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Some notes on self-injury . Jessica Garisch Tamsyn Gilbertson Robyn Langlands Angelique O’Connell Lynne Russell Marc Wilson Emma Brown Tahlia Kingi. So what are we talking about…? Non-Suicidal Self-Injury (NSSI) is… (from the International Society for Study of Self-injury, 2007):
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Some notes on self-injury Jessica Garisch Tamsyn Gilbertson Robyn Langlands Angelique O’Connell Lynne Russell Marc Wilson Emma Brown TahliaKingi
So what are we talking about…? Non-Suicidal Self-Injury (NSSI) is… (from the International Society for Study of Self-injury, 2007): “…the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned. It is also sometimes referred to as self-injurious behavior, non-suicidal self-directed violence, self-harm, or deliberate self-harm (although some of these terms, such as self harm, do not differentiate non-suicidal from suicidal intent).”“As such, NSSI is distinguished from suicidal behaviors involving an intent to die, drug overdoses, and socially-sanctioned behaviors performed for display or aesthetic purposes (e.g., piercings, tattoos). Although cutting is one of the most well-known NSSI behaviors, it can take many forms including but not limited to burning, scratching, self-bruising or breaking bones if undertaken with intent to injure oneself. Resulting injuries may be mild, moderate, or severe.”
Prevalence… • 2,087 ED presentations across 4 regions over 12 months, 20% repeat presentations1 • 24% - Lifetime prevalence among community-based New Zealand adults2 • 48% of adolescents presenting to CAMHS reported SH at initial assessment3 • 20% of 9,000 secondary students reported SH in previous year4 • 31% of 1,700 secondary students thought of SH in previous month, 20% acted on it over 5 years5 • (conflation between SSI and NSSI) • 1. Hatcher et al., 2009. • 2. Nada-Raja et al., 2004. • 3. Fortune et al., 2005. • 4. Fortune et al., 2010. • 5. Pryor & Jose, 02/04 to 09/09.
Prevalence… † r=.40 with suicidal behaviour
Prevalence… † r=.40 with suicidal behaviour
Prevalence… † r=.40 with suicidal behaviour
Prevalence… † r=.40 with suicidal behaviour ‡ correlates .79 with the full 14-item DSHI
Interpersonal Intrapersonal
Affect regulation was the most strongly endorsed function and, overall, intrapersonal functions were the most strongly endorsed.
Myths of self-injury: All people who self-injure are suicidal Self-injury is a female issue Only adolescents hurt themselves People who hurt themselves are mentally ill People who hurt themselves have been abused Supporting people who self-injure: 1. Avoid pejorative labels 2. Remember the myths! 3. Aim for low-key dispassionate demeanour and respectful curiosity – be professional! 4. Aim for a balance of appropriate level of concern that doesn’t alarm the person, condone the behaviour, but also provides support 5. Pass it on to the professionals – be clear of your own limits.
Useful resources Excellent factsheets developed by the team from the Cornell Research Programme on Self-injurious behaviour in adolescents and young adults: http://www.crpsib.com/resources.asp An information booklet written by an Australian psychologist for young people who self-injure: http://www.decd.sa.gov.au/speced2/files/pages/chess/hsp/Information/revised_selfharm_finalweb.pdf An online power-point presentation for parents with children who are self-injuring: http://store.selfinjury.com/products/Parents-Webinar%3A-by-Dr.-Wendy-Lader.html A free, downloadable copy of 'Healing the Hurt Within' by Jan Sutton: http://www.e-booksdirectory.com/details.php?ebook=2363 Our website: http://www.victoria.ac.nz/psyc/research/youth-and-wellbeing-study/news-and-events
Where next? Towards understanding how NSSI starts, stops, and continues… Year 9 and older Longitudinal Funded by the Health Research Council of New Zealand To be on our newsletter mailing list email jessica.garisch@vuw.ac.nz