Non-Self-injury – perceived helpfulness

1. RESULTS Description of Participants’ Clinical Symptoms, and Self-Injurious Thoughts and Behaviour Participants were seeking care at the clinic for a variety of mental health problems, including anxiety, depression, adjustment disorder, school refusal, and aggression. There were a total of 39 days whereby a participant had thoughts about self-injury during the diary week, with 13 self-injurers and three non-self-injurers reporting this self-injury ideation (range 1 to 6 incidents). Six self-injury participants engaged in a total of eight incidents of self-injurious behaviour (range 1 to 3 incidents). On average, participants only thought about self-injury on 2 of the 7 days. Comparisons of Females with and without a History of Self-Injury (FIGURE 1) There were no significant differences between self-injurers and non-self-injurers when the average level and variance in negative affect were compared (see Figure 1) Although average level of positive affect did not differ between groups, self-injurers, compared to the non-self-injuring clinical comparison group, had less fluctuations in their positive affect across the 7 days, t (32) = 2.4, p<.05 (see Figure 1). FIGURE 2 There were no significant differences between self-injurers and non-self-injurers for any aspect of daily hassles (see Figure 2). FIGURE 3 Self-injurers were lower than non-self-injurers on the 7-day average of perceived helpfulness of positive cognitive restructuring as a coping strategy, t (28) =2.4 , p<.05. Self-injurers also showed more fluctuations in perceived helpfulness of problem-focused support coping when compared to non-self-injurers, t(23) = -2.9, p<.01. (see Figure 3). Self-injurers showed more fluctuations in perceived helpfulness of support seeking coping when compared to non-self-injurers, t(27) = -2.6, p<.05. a lower 7-day average of perceived helpfulness for the positive cognitive restructuring coping strategies utilised, t (28) =2.378 , p<.05. more fluctuations in their perceived helpfulness of the problem-focused support coping strategies utilized, t(23) = -2.893, p<.01. (see Figure 3). more fluctuations in their perceived helpfulness of support seeking coping strategies, t(27) = -2.579, p<.05. Background Much of the knowledge on adolescents’ self-injurious behaviour has been derived from psychoanalytically oriented case-studies or studies of selected populations (e.g., Brodsky, Coiltre, & Dulit, 1995; Haines & Williams, Zlotnick, Mattia, & Zimmerman, 1999). Much of the past research also has been unable to isolate the correlates of self-injury from the correlates of suicidal behaviors, as most studies of self-injury have not excluded those who have engaged in significant suicidal behaviour. In these studies, however, past researchers have described findings about individuals’ emotional states prior to, during, and after self-injurious acts, but this information has been most often collected using retrospective reporting methods (e.g., Briere & Gil, 1998; Nixon,Cloutier, & Aggarwal, 2002). The current study of adolescent females with a history of self-injury addressed these issues by first, excluding adolescents who had also attempted suicide and second, using daily diary methods. The repeated assessment method was deemed particularly useful for testing the affect regulation theory of self-injury by providing data to more precisely examine the process and dynamics of daily stress, affect, and affect regulation and coping.The use of repeated assessments of three sets of constructs -- daily stressful events, affect, and coping behaviours -- was supported by evidence that day-to-day hassles have a more significant influence on distress and associated problems than do major life events (e.g., Pillow, Zautra, & Sandler, 1996). Data were also collected from a comparison group of females who were accessing the same mental health clinics, but did not have a history of self-injury. Study Aims Girls with and without a history of self-injury were compared to (1) determine whether girls who self-injure had elevated and/or greater fluctuations in day-to-day hassles, and negative/positive mood, and (2) examine whether girls who self-injure use different coping behaviours when stressed and perceive particular coping behaviours to be less effective. Method Participants were 34 female adolescents between the ages of 13 and 18 years (M age = 14.75 years). All were recruited after they accessed a child and adolescent community mental health clinic. Self-injurious behavior was assessed and participants were classified as self-injurers or non-self-injurers: SELF-INJURERS: Participants (n=22, M age = 14.8 years) who at the time of intake reported a recent history of self-injury NON-SELF-INJURERS: A clinical comparison group (n=12, M age =14.7 years) with no reported history of self-injury. Participants completed 7 diary forms over a one-week period, the diary form contained three measures: 