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Australian National Epidemiological Study of Self Injury (ANESSI)

Australian National Epidemiological Study of Self Injury (ANESSI). Sarah Swannell , The University of Queensland, Australia Prof Graham Martin, The University of Queensland, Australia A/Prof Philip Hazell , University of Sydney, Australia Dr James Harrison, Flinders University, Australia

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Australian National Epidemiological Study of Self Injury (ANESSI)

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  1. Australian National Epidemiological Study of Self Injury (ANESSI) Sarah Swannell, The University of Queensland, Australia Prof Graham Martin, The University of Queensland, Australia A/Prof Philip Hazell, University of Sydney, Australia Dr James Harrison, Flinders University, Australia Dr Anne Taylor, Department of Health, South Australian Government 12th European Symposium on Suicide and Suicidal Behaviour27th - 30th August 2008Glasgow - Scotland Saturday August 30, 2008 010.8.2 (0900-1100) 0915-0930

  2. OUTLINE • Background of self injury • Population estimates of self injury • Aims • Design/sampling • Survey • Sample characteristics • Characteristics of those who self injure • Comparisons with earlier research • Imminent analyses

  3. BACKGROUND • Deliberate self harm burdens the Australian health care system1 • Non-suicidal self-injury (NSSI) is a type of self-harm • Causes distress for patients, families and therapists2 • Is a risk factor for future self harm and suicide3,4 • Differences between self injurers and suicide attempters ‘repulsion of life’ 5 • No empirically proven treatments4 • NSSI not understoodstigmatisation/social exclusion • Need more information about the problem • Difficult to measure in population compared to clinical samples 1Steenkamp et al 2000, 2Lindgren et al 2004, 3Garzotto et al. 1977, 4RANZCP 2004, 5Muehlenkamp et al. 2004

  4. POPULATION ESTIMATES

  5. AIMS • Prevalence and nature of self injury in Australia • Differences between those who and do not self injure • Interactions between demographic, social and individual factors associated with self-injury and their relative importance

  6. DESIGN/SAMPLING N=217 N=8285 N=3975 N=42,938 • N=11,722 • Non-connections (80.5%) • Non-residential (11.3%) • Fax/modem (7.7%) N=3229 N=14688 N=10619 N=1093 Attempted CATI N=31,216 • N=19,206 • Refusals 48.5% • Non-contact 7.5% • Language 2.3% • Incapacitated 2.9% • Terminated 0.6% • Unavailable 1.1% 12,010 12,006

  7. SURVEY Alcohol intake, binge drinking, tobacco smoking, illegal drugs • GHQ-12 • Dissociation (DES) • Emotion Regulation (ERQ) • Impulsivity/aggression (PIS) • Coping (COPE) • Alexithymia (TAS) Telephone and internet Neglect, sexual and physical abuse Heterosexual, homosexual, bisexual, unsure Freq, rec, sev, age onset, methods, medical att., stopping, how, who knew, help seeking Ideation (GHQ-28)/attempts Demographics: age, gender, education level, work status, postcode, suburb, country of birth, main language spoken at home, Aboriginal or Torres Strait Islander

  8. SURVEY • Average survey time 14 mins • Interviewed in English, Italian, Greek, Vietnamese, Chinese and Arabic • Lifeline and Kids Help Line numbers were offered at the end of the survey • Parental consent required for those under 18

  9. PARTICIPANTS BY AGE AND GENDER 12.3% 87.7%

  10. 2006 Census ANESSI

  11. PARTICIPANTS – EDUCATION, MARITAL STATUS AND ETHNICITY Indigenous Australians Females n=99 (0.8%) Males n=57 (0.5%)

  12. SELF INJURY BY AGE AND SEX Overall 12-month prevalence 1.7% Overall lifetime prevalence 8.3% 12 month proportions Lifetime proportions

  13. SELF INJURY, INDIGENOUS STATUS AND MENTAL HEALTH Indigenous (Aboriginal or Torres Strait Islander) or Not Indigenous Mental Health – GHQ12

  14. METHODS AND MOTIVATIONS Methods Motivations

  15. COMPARISONS WITH EARLIER RESEARCH • In line with: • Ross & Heath, Laye-Gindhu et al., Patton et al., De Leo & Heller, adolescent samples, 12 month prevalence, females more likely to self injure • Hawton et al., Patton et al. & De Leo & Heller, adolescent samples, 12 month prevalence 4-6% • Ross & Heath, Muehlenkamp & Guttierrez, adolescent sample, lifetime prevalence 13-16% (our estimate was slightly lower) • Briere & Gil (1998), adult sample, no difference between genders • Muehlenkamp & Guttierrez, adolescent sample, lifetime prevalence, most common methods cutting and scratching • Lower prevalence than: • Laye-Gindhu et al. (13.2%; they included reckless behaviour), Ross & Heath (13.86%; lifetime, still higher), Muehlenkamp & Guttierrez (15.9 and 23.2%), Nada-Raja (23.5%), Hasking et al. (46%) and Lloyd-Richardson et al. (46.5%)

  16. Imminent analyses • Age standardisation • Social exclusion • Remoteness • Dissociation • Emotion regulation • Coping • Suicidal ideation • Suicide attempt • Neglect, sexual abuse, physical abuse • Sexual orientation • Substance use

  17. Thank you for your attention!

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