Dataset Information

Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation.

ABSTRACT: Self-harm is common and associated with adverse outcomes. Research about the risk factors for self-harm has informed the field with regard to clinical interventions that should be delivered for young people who engage in self-harm. Missing is an in-depth understanding of what the triggers of an urge to self-harm might be, including in young people being treated with a clinical intervention. Therefore, there is little knowledge about what techniques young people find helpful to deal with urges to self-harm when they occur. This qualitative study engaged seven young people with lived experience of self-harm in semi-structured interviews about the immediate triggers of the urge to self-harm, and helpful strategies to manage this urge. Thematic analysis using a general inductive approach revealed distressing emotions and a sense of isolation as key themes, with other triggers associated with their induction. Highlighted was the wide range of situations and emotions that can be triggering, such that a further key theme was the idiosyncratic nature of the self-help strategies young people found helpful. Interventions that are developed to support young people who self-harm must address this complexity and findings highlight the need for young people to maintain some autonomy and control while being supported to connect with others for support. This research adds to the literature on self-help strategies to support young people in moments when they are experiencing distressing emotions, feel isolated, and have an urge to self-harm providing important insight to the prevention and intervention for self-harm among young people.

SUBMITTER: Hetrick SE

PROVIDER: S-EPMC6968776 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation.

Hetrick Sarah E SE Subasinghe Aruni A Anglin Kate K Hart Laura L Morgan Amy A Robinson Jo J

Frontiers in psychology 20200110

Self-harm is common and associated with adverse outcomes. Research about the risk factors for self-harm has informed the field with regard to clinical interventions that should be delivered for young people who engage in self-harm. Missing is an in-depth understanding of what the triggers of an urge to self-harm might be, including in young people being treated with a clinical intervention. Therefore, there is little knowledge about what techniques young people find helpful to deal with urges to ...[more]

PMID: 31998182

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Project description:BackgroundGiven the concerns about bullying via electronic communication in children and young people and its possible contribution to self-harm, we have reviewed the evidence for associations between cyberbullying involvement and self-harm or suicidal behaviors (such as suicidal ideation, suicide plans, and suicide attempts) in children and young people.ObjectiveThe aim of this study was to systematically review the current evidence examining the association between cyberbullying involvement as victim or perpetrator and self-harm and suicidal behaviors in children and young people (younger than 25 years), and where possible, to meta-analyze data on the associations.MethodsAn electronic literature search was conducted for all studies published between January 1, 1996, and February 3, 2017, across sources, including MEDLINE, Cochrane, and PsycINFO. Articles were included if the study examined any association between cyberbullying involvement and self-harm or suicidal behaviors and reported empirical data in a sample aged under 25 years. Quality of included papers was assessed and data were extracted. Meta-analyses of data were conducted.ResultsA total of 33 eligible articles from 26 independent studies were included, covering a population of 156,384 children and young people. A total of 25 articles (20 independent studies, n=115,056) identified associations (negative influences) between cybervictimization and self-harm or suicidal behaviors or between perpetrating cyberbullying and suicidal behaviors. Three additional studies, in which the cyberbullying, self-harm, or suicidal behaviors measures had been combined with other measures (such as traditional bullying and mental health problems), also showed negative influences (n=44,526). A total of 5 studies showed no significant associations (n=5646). Meta-analyses, producing odds ratios (ORs) as a summary measure of effect size (eg, ratio of the odds of cyber victims who have experienced SH vs nonvictims who have experienced SH), showed that, compared with nonvictims, those who have experienced cybervictimization were OR 2.35 (95% CI 1.65-3.34) times as likely to self-harm, OR 2.10 (95% CI 1.73-2.55) times as likely to exhibit suicidal behaviors, OR 2.57 (95% CI 1.69-3.90) times more likely to attempt suicide, and OR 2.15 (95% CI 1.70-2.71) times more likely to have suicidal thoughts. Cyberbullying perpetrators were OR 1.21 (95% CI 1.02-1.44) times more likely to exhibit suicidal behaviors and OR 1.23 (95% CI 1.10-1.37) times more likely to experience suicidal ideation than nonperpetrators.ConclusionsVictims of cyberbullying are at a greater risk than nonvictims of both self-harm and suicidal behaviors. To a lesser extent, perpetrators of cyberbullying are at risk of suicidal behaviors and suicidal ideation when compared with nonperpetrators. Policy makers and schools should prioritize the inclusion of cyberbullying involvement in programs to prevent traditional bullying. Type of cyberbullying involvement, frequency, and gender should be assessed in future studies.

