Self-harm Behaviors Research Articles

A Multiperspective Approach to Self-Injurious Behavior, Bullying, and Student Mental Health: A conceptual research

Challenges in the education sector in Indonesia are not limited to numerical skills, literacy, and life skills alone but have expanded to encompass the low quality of students' attitudes and behaviors. These behaviors are reflected in self-harm actions, bullying, and can have negative impacts on students' mental health. The aim of the research is to provide a basis for the development of holistic intervention strategies based on a multiperspective approach to address self-harm behaviors, bullying, and mental health issues among students. A multiperspective approach allows for the integration of various perspectives in analyzing this complex phenomenon. This paper will delve deeply into these three issues. First, self-harm behaviors will be explained in various forms, including self-harm and addiction. Analysis is conducted involving psychological, social, and neurobiological perspectives to understand the causes and impacts of self-harm behaviors on students. Second, bullying as a social phenomenon is also analyzed in depth using a multiperspective approach. Individual, environmental, and cultural factors influencing bullying are explored through psychological, sociological, and educational perspectives. Finally, students' mental health becomes another focus of this paper. By utilizing a multiperspective approach, the author seeks to identify factors contributing to mental health issues among students. The analysis involves psychological dimensions, school environment, and social support. Overall, the study of a multiperspective approach is expected to provide deep insights into the complexity of the issues under examination. This holistic analysis is expected to serve as a solid basis for the development of policies, interventions, and better approaches in responding to and preventing self-harm behaviors, bullying, and mental health issues among students.

An Action Study of Feminist Group Counseling on the Self-Identity of Children Who Self-Injured

<p>本研究旨在以女性主義取向團體輔導方案的介入，探討具有自傷行為兒童在團體歷程中的自我認同發展。本研究採取行動研究，招募五名國小六年級學童為研究對象（四女一男），進行每週一次，一次四十分鐘，為期八次的小團體輔導。團體設計以女性主義諮商理論為本，涵蓋身份覺察、賦能、敘說、平權等重要議題。透過省思札記、成員及師長的訪談記錄、觀察員的觀察與回饋等多種方式蒐集資料，結合三角驗證方式分析，以瞭解具有自傷行為兒童在女性主義團體輔導歷程之經驗內涵。重要結果如下：一、女性主義取向強調團體敘說、平權關係與支持關懷，促使學童有機會自我揭露生命故事，從而連結彼此。二、女性主義團體輔導方案的介入，有助於學童對社會角色的覺察，轉化以正向觀點定義自己，增進改變的行動力。三、學童在團體的普同經驗，促使學童降低孤獨感，進而坦然面對自傷與真實自我。四、學童覺察與肯定其優勢能力，提升我能感，促使增進自信心與自我認同。五、在團體歷程中的行動與改變，促進學童對自我的賦權，進而提升自我認同與悅納，進而將改變實踐於日常生活。</p> <p> </p><p>This study explored the self-identity development of children with non-suicidal self-injury behavior through a feminist-oriented group counseling program intervention. This study adopted an action research approach and included five participants from the sixth grade: four females and one male. The group met once a week for 40 minutes each time, for eight weeks. The group project involved doctrines of feminist counseling theory, including awareness, empowerment, narrative, and equality. Data were collected through the researcher’s reflections, observer’s notes, and interviews with the participants and with the participants’ teachers and parents. The researcher analyzed data and verified the analysis by using the triangulation method. This study’s findings are summarized as follows: 1. The narratives, equality, and supportive care that the feminist group counseling approach emphasizes provided the self-harm student participants the opportunities to tell and re-tell their life stories; disclosing their stories helped them connect to the other participants. 2. The group counseling intervention helped students aware of their social roles, transform their thoughts into a positive perspective, and enhance their capacities to change. 3. The common experience that the students shared during the group process helped reduce their loneliness, rethink their self-harm behaviors, and face their true selves openly. 4. Through the group process, students gained more awareness and confidence regarding their strengths in abilities, enhanced their sense of power, and fostered a strong sense of self-identity. 5. The action and change during the group process facilitated the students’ self-empowerment, enriched their self-identity and self-acceptance, and finally, helped them implement changes in everyday life.</p> <p> </p>