1) the child version of the Positive and Negative Affect Scale (PANAS-C: Laurent et al., 1999), 2) a modified version of daily hassles adapted from the Daily Life Stressors Scale (DLSS; Kearney, Drabman, & Beasley, 1993) and the Daily Stress Inventory (DSI; Brantley, Waggoner, Jones, & Rappaport, 1987), and 3) the Children’s Coping Strategies Checklist (CCSC, Sandler et al., 1994). Participants were phoned each night at a prearranged time to assist with completion of the diary forms, with the researcher recording all of the information provided by the participant. Abstract The aim of this study was to test hypotheses about links between self-injurious behaviour, daily hassles, mood levels and fluctuations, and coping behaviours. The current study broadens the focus of the affect regulation theory of self-injury (e.g., Briere & Gil, 1998; Suyemoto, 1998) to also include behavioural and cognitive components of self-regulation operationalised as coping behaviours.To do this, 22 female adolescent self-injurers and 12 female non-self-injuring adolescents attending a clinic for mental health services completed structured diary forms for seven consecutive days. The dairy forms contained measures of affect, hassles and perceived stressfulness, and coping strategies employed and their perceived usefulness. Daily, 7-day average, and 7-day variance in positive and negative affect, hassles, and coping strategies were computed. Self-injurers and non-self-injurers were compared with t-tests. Results showed that, compared to non-self-injurers, self-injurers had less variance in their positive affect over the seven days. Also, significant differences were found between self-injurers and non-self-injurers for the perceived helpfulness of the following coping strategies: positive cognitive restructuring, problem-focused support coping, and seeking social support – with self-injurers perceiving these strategies as less effective or reporting less variance in the helpfulness of coping behaviours employed. However, unexpectedly, there were no group differences in negative affect or daily hassles – either in level or variance over the 7 days. Future research will examine and compare combinations of hassles, affect, and coping strategies, and focus on affect and coping behaviours prior to and after thoughts of self-injury or actual self-injurious behaviours. Figure 2. Average total hassles and perceived stress reported by female adolescents with and without a history of self-injury Figure 1. Average positive and negative affect reported by female adolescents with and without a history of self-injury Non-Self-injury – perceived stress of hassles Non-Self-injury – negative affect Self-injury – negative affect Self-injury – perceived stress of hassles Non-Self-injury – positive affect Non-Self-injury – total hassles Self-injury – positive affect Self-injury – total hassles Figure 3. Average use of problem-focused support coping and perceived helpfulness of this strategy reported by female adolescents with and without a history of self-injury Non-Self-injury – perceived helpfulness Self-injury – perceived helpfulness Non-Self-injury – freq of use Self-injury – freq of use Diaries of Mood, Daily Hassles and Coping Strategies in Self-InjuringFemale Adolescents and a Clinical Comparison GroupAlison L Bocquée and Melanie J Zimmer-Gembeck, PhDGriffith University, Gold Coast Campus, Queensland, Australia Summary Most differences between self-injurers and non-self-injurers were in the area of coping behaviours and the perceptions of the effectiveness of particular coping behaviours. It appears that the perceived helpfulness of coping strategies among female adolescents who self-injure may be an important area for future research. For example, perhaps female self-injurers who attend a clinic do not implement coping strategies consistently and persistently or they do not have the competence to always ask for and receive forms of social support they may assist them to cope with stress (or they perceive different responses to requests for support then other females who have mental health problems). These findings are somewhat consistent with these ideas, but further research is needed to understand why variations in the perceived effectiveness of coping behaviours would differ between self-injurers and other females receiving mental health care. Further analyses will focus on comparing how self-injurers and non-self-injurers differ on combinations of moods, daily hassles and coping behaviours. For example, hassles do not seem to differ for female self-injurers and non-self-injurers who have all attended a psychology clinic for mental health care, but it remains possible that self-injurers use different coping strategies in response to stressors of particular types when compared to non-self-injurers. Other analyses will examine stress, mood, and coping on days prior to and after thoughts of self-injury or actual self-injurious behaviour.