic units of the interview were classified into 32 initial codes. The extracted sub-themes were as follows: A rejection of new identities, repression, the disintegration of social identity, materialism, economic poverty, unresolved parental conflicts, the lack of authority, the ambivalency between boundaries and freedom, shame, and guilt, blame, fear of harm, liberation, self-care, escape mechanism, and replacement, affect regulation, coping with self-disintegration and self-esteem, relationship conflicts with adults and peers, identity creation, identity disorder, boundless mental structure, lack of self-confidence, and distorted self-perception. The following four themes were categorized as subcategories of transformational injuries: Traumatic society, vulnerable family, interpersonal impact, and interpersonal effectiveness. Conclusion: Mental health specialists considered deliberate self-harm traumatic; however, they deem it for eliminating negative emotions and controlling the internal and external world of adolescents. Furthermore, they consider this behavior a reaction to cultural conflicts, cultural materialism, and the disintegration of identity and role during adolescence in families not being capable to facilitate low-risk transformation for adolescents because of economic and psychological factors.

Adolescent Predictors of Deliberate Self-Harm Thoughts and Behavior Among Young Adults: A Longitudinal Cross-National Study

PurposeThis study builds upon and extends previous longitudinal research on deliberate self-harm (DSH) among youth by investigating which risk and protective factors during adolescence predict DSH thoughts and behavior in young adulthood. MethodsSelf-report data came from 1,945 participants recruited as state-representative cohorts from Washington State and Victoria, Australia. Participants completed surveys in seventh grade (average age 13 years), as they transitioned through eighth and ninth grades and online at age 25 years. Retention of the original sample at age 25 years was 88%. A range of risk and protective factors in adolescence for DSH thoughts and behavior in young adulthood were examined using multivariable analyses. ResultsAcross the sample, 9.55% (n = 162) and 2.83% (n = 48) of young adult participants reported DSH thoughts and behaviors, respectively. In the combined risk-protective factor multivariable model for young adulthood DSH thoughts, depressive symptoms in adolescence (adjusted odds ratio [AOR] = 1.05; confidence interval [CI] = 1.00–1.09) increased risk, while higher levels of adolescent adaptive coping strategies (AOR = 0.46; CI = 0.28–0.74), higher levels of adolescent community rewards for prosocial behavior (AOR = 0.73; CI = 0.57–0.93), and living in Washington State decreased risk. In the final multivariable model for DSH behavior in young adulthood, less positive family management strategies during adolescence remained the only significant predictor (AOR = 1.90; CI = 1.01–3.60). DiscussionDSH prevention and intervention programs should not only focus on managing depression and building/enhancing family connections and support but also promote resilience through efforts to promote adaptive coping and connections to adults within one's community who recognize and reward prosocial behavior.

Pengalaman Remaja Perempuan Melakukan Deliberate Self-Harm: Sebuah Kajian Fenomenologis

Self harm or Deliberate Self-Harm (DSH) is carried out with the intention of intentionally injuring a member of the body without any suicidal intent. Previous research has stated that adolescent girls are the most vulnerable group to DSH. DSH behavior in adolescence that is repeated with increasing intensity increases the risk of suicide in adulthood. This research was conducted to find out how the first experience of DSH behavior was carried out by female adolescents and how self-harm was used. A qualitative approach with the type of generic qualitative study is carried out to answer these questions. Participants were selected by snowball sampling technique with the characteristics of female adolescents aged 12-23 years and had DSH in the last three months. Data were collected and processed using thematic analysis. The results show that the teenage girls in this study have been doing self-harm for more than five years and it begins by looking at social media which shows that self-harm can be a solution to the problems they face. The methods of self-harm and the depth of injury that arise due to DSH behavior are increasingly varied and increase the risk for the perpetrator. DSH behavior is important to pay attention to considering the risks and dangers it poses and has the potential to increase the possibility of suicide.