Exploring lesbian internalised homophobia and self-harming: A thematic analysis

BackgroundInternalised homophobia has been associated with maladaptive coping and higher levels of psychological distress. Self-harm within a lesbian population is under researched, specifically in relation to internalised homophobia. The study aimed to explore whether internalised homophobia influences self-harming and coping mechanisms in a lesbian population.MethodAll participants (N = 103) were over 18 (M = 22.87, SD = 6.9) assigned female at birth, and identified as lesbian. The study implemented a qualitative design through an online questionnaire which asked six open-ended questions regarding sexuality, coping mechanisms and internalised homophobia. Results: Through thematic analysis three themes were identified: the role of sexuality on self-harm, importance of LGBTQ+ community, and negative societal perceptions which were explored in relation to relevant literature.ConclusionThrough thematic analysis, internalised homophobia was identified as a sub-theme of self-harming behaviours. The LGTBQ+ community was found to be a protective factor from maladaptive coping behaviours through belonging and shared culture. Participants highlighted there were negative societal perceptions regarding the LGBTQ+ community in general, but also their struggles with self-harm and mental health. The strengths and limitations of the study are addressed alongside suggestions for future research.

Exploratory Analysis of the Self-Harming Behaviors Among University Students

This study examines the self-harming behavior of some university students and determines the types of self-harming behavior these students engage in. A self-report questionnaire on self-harm was used in this study for 319 students. Results of the study show that the most common self-harming behaviors exhibited by the students were banging the head, abusing alcohol, cutting the self, hitting the self, and scratching the self on purpose, while the least common self-harming behaviors include torturing the self with self-defeating thoughts, being promiscuous, distancing self from God as punishment, driving recklessly on purpose, and engaging in emotionally abusive relationships. There is no significant difference in terms of gender among males and females who engaged in self-harming behaviors. However, exploratory analysis identifies significant mean differences in self-harming behaviors between students from different programs. It is recommended that an intervention program should be prepared in order to protect the mental health of the respondents and the university students in general.

Prevalence of non-suicidal self-injury in medical students of Rawalpindi; its socio-demographics, methods, and functions

Objective: To investigate the prevalence of non-suicidal self-injury among Pakistani medical students, its association with demographic variables, and the distribution of its methods and functions. Method: The cross-sectional study was conducted in from April 2021 to March 2022 at Rawalpindi Medical University, Rawalpindi, Pakistan, and comprised medical students regardless of gender and year of study. Data was collected using the inventory of statements about self-harm scale to assess their socio-demographics, non-suicidal self-injury behaviors and functions. Data was analyzed using SPSS 28. Results: Of the 411 subjects approached, 386(94%) correctly filled the forms; 170(44%) males and 216(55.9%) females. The overall mean age was 19.7 ±1.5 (range: 17-27 years). There were 132(34.1%) students from first year, 146(37.8%) second year, 44(11.3%) third year, 54(13.9%) fourth year and 10(2.5%) from the final year. There were 110(28.4%) with non-suicidal self-injury; 60(54.5%) males and 50(45.4%) females (p=0.008). There were 18(4.7%) subjects aged 18 years, and, of them, 14(77.7%) exhibited self-harm behavior. Among specific non-suicidal self-injury behaviors, ‘interfering with scabs and wound healing’ was the most common method 80(72.7%). As for the functions of non-suicidal self-injury behavior, there was a significant difference between intrapersonal and interpersonal functions (p<0.05). Conclusion: Non-suicidal self-injury was highly prevalent among the young subjects, and it needs proper intervention for timely management. Key Words: Behavior, Behavior mechanisms, Pakistan, Personality inventory, Self-injurious behavior, Young adult.

Latent Profile Analysis of Urges for Suicidal and Self-Harming Behavior: The Role of Social Support Instability

College counseling centers are seeing increasing rates of suicidal thoughts and behaviors, and nonsuicidal self-injury (NSSI) among students. The high degree of need and limited resources underscores the need for novel approaches to identify at-risk students. We used latent profile analysis (LPA) to identify subgroups of students (n = 371) with different patterns of interpersonal factors and examine whether these subgroups differed by risk for self-injurious thoughts and behaviors. The best-fitting LPA had three profiles, which differed in urges to die by suicide and engage in NSSI. The profile with low average social support and higher instability (greater day-to-day fluctuations of self-reported social support and rejection) was associated with greatest risk, suggesting that this combination leaves individuals more vulnerable to suicide and NSSI.