Project description:Youth who self-harm report high levels of trait impulsivity and identify impulsive behaviour as a proximal factor directly preceding a self-harm act. Yet, impulsivity is a multidimensional construct and distinct impulsivity-related facets relate differentially to self-harm outcomes. Studies have yet to examine if and how a multidimensional account of impulsivity is meaningful to individual experiences and understandings of self-harm in youth. We explored the salience and context of multidimensional impulsivity within narratives of self-harm, and specifically in relation to the short-term build-up to a self-harm episode. Fifteen community-based adolescents (aged 16-22 years) attending Further Education (FE) colleges in the UK took part in individual face-to-face sessions (involving exploratory card-sort tasks and semi-structured interviews) which explored factors relating to self-harm, impulsivity and the broader emotional, developmental and cognitive context. Session data were analysed thematically. Two overarching themes, and associated subthemes, were identified: 'How I respond to strong negative emotions'; and 'Impulse versus deliberation- How much I think through what I'm doing before I do it'. Self-harm was typically a quick, impulsive act in the context of overwhelming emotion, underpinned by cognitive processing deficits. The dynamic tension between emotion-based impulsivity and controlled deliberation was articulated in the immediate moments before self-harm. However, impulsive responses were perceived as modifiable. Where self-harm patterns were established, these related to habitual behaviour and quick go-to responses. Young people identified with a multidimensional conception of impulsivity and described the impulsive context of a self-harm act as dynamic, contextual, and developmentally charged. Findings have implications for youth-focused work. Card-task frameworks are recommended to scaffold and facilitate discussion with young people, particularly where topics are sensitive, complex and multifactorial.

Project description:BackgroundSelf-harm, an act of self-poisoning or self-injury irrespective of motivation, is a major public health concern. Use of alcohol prior to or alongside acts of self-harm is common but little is known about the alcohol-related mechanisms of self-harm enaction. We utilised an ideation-to-action approach to clarify the extent to which volitional alcohol factors differentiated those who have thoughts of self-harm but do not act on them (self-harm ideation) and those who engage in self-harm (self-harm enaction).MethodsCross-sectional analyses of the baseline phase of the Health Lifestyle and Wellbeing study: 1546 adults (1079 female; Mean age = 34 y; 92% White) resident in Scotland completed measures of demographics, lifetime self-harm, volitional alcohol factors and psychosocial factors. Multinomial logistic regression compared those with a history of self-harm thoughts ('ideation', n = 297), self-harm acts ('enaction', n = 346) and 'controls' (n = 897) to identify volitional alcohol factors associated with self-harm enaction.ResultsVolitional alcohol factors differentiated those with a history of self-harm enaction from those with a history of self-harm ideation (as well as those with no history) in initial models adjusted for demographics and depressive symptoms: the self-harm enaction group reported stronger alcohol-related negative urgency (OR = 1.74, 95% CI 1.41-2.16, p < .001), more frequent heavy drinking (OR = 1.46, 95% CI 1.24-1.72, p < .001) and stronger expectancies that drinking alcohol leads to negative self-perceptions (OR = 1.33, 95% CI 1.03-1.72, p = 0.03) and markers of self-harm risk (OR = 1.64, 95% CI 1.18-2.30, p = 0.004). Alcohol-related negative urgency and heavy-drinking frequency continued to differentiate those in the self-harm enaction group from those in ideation group in multivariate models. Consistent with theoretical models positing phase-specific moderators of self-harm ideation and enaction, psychosocial factors (perceived stress, support, negative mood regulation expectancies) differentiated those with a history of self-harm ideation from those without but not those in the ideation and enaction groups.ConclusionsManagement of self-harm risk requires better understanding of alcohol-related mechanisms of self-harm enaction. Volitional alcohol factors may play a role in governing the translation of self-harm thoughts into self-harm acts.

Dataset Information

Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation.

Publications

Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation.

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