IMPLICATIONS OF CHILDHOOD TRAUMA ON SUICIDAL BEHAVIOR AND DELIBERATE SELF-HARM IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER

Traumatic experiences in the first years of life have an important role in the occurrence of major depression as well as many psychiatric diseases. The aim of this study is to investigate the relationship between childhood trauma (CT), suicidal behavior and deliberate self-harm (DSH) behavior in patients who are diagnosed with major depressive disorder (MDD). 106 patients who were admitted with depressive complaints to the psychiatry outpatient clinic of Recep Tayyip Erdogan University Training and Research Hospital in Turkey were included in the study. Sociodemographic and clinical features data form, Hamilton Depression Rating Scale (HAD-D), Childhood Trauma Questionnaire (CTQ-28) and Intentional Self-harm Questionnaire (DSHI) were applied to all of the cases. 86 (81.1%) of the cases were female and 20 (18.9%) were male. It was determined that 68.9% of the patients had CT, 49.1% had a history of DSH, and 52.1% had a suicide attempt history. It was determined that 75% of those with DSH behavior had a history of suicide attempt. There was a significant difference between the groups (p˂0.001). When the subtypes of CT, suicide ideation, suicide attempt and DSH behavior, were compared to each other, a significant relationship was found for all of the subtypes. A significant correlation was found between the number of CT and suicide attempts and DSH (p˂0.001). In this study, high levels of CT and its subtypes were found in patients with MDD. In the presence of CT and all of its subtypes, suicide attempt and DSH were significantly higher. In the follow-up of cases diagnosed with MDD, questioning CT is important in terms of suicide attempt and prevention of DSH.

Psychometric Properties of the Chinese Version of the Functional Assessment of Self-Mutilation (FASM) in Chinese Clinical Adolescents.

BackgroundFunctional Assessment of Self-Mutilation (FASM) is one of the most widely used tools assessing adolescent's non-suicidal self-injury. However, the Chinese version of FASM (C-FASM) is lacking. The present study aimed to adapt the FASM to the Chinese patients and examine its reliability and validity.MethodsThe original English version of the FASM was translated into Chinese following Brislin's model of cross-culture translation, and then, pilot study and cognitive interview were carried out with 15 adolescent patients to assess the acceptability and comprehensibility of all items. The items were subsequently tested in a sample of 621 Chinese adolescent patients recruited by 20 psychiatric or general hospitals in nine provinces across China. We examined the distribution of responses for each item. Factor analysis, Cronbach's α and McDonald's Ω, intraclass coefficient, and Spearman's rank correlations were deployed to assess the dimensional structure, internal consistency reliability, test–retest reliability, and criterion validity.ResultsThe final adapted C-FASM included a 10-item method checklist and a 15-item function checklist of NSSI, and other characteristics of NSSI. C-FASM exhibited acceptable internal consistency (α = 0.81 and Ω = 0.80 for method checklist; α = 0.80 and Ω = 0.76 for function checklist) and test–retest reliability (method checklist: 0.79; function checklist: 0.87). Factor analysis for NSSI functions yielded a three-factor model with a good model fit. In addition, the instrument showed an expected correlation with the instrument of the Deliberate Self-Harm Behavior Inventory (r = 0.84, p < 0.001).ConclusionsThe C-FASM has good content, structural validity, and reliability. The instrument can be helpful to Chinese adolescents as a comprehensive measure of NSSI behaviors.

Naltrexone as an Adjunctive Treatment for Adolescents With Deliberate Self-Harm Behavior and Cannabis Use: A Case Series

Nonsuicidal self-injury (NSSI) or deliberate self-harm is defined as the volitional, direct injury of the body tissue without suicidal intent. Substance abuse complicates the presentation because it masks the precipitating psychiatric underpinning, and some data show an association between NSSI and cannabis use.

Mindfulness-based psychological interventions for improving mental well-being in medical students and junior doctors.