Bullying and self-harming behavior in universities – A cross-sectional study of a sample of 327 university students

IntroductionBullying is a widespread public health issue, found in different contexts (e.g. schools, universities, workplaces, families), and it has negative consequences on both the perpetrator and the victim. There is a lack of studies addressing bullying among university students in Arab countries and more specifically in Lebanon. The objective of our study was to determine the prevalence of bullying among a sample of university students in Lebanon, its forms, and associated factors. MethodsThe study consists of a cross-sectional online survey addressed to university students in Lebanon that evaluates sociodemographic data, presence and type of bullying, history of bullying during childhood, adverse childhood experiences, daily life functioning, and mental health status (reported psychiatric disorders, substance use, self-harming behaviors, and suicidal attempts). Chi-Square and Fisher's exact tests were used to compare the results between victims of bullying and the rest of the sample. ResultsThree hundred and twenty-seven university students participated in this study. The prevalence of bullying was 14.1%. The main forms of reported bullying were verbal (58.7%) and social bullying (65.2%). The main associated factors were being a witness of bullying at university (84.8% vs. 56.2% – P<.001) and history of cyberbullying (13% vs. 4.6% – P=.024). Among students who reported current bullying, 28.3% had a psychiatric diagnosis, 19.6% reported substance use, 15.2% had self-harming behaviors, and 8.7% had suicide attempts. Victims of bullying in the university reported a significant negative impact on their daily lives (lack of interest in daily activities, academic decline) (83.7%) and mental health concerns (psychiatric disorders, substance use, suicide attempts) (88.4%). ConclusionEven though bullying is an event less experienced in university than in school, it is nevertheless still present with potential negative impact on the victims. Bullying in a university setting is a public health issue that could benefit from more studies as well as prevention and intervention programs.

Self Harm and Suicide in Adolescents

Self harm is also called Non-Suicidal Self-Injury (NSSI). NSSI is defined as intentional self-injurious behavior to cause minor bodily harm without suicidal intent. Self-harm is strongly associated with suicidal thoughts and approximately 27-30% of adolescents with NSSI have reported suicide attempts. Based on the explanation above, the author is interested in discussing self-harm and suicide to explore the definition and management of self-harm and suicidal behavior in adolescents. In writing this literature review, we used a literature study method from various references and focused on discussions about self-harm and suicide. The search engines used were PubMed, ProQuest, and Google Scholar with the keywords "Self harm and suicide", "Epidemiology", "Diagnosis", and "Management". Overall, there were 30 articles used as references for preparing the literature review. The results of the investigation showed that self-harm and suicide are mental problems that often occur in teenagers and therefore require appropriate management using non-pharmacological and pharmacological medical approaches.

Perampanel effectiveness in treating ROGDI-related Kohlschütter-Tönz syndrome: first reported case in China and literature review

PurposeThis study reported the first case of Kohlschütter-Tönz syndrome (KTS) in China and reviewed the literature of the reported cases.MethodsThis patient was registered at the Children’s Hospital of Chongqing Medical University. The patient’s symptoms and treatments were recorded in detail, and the patient was monitored for six years. We employed a combination of the following search terms and Boolean operators in our search strategy: Kohlschütter-Tönz syndrome, KTS, and ROGDI. These terms were carefully selected to capture a broad range of relevant publications in PubMed, Web of Science, WHO Global Health Library, and China National Knowledge Infrastructure, including synonyms, variations, and specific terms related to KTS. The pathogenicity of the variants was predicted using SpliceAI and MutationTaster, and the structures of the ROGDI mutations were constructed using I-TASSER.ResultsThis is the first case report of KTS in China. Our patient presented with epilepsy, global developmental delay, and amelogenesis imperfecta. A trio-WES revealed homozygous mutations in ROGDI (c.46-37_46-30del). The brain magnetic resonance imaging (MRI) and video electroencephalogram (VEEG) were normal. The efficacy of perampanel (PMP) in treating seizures and intellectual disability was apparent. Furthermore, 43 cases of ROGDI-related KTS were retrieved. 100% exhibited epilepsy, global developmental delay, and amelogenesis imperfecta. 17.2% received a diagnosis of attention deficit hyperactivity disorder (ADHD), and 3.4% were under suspicion of autism spectrum disorder (ASD). Language disorders were observed in all patients. Emotional disorders, notably self-harm behaviors (9.1%), were also reported.ConclusionROGDI-related KTS is a rare neurodegenerative disorder, characterized by three classic clinical manifestations: epilepsy, global developmental delay, and amelogenesis imperfecta. Moreover, patients could present comorbidities, including ADHD, ASD, emotional disorders, and language disorders. PMP may be a potential drug with relatively good efficacy, but long-term clinical trials are still needed.

