Transcript to view my artifact. - Stephen Matteson, MA

Non-Suicidal Self-Injury
Prevention Module
By: Stephen Matteson, Angela Mion,
Gregory Satmare, & Claire Wilmoth
Ball State University
Introduction
This module will increase knowledge in areas of:
● The etiology of NSSI (what it actually is)
● Differentiating between NSSI and suicidal ideation
● Warning signs and risk/protective factors for NSSI
● Interventions effective in treating NSSI
● Cultural implications of NSSI/how it might vary between cultures
Knowledge Check
(True or False)
Participants will complete an evaluation after the module.
What is NSSI?
NSSI is an acronym for Non-Suicidal Self-Injury
NSSI is…
“the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially
sanctioned” (ISSS, 2007, para. 1).
Some examples of common non-suicidal self-injury include: a student cutting on their arms, legs, or stomach,
scratching skin to the point of bleeding, embedding objects under one’s skin, self-batter or banging, or inflicting
small burns somewhere on their body.
NSSI is not… (for the purposes of this module)
Chronic health concerning behaviors such as drug use, alcohol use, smoking, or vehicular speeding.
Knowledge Check
(True or False)
NSSI is any injury (accidental or otherwise) a person inflicts on
him or herself that isn’t meant to be fatal.
Differentiating between NSSI and Suicidal Ideation
Suicidal behavior and NSSI are differentiated in terms of intent, frequency, and
lethality (Guertin, Lloyd-Richardson, Spirito, Donaldson, & Boergers, 2001;
Muehlenkamp & Gutierrez, 2007). Both types of behaviors are aimed at relieving
distressing affective states (Brown, Comtois, & Linehan, 2002) , but…
Suicidal Behavior:
● is intended to end one’s life.
● is engaged in less frequently (Nock
& Prinstein, 2004).
● includes more lethal methods such
as overdose, cutting wrists parallel
to the arm, hanging, etc. (Andover
& Gibb, 2010).
Non-Suicidal Self-Injury:
● is not intended to end one’s life.
● is engaged in more frequently
(Nock & Prinstein, 2004).
● includes less lethal methods such as
burning, cutting wrists
perpendicular to the arm, picking at
wounds, etc. (Andover & Gibb,
2010).
Knowledge Check
(True or False)
Three ways to tell the difference between suicidal behaviors and
NSSI are intent, method, and lethality.
Warning Signs and Risk/Protective Factors for NSSI
● Previous NSSI (Wilkinson, Kelvin, Roberts, Dubicka, & Goodyear, 2011)
● Poor emotional regulation (Andrews, Martin, Hasking & Page, 2013)
● Self-injurers’ ability to endure pain (Andrews, Martin, Hasking & Page, 2013)
● Cognitive style that involves high levels of self-criticism
● Low feelings of self-worth
● Highly-self critical (Hooley, St. Germain, 2014)
● Tendency to objectify the body
Knowledge Check
(True or False)
Someone with poor emotional regulation would not be at risk
for NSSI.
Warning Signs and Risk/Protective Factors for NSSI
● Diminished aversion to self-cutting stimuli may longitudinally predict NSSI
● Believe they deserve punishment (Franklin, Puzia, Lee, and Prinstein, 2014)
● Risk factors that overlap with those of other conditions like eating disorders
● Body objectification coupled with emotion dysregulation
● The higher someone’s scores on negative self-beliefs, the longer they were willing
or able to endure pain.
● Lack of aversion to stimuli that depict blood, wounds, knives, or other images
Knowledge Check
(True or False)
If someone doesn’t have a lot of friends, they probably engage in
NSSI.
Interventions Effective in Treating NSSI
Cognitive Therapy
Therapeutic Assessment
Long-term relationship with a clinician (Gonzales & Bergstrom, 2013)
Teacher, counselor, psychologist, nurse, or social worker
Universal prevention involving a three-tiered approach (Wells & Axe, 2013)
1st Tier- Education on detecting the signs of NSSI, building relationships with
students, and reducing the spread of NSSI
2nd Tier- CBT, function based approaches, and clinical therapy
3rd Tier- Implementation of a crisis team at the school and training in deescalation strategies and physical restraints
Knowledge Check
(True or False)
School personnel may be able to help NSSI students by building
relationships with them.
General Tips when Working with NSSI Students
Tips provided by Wells & Axe (2013), pg. 37
● Try to approach the student in a calm and caring way
● Accept the student even though you may not accept the behavior
● Let the student know how much you care about him or her and believe in his
or her potential
● Refer the student to your school-based professional
● Listen! Allow the student to talk to you. Be available
(See Wells and Axe [2013] for additional suggestions for teachers on both what to do and what not to do.)
Knowledge Check
(True or False)
The only thing school personnel can do when working with an
NSSI student is refer them to a school-based professional.
Cultural Implications of NSSI
“NSSI differs from culturally sanctioned self-injury, such as piercing or tattooing, by
intention rather than form as well as by injurious agent (piercing and tattooing are
most commonly performed by someone other than oneself, while the reverse is usually
true for NSSI)” (Whitlock, 2010)
Gender
Socioeconomic Status
Sexual