Mindfulness interventions are increasingly popular as an approach to improve mental well-being. To date, no Cochrane Review examines the effectiveness of mindfulness in medical students and junior doctors. Thus, questions remain regarding the efficacy of mindfulness interventionsas a preventative mechanism in this population, which is at high risk for poor mental health. OBJECTIVES: To assess the effects of psychological interventions with a primary focus on mindfulnesson the mental well-being and academic performance of medical students and junior doctors. We searched the Cochrane Central Register of Controlled Trials (CENTRAL),MEDLINE, Embase and five other databases (to October 2021) and conducted grey literature searches. SELECTION CRITERIA: We included randomised controlled trials of mindfulness that involved medical students of any year level and junior doctors in postgraduateyears one, two or three.We included any psychological intervention with a primary focus on teaching the fundamentals of mindfulness as a preventative intervention. Our primary outcomes were anxiety and depression, and our secondary outcomes included stress, burnout, academic performance, suicidal ideationand quality of life. DATA COLLECTION AND ANALYSIS: We used standard methods as recommended by Cochrane, including Cochrane's risk of bias 2 tool (RoB2). MAIN RESULTS: We included 10 studies involving 731 participants in quantitative analysis. Compared with waiting-list control or no intervention, mindfulness interventions did not result in a substantial differenceimmediately post-intervention for anxiety(standardised mean difference (SMD) 0.09, 95% CI -0.33 to0.52; P = 0.67, I2= 57%; 4 studies, 255 participants; very low-certainty evidence). Converting the SMD back to the Depression, Anxiety and Stress Scale 21-item self-report questionnaire (DASS-21) showed an estimated effect size which is unlikely to be clinically important. Similarly, there was nosubstantial differenceimmediately post-intervention for depression (SMD0.06, 95% CI -0.19to0.31; P = 0.62, I2 = 0%; 4 studies, 250 participants; low-certainty evidence). Converting the SMD back to DASS-21 showed an estimated effect size which is unlikely to be clinically important. No studies reported longer-term assessment ofthe impact of mindfulness interventionson these outcomes. For the secondary outcomes,the meta-analysis showed a small, substantial differenceimmediately post-intervention for stress, favouring the mindfulness intervention (SMD -0.36, 95% CI -0.60to-0.13; P < 0.05, I2= 33%; 8 studies, 474 participants; low-certainty evidence); however, this difference is unlikely to be clinically important.The meta-analysis foundno substantialdifferenceimmediately post-intervention for burnout (SMD -0.42, 95% CI -0.84 to 0.00; P = 0.05, I² = 0%; 3 studies, 91 participants; very low-certainty evidence). The meta-analysis founda small, substantial differenceimmediately post-intervention for academic performance(SMD-0.60, 95% CI -1.05to -0.14; P < 0.05, I² = 0%; 2 studies, 79 participants; very low-certainty evidence); however, this difference is unlikely to be clinically important. Lastly, there was nosubstantial differenceimmediatelypost-intervention for quality of life (mean difference(MD) 0.02, 95% CI -0.28 to0.32; 1 study, 167 participants; low-certainty evidence). There were no data available for three pre-specified outcomes of this review: deliberate self-harm, suicidal ideation and suicidal behaviour. We assessed thecertainty of evidence to range from low to very low across all outcomes. Across most outcomes, we most frequently judged the risk of bias as having 'some concerns'. There were no studies with a low risk of bias across all domains. AUTHORS' CONCLUSIONS: The effectiveness of mindfulness in our target population remains unconfirmed. There have been relatively few studies of mindfulness interventions for junior doctors and medical students. The available studies are small, and we have some concerns about their risk of bias. Thus, there is not much evidence on which to draw conclusions on effects of mindfulness interventionsin this population. There was no evidence to determine the effects of mindfulness in the long term.

Clinical Correlates of Deliberate Self-Harm Among Migrant Trauma-Affected Subgroups.

Introduction: Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health. Migrants with a history of PTEs are more likely to inflict deliberate self-harm (DSH), a spectrum of behavior that includes non-suicidal self-injury (NSSI). With reference to a nonclinical sample of trauma-exposed migrants, this study aims to explore the prevalence of DSH and to assess the association with sociodemographic characteristics and clinical conditions, with particular attention to post-traumatic stress disorder (PTSD) symptoms, resilience capabilities, and feelings of hopelessness.Methods: A sample of migrants underwent a baseline evaluation at an outpatient department of the National Institute for Health, Migration and Poverty (INMP). Migrants with a history of torture, rape, or other severe forms of psychological, physical, or sexual violence were invited to undergo screening at the Institute's Mental Health Unit. Trauma-exposed migrants completed a series of self-report questionnaires that assessed the presence of PTSD, depression, anxiety, suicidal ideation, resilience, and feelings of hopelessness, in addition to DSH. Univariate and multivariate log-binomial regression models were used to test the association of age and clinical characteristic of migrants with DSH. Prevalence ratio (PR) with 95% confidence intervals (95% CI) and p-values were estimated.Results: A total of 169 migrants (76.9% males), aged between 18 and 68 years, M = 28.93; SD = 8.77), were selected. Of the sample, 26.6% were frequently engaging in some form of DSH, and 30.2% were diagnosed with at least one trauma-related disorder. DSH behaviors were most common in single and unemployed migrants as well as in subjects with post-traumatic stress symptoms, feelings of anxiety, hopelessness, low capability of resilience, and suicidal ideation. Taking into account age and hopelessness, we found that PTSD and low resilience capabilities were associated with a higher risk of DSH [PR adj: 2.21; 95% CI: (1.30–3.75) and PR adj: 2.32; 95% CI: (1.16–4.62), respectively].Conclusion: Given the association between trauma exposure and DSH among migrants, exploring the presence of DSH behavior within the immigrant community is crucial for the implementation of measures to develop intervention in a clinical setting.