Establishing the Manner of Death: A 3D Reconstruction of a Case of Hanging

Establishing the manner of death is one of the most challenging tasks for forensic pathologists. We present the case of a 24-year-old woman found dead in the early morning on a flyover. The body was sitting on the ground with the back leaning against a wall. The neck was encircled by a white phone charger cable knotted to the staircase’s handrail. The victim had argued with her boyfriend and tried to jump out of his car while coming home from a wedding party the night before. After that, she left home alone with her phone charger in her hand. Due to self-harm behaviors, the first hypothesis was suicide by hanging. However, the ligature crossed immediately beneath the thyroid cartilage and encircled the neck twice horizontally; the two ends of the cable overlapped, forming a cross-over point in the front-right of the neck. Then, the ligature passed obliquely through the nape, gradually disappearing, forming a gap in the mark. The mark was sharply defined, stiff, yellow, and parchment-like. The investigators performed a three-dimensional scene reconstruction using the Trimble X7 Laser Scanner and the PC-Crash Multibody System. Even though the geometry of the ligature mark in the present case raised doubts about the manner of death, the three-dimensional reconstruction confirmed that the hanging was feasible without any external intervention.

Life experienced as worth living and beyond: a qualitative study of the pathways to recovery and flourishing amongst individuals treated for borderline personality disorder

BackgroundDialectical Behaviour Therapy (DBT) is recognized as a leading evidence-based treatment, effective in reducing symptoms of borderline personality disorder (BPD), as well as co-occurring clinical syndromes. However, symptom remission may not be the same as a life experienced as worth living. The purpose of the study was to understand, from the perspective of individuals with lived experience, the concepts of recovery, life experienced as worth living and flourishing after treatment for BPD, and to describe the pathways to wellness after symptom remission.MethodsSemi-structured interviews were conducted with nine adult women previously diagnosed with BPD, co-occurring clinical syndromes and severe self-harm behaviour who self-identified as recovered for a minimum of two years, recruited from a network for individuals with lived experience. The average duration of recovery was 5.7 years with a range from 2 to 10 + years. Data were analysed using thematic analysis.ResultsFour main themes and 14 subthemes were generated from our analyses. Main themes indicated that loved ones helped recovery and to create a life worth living, that participants identified as recovered and as healthy and beyond, and that becoming well is a long process associated in part with reclaiming a healthy identity. Participants defined recovery as separate but related to a life worth living, which in turn was separate but related to being healthy and having lives they described as being beyond health and well-being. The wellness process was described as lengthy and non-linear, including setbacks that with time no longer derailed daily life. A proposed theoretical model depicting the wellness process over time from symptom remission to the experience of a life beyond health and wellness is presented.ConclusionsThis qualitative study contributes knowledge of what a life experienced as worth living means, as well as how wellness progressed into flourishing for some participants within a sample of individuals with lived experience. Our findings may inform treatment development that targets more than symptom reduction, which in turn may shorten trajectories from symptom remission to health, wellness, and flourishing.

Risk of self-harm in patients with eating disorders: English population-based national record-linkage study, 1999-2021.