Deliberate self-harm among adolescents: A structural equationmodelling analysis.

Deliberate self-harm is an intentional behaviour involving direct destruction of body tissues that causes non-fatal physical trauma to the extent that bleeding or bruising occurs without conscious suicidal intent. Adolescents' self-harm is an important issue in mental health work due to its high prevalence in Thailand. This study aims to test a causal model of deliberate self-harm and identify how sex, family relationship, school connectedness, stress, resilience, and self-control influenced deliberate self-harm behaviour in Thai adolescents. A model-testing, cross-sectional study was conducted to test a causal model of deliberate self-harm in Thai adolescents. Multi-stage random sampling was used to recruit 360 adolescents. Adolescents completed six self-report instruments: the family relationship questionnaire, student-school connectedness scale, resilience factors scale for Thai adolescents, self-control questionnaire, Perceived Stress Scale-10 (Thai version), and Deliberate Self-Harm Inventory. Internal consistencies ranged from 0.81 to 0.89. Data were analysed by using descriptive statistics and structural equationmodelling. The findings found sex, resilience, stress, and school connectedness had direct effects on deliberate self-harm (β=-0.139, β=-0.266, β=0.163, and β=-0.671, respectively). Resilience and stress also mediated the links between sex (female), family relationship, school connectedness, and deliberate self-harm. The variables accounted for 65.2% of the variance in the prediction of deliberate self-harm behaviour in Thai adolescents. These findings suggest the causal model of deliberate self-harm fit the empirical data. Interventions to reduce stress and strengthen school connectedness, family relationship, and resilience among Thai adolescents should be implemented, particularly for boys, to prevent deliberate self-harm.

Factors associated with multiple suicide attempts in a nationally representative study of U.S. military veterans

ObjectiveVeterans with a history of multiple suicide attempts are at increased risk for suicide mortality relative to those with a single attempt. However, little is known about factors that differentiate veterans who attempt suicide once compared to more than once. This study examined factors that distinguish single suicide attempters (SSA) from multiple suicide attempters (MSA) in a nationally representative sample of U.S. military veterans. MethodsData were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a representative sample of 4069 U.S. veterans. Analyses: (a) estimated the lifetime prevalence of SSA and MSA; and (b) examined factors that differentiated veterans with a SSA from MSA. ResultsThe lifetime prevalences of SSA and MSA were 1.9% and 2.0%. The strongest correlates of MSA were history of lifetime depression (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.43–8.35), non-suicidal self-injury (OR, 3.28; 95% CI, 1.27–8.45), drug use disorder (OR, 4.0; 95% CI, 1.67–9.54), and marital status (OR, 0.40, 95% CI, 0.18-0.87), which accounted for 15.5%–41.4% of the total explained variance in MSA. DiscussionHalf of military veterans who have attempted suicide in the United States report more than one attempt, suggesting that suicide attempts are not a one-time occurrence for a substantial proportion of veterans. Veterans who attempt suicide more than once show more deliberate self-harm behavior and have greater psychiatric comorbidities relative to single attempters. Implications for future research examining risk factors for suicide attempts among veterans are discussed.

Cessation of Deliberate Self-Harm Behavior in Patients With Borderline Personality Traits Treated With Outpatient Dialectical Behavior Therapy.

The first aim of the study was to identify when deliberate self-harm (DSH) behavior ceased in patients with borderline symptoms undergoing dialectical behavioral treatment (DBT). The second aim was to compare patients who ceased their self-harm behavior early or late in the course of treatment, with regard to demographics, comorbidity, and symptom severity. The study used a naturalistic design and included 75 treatment completers at an outpatient DBT clinic. Of these 75 patients, 46 presented with self-harming behavior at pre-treatment. These 46 participants where split into two groups, based on median amount of time before ceasing self-harm behavior, termed early (up to 8 weeks) and late (8+ weeks) responders. Treatment duration varied from 16 to 160 weeks. Patients were assessed pre- and post-treatment using measures of depression, hopelessness, personality traits, quality of life, and global assessment of symptoms and functioning. The majority (93.5%) ceased their self-harming within the first year, and the average number of weeks was 15.5 (SD = 17.8). Twenty-five percent of patients ceased their DSH behavior during the first week of treatment. For the remaining patients, the cessation of DSH continued gradually across a 1 year period. We found no differences between early and late responders with respect to demographics, comorbidity, symptom severity, or treatment outcome. None of the patients committed suicide. The findings indicate that self-harming behavior decreases gradually across the first year after starting DBT.

Characteristics and Clinical Outcomes of Patients Attending a Victorian Metropolitan Crisis Intervention Team

Background: Little is known about the nature of service users who seek crisis community care in recent times in the Australian context. Objectives: The objective of this study was to describe the sociodemographic, clinical, and service provision characteristics and 12-month clinical outcomes of patients in a metropolitan crisis intervention team. Methods: Patients who were registered during the study period (May 1, 2015–October 30, 2015) for crisis intervention from a metropolitan community mental health team were included for this retrospective cohort study. The type of psychosocial stressor triggering the crisis was assessed by the social readjustment scale. Results: A situational crisis or adjustment disorder (26.6%) was the most common primary diagnosis, followed by an affective disorder. Deliberate self-harm behavior was the leading risk behavior (18.1%). Major injury or illness to self (16%) was the main psychosocial stressor associated with crisis presentation. The primary health sector was the main source of referral and discharge destination. Nearly 40% of patients were re-referred within a 12-month period since index contact. The characteristics of re-referred patients were men, living with a housemate or other family, triage category C, diagnosis of a mood disorder, needing medication supervision, and discharged to inpatient treatment during the index episode of care. Conclusions: A continuous and collaborative model of care between the primary health sector and community mental health services might be more beneficial in the early identification and management of the acute crisis in a subgroup of patients. A diverse range of skills are needed for clinicians working in the crisis intervention service in the current times.

Phenotypic Characterization of Youth Admitted To Acute Psychiatric Inpatient Unit Following Self-Harm Behavior

Objective Deliberate self-harm (DSH) is a major health concern among adolescents, and is often associated with the need for inpatient psychiatric hospitalization. The aim of this study was to identify clinical and demographic characteristics associated with DSH behavior among adolescents admitted to an acute psychiatric inpatient unit. Method We retrospectively analyzed data from the electronic medical records of consecutive admittances to a single acute adolescent inpatient unit (n = 703, mean age 15.2). We compared inpatients with DSH to inpatients without DSH and further compared within the DSH group based on the presence of suicidal intent. Results Compared to Non-DSH inpatients (n = 497), youths admitted following DSH (n = 206) were more likely to be female (OR = 2.6, 95%CI 1.7–4), currently in depressive exacerbation (OR = 2.4, 95%CI 1.6–3.6), with concurrent suicidal ideation (OR = 3.9, 95%CI 2.5–5.9), and history of alcohol use (OR = 5.6, 95%CI 3.2–9.5). Within DSH youths, no significant clinical differences were identified between those admitted following a suicide attempt (n = 102) compared to non-suicidal-self-injury (n = 104), who were generally younger. Conclusions Findings suggest that early detection and intervention of DSH and depressive crisis is warranted, regardless of the self-harm subtype. HIGHLIGHTS Deliberate self-harm is common among adolescent psychiatric inpatients. Adolescent inpatients with deliberate self-harm are predominantly females with concurrent depression and suicidal ideation. We did not detect significant clinical and demographic differences between self-harmers with or without suicidal intent.