Anorexia nervosa (AN) and bulimia nervosa (BN) are eating disorders associated with high rates of self-harm (SH). This is the first national study in England to quantify this association in a hospital population. A retrospective cohort study using a linked national dataset of Hospital Episode Statistics for 1999-2021. The exposure cohort included individuals aged <35 years admitted to hospital with a diagnosis of AN or BN. The reference cohort included hospital controls. We calculated the rate ratio (RR) of SH in each cohort. The individuals in the two cohorts were matched on multiple socio-demographic indicators. The main outcome was a subsequent hospitalization or death record with an SH diagnosis. We identified 15,004 females and 1411 males with AN, and 6055 females and 741 males with BN. The RR with 95% confidence intervals (95%CI) for a subsequent admission with intentional self-harm after admission with AN was 4.9 (95%CI 4.7-5.1) in females and 4.8 (95%CI 3.9-5.8) in males. For BN it was 9.0 (95%CI 8.4-9.6) in females and 9.8 (95%CI 7.7-12.2) in males. There were strong associations between AN and BN and other SH. Women and men admitted to English hospitals with AN or BN have a very high risk of a subsequent admission with SH. For some SH behaviors, such as alcohol intoxication, the RR was >10-fold elevated. The magnitude of risk was higher for BN than for AN. Clinicians should be aware of the scale of risk increase. Providing those at risk with appropriate support is required. This study is the first national study in an English hospital population that confirms and quantifies the association between eating disorders and self-harm. We have found that both women and men admitted to hospital with anorexia nervosa or bulimia nervosa are at an increased risk of subsequent admission with self-harm. It is important that clinicians are aware of this increased risk to support those at highest risk of self-harm.

Sociodemographic Profile and Psychological Factors Influencing Deliberate Self Harm in a Tertiary Rural Health Care Setup: A Cross-sectional Study

Introduction: There has been a rising trend of deliberate self-harm (DSH) in India recently. The tendency to harm oneself is associated to female sex, younger age, stressful life events and mental illnesses such as depression. Knowledge of socio-demographic factors and psychiatric morbidities in patients having self-harming behavior can be helpful in planning suicide prevention strategies.Methods: This was a hospital-based descriptive, observational, cross-sectional study. The data was collected from 150 consecutive referrals DSH to the psychiatry OPD in Rural Tertiary Care Centre. Corresponding validated psychometric scales quantified severity of depression, and suicide intent.Results: Most of the study population belonged to 18 to 29 years age group and most were males (n = 105, 70%). Poisoning was the most common mode of DSH (n = 133, 88.7%). Diagnosable psychiatric illnesses were found in 52 (34.6%) patients, most common being adjustment disorder (n = 25, 16.6%).Conclusion: Our study highlights the socio-demographic, psychosocial and clinical factors present in individuals attempting self-harm.

Personality and Acculturation as Predictors of Self-harm Behaviors in Latinx Young Adults

Personality and Acculturation as Predictors of Self-harm Behaviors in Latinx Young Adults

Therapeutic and Preventive Interventions in Adolescents with Borderline Personality Disorder: Recent Findings, Current Challenges, and Future Directions.

Borderline personality disorder (BPD) has long suffered from overshadowing in adolescents and hopelessness from the psychiatrists themselves. Comprehensive guidelines for this age group are lacking. This narrative review aims to describe current recommendations for BPD and recent empirical evidence on effective treatments (both pharmacological and non-pharmacological) and preventive approaches. Innovative approaches, based on recent and original research on BPD adolescents, are also discussed. Very low-certainty evidence has supported that medication has a positive effect on core BPD symptoms in adolescents. Medication prescribed for suicidal crises or associated disorders should be included in a global therapeutic plan, including efficacy reassessment, treatment duration, and a security plan. The overall benefit of structured psychotherapy for adolescents with BPD (cognitive behavioral therapy, mentalization-based therapy, dialectic behavioral therapy, and group therapy) is more important for self-harm behaviors than other BPD symptoms. Their specific efficacy, although difficult to distinguish from the overall non-specific effect of integrative care. structured care of young BPD individuals should be based on the following principles: (1) setting the frame of care, including recognition of the diagnosis, and sharing information with patients and families about symptoms, prognosis, and putative psychological mechanisms involved; and (2) promoting comprehensive approaches, including both specific and non specific therapy, ecological interventions, community care, and preventive interventions in at-risk groups.

Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe self-harm - results from the Extreme Challenges project.

Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm.