The psychometric properties and clinical utility of the Norwegian versions of the deliberate self-harm inventory and the inventory of statements about self-injury

Deliberate self-harm (DSH) is a widespread transdiagnostic health problem with increasing prevalence among adolescences, and young adults. It is therefore essential to effectively chart the epidemiology of DSH, as well as to assess the efficacy of interventions designed to modify this behavior. The aim was to translate and analyze the psychometric properties of the Norwegian versions of two instruments designed to assess DSH: the Deliberate Self-harm Inventory (DSHI) and the Inventory of Statements About Self-Injury (ISAS), as well as to assess the prevalence of DSH within a nonclinical Norwegian adult population. Of the 402 participants who completed a questionnaire packet comprising the DSHI, ISAS, general questions about DSH, and other related measures, 30.6% reported some form of DSH. Those with a history of DSH reported greater difficulties with emotion regulation than those without. Participants with and without a history of DSH did not differ in unrelated constructs, including social desirability. The frequency of specific DSH behaviors was in accordance with previous research, with cutting being the most frequent. The factor structure of DSH functions in the Norwegian ISAS was generally comparable to the factor structure of the English version. Overall, results indicate that: a) the Norwegian versions of the DSHI and ISAS behave as expected and in accordance with prior research in other languages and other populations, and b) both the DSHI and ISAS have high internal consistency and adequate construct, convergent, and discriminant validity, and may be applied to evaluate DSH in adult Norwegian populations.

Self-Harm Behavior among Adolescent Students of Higher Secondary Schools of Kathmandu Valley, Nepal

Introduction: A sizable amount of adolescents do self-harm, but most cases do not reach medical services as well as the attention of college administration and parents, making such a study essential to be carried out. The prevalence of suicidal thoughts and deliberate self-harm behavior remains largely unexplored. In this study, self-harm behaviors among adolescents studying at higher secondary schools were evaluated in selected schools of Kathmandu Valley in Nepal.&#x0D; Methods: The purposive sampling of five different higher secondary schools in the Kathmandu valley were taken as a study area and the census was done to select the sample population of the selected higher secondary school. A crosssectional analysis of self-administered questionnaire data was collected aftertaking informed and assent consent from participants (n= 243)14-19 years old.&#x0D; Results: The prevalence of lifetime self-harm was approximately 55.6%. The most commonly used self-harm method was scratching the skin intensely (14.5%) and was followed by carving words or other marks on the skin (14.0%). Of those who reported self-harm, 34.8%, intentionally hurt themselves to get the attention of others and 17.8% to punish themselves. Concurrent alcohol consumption (OR=3.660), cigarette smoking (OR=2.50), and depression (OR= 3.01) were associated with a significantly increased risk of self-harm. Similarly, problems with various social relationships were associated with the risk of self-harm. 68.1% knew other people harming themselves before they were involved in self-harm and 19.6% were influenced by family, friends, and media to harm themselves.&#x0D; Conclusions: Self-harm behaviors are common among adolescents. Although the majority of self-harm behavior is not accompanied by a desire to die (serious attempt), all self-harm regardless of motivation is associated with an increased risk of deliberately harming when it is carried out repeatedly.

Acoso escolar, conductas autolesivas, ideación, e intentos autolíticos en una muestra clínica de un centro de salud mental

El acoso escolar es un problema muy relevante actualmente pero difícil de cuantificar. Se ha demostrado el considerable impacto del acoso escolar sobre la salud mental de los adolescentes. En los últimos años, se han publicado varios artículos relacionando el maltrato entre iguales como factor de riesgo para la aparición de conductas autolesivas, incluyendo los gestos con intencionalidad autolítica. Metodología: diseño de un estudio observacional transversal, con una muestra clínica obtenida de un centro de salud mental (Programa de Niños y Adolescentes) en la ciudad de Madrid. Se administró un cuestionario específicamente diseñado para este estudio. Resultados: se recopilaron 129 casos en total. De esa muestra, se detectaron 22 casos de acoso escolar (17.1% de la muestra total del estudio). Se detectaron 26 casos con conductas autolesivas, de los cuales 7 casos habían sido acosados (31%). El porcentaje de autolesiones en el grupo de acoso escolar era mayor que en la población control. En la muestra con historia de acoso escolar era mayor la aparición de ideación autolítica que en la muestra sin acoso escolar. El riesgo de intentos autolíticos en la muestra de acoso escolar no llega a ser estadísticamente significativo. Conclusiones: este estudio da una idea del impacto emocional del maltrato entre iguales, sobre todo con consecuencias significativas en la salud mental de los adolescentes.