Differentiating between intrapsychic symptoms and behavioral expressions of borderline personality disorder in relation to childhood emotional maltreatment and emotion dysregulation: an exploratory investigation

ABSTRACT Background: Borderline personality disorder (BPD) is a severe mental disorder, characterized by pronounced instability in emotions, self-image, and interpersonal relationships. Experiences of childhood maltreatment are among the risk factors for BPD. While self-damaging and aggressive acts often occur, not every person with the disorder shows markedly dysregulated behaviour. Internalized symptoms, such as shame, loneliness, and self-disgust tend to be more pervasive and persist after clinical remission. Objective: Here we investigated associations between BPD symptom severity, childhood maltreatment, and emotion regulation difficulties. We further explored if the Borderline Symptom List (BSL) could potentially be used to differentiate between internalized symptoms (intrapsychic strain) and externalized symptoms (dysregulated behaviours) in future research. Method: 187 women with at least mild BPD symptoms (65% having a diagnosis of BPD) completed the BSL 23 including its 11-item supplement (BSL-S), the Childhood Trauma Questionnaire (CTQ), and Difficulties in Emotion Regulation Scale (DERS). Participants further underwent a semi-structured clinical interview to assess BPD criteria (International Personality Disorder Examination, IPDE). Multivariate models and regression-based bootstrapping analyses were performed to test direct and indirect effects. Results: Childhood trauma severity, especially emotional abuse, positively predicted BPD symptom severity. A significant indirect effect through emotion regulation difficulties was found (k 2=.56). When exploring associations with BPD criteria (IPDE), the BSL-23 mean significantly correlated with separation anxiety, identity and mood problems, chronic emptiness, suicidal ideation, and dissociation, while the BSL-S correlated with self-harming impulsive behaviour and anger outbursts. Conclusions: Findings complement previous research, highlighting the role of childhood maltreatment and emotion regulation difficulties in BPD. While our findings need to be seen as preliminary and interpreted with caution, they suggest that the BSL may be used to differentiate between internalized symptoms and behavioural expressions of BPD in future research. Such a distinction might help to deepen the understanding of this complex heterogenous disorder.

자해를 하는 사람들의 온라인 활동에 대한 내용 탐색

Objectives This study aims to understand the characteristics of self-harming people by analyzing the contents of comments uploaded by self-harming people to YouTube videos related to “self-harm,” and to find effective counseling intervention by confirming the characteristics of their online activities.&#x0D; Methods Comments on the top 9 videos derived by searching for the keyword “self-harm” on YouTube were collected. Among them, topic modeling was conducted with comments from users who reported that they had self-harm experience. Topic modeling is a method of deriving core topics from big data and reviewing and pre-senting optimal documents representing the derived core topics. Through this, 10 topics and 20 sub-topics were selected.&#x0D; Results Selected topics include “Psychiatry and medication started with fear of self-harm.”, “Response to the content of the video.”, “Difficulties faced in consulting with self-harm.”, “Reaction to the video you uploaded.”, “Self-harm related bullying, academic problems.”, “The will to commit suicide and the hesitation caused by family.”, “Self-harm that was attempted suicide.”, “Parents' reaction to self-harm.”, “Short-term and long-term effects of self-harm.”, “The emotions that others react to self-harm.”.&#x0D; Conclusions Measures should be prepared to increase accessibility to medical and counseling interventions to reduce self-harm behavior, and to solve ethical difficulties that may be experienced when counseling self-harm participants. Self-harming people were being comforted by the empathy they got online and were praying for ev-eryone's recovery. Based on this, a counseling intervention method that can help self-harming people was pre-sented, and opinions on the significance, limitations, and future research were presented.

To what extent are depressive or other mood disorders a consequence of earlier traumatic experiences?

The potential relationships between traumatic experiences and the onset and course of major mood disorders have always been controversial. Some experiences, most notably physical or sexual abuse, as well as substantive bullying in childhood, are clearly recognised as major risk factors for a range of mental disorders, as well as a range of linked phenomena including self-harm and suicidal behaviours (McKay et al., 2021; Zatti et al., 2017). There is considerable interest and ongoing research into how these adverse experiences come to be ‘encoded’ via neurobiological or genetic mechanisms that then transmit those effects into later-onset major mental disorders, substance misuse or other self-harming behaviours (Maddox et al., 2019).

Does declining social connection, and increased reported loneliness, explain the apparent increase in depressive and other mood disorders, particularly among younger people?

There is much conjecture about which social factors underpin an apparent increase in the incidence of psychological distress, depression and other mood disorders, self-harm and suicidal behaviour and presentations for mental health care (in economically-developed countries). These concerns are particularly focused on younger birth cohorts, where the epidemiological evidence appears strongest for a genuine increase in incidence of mood disorders and self-harming behaviours (Twenge et al., 2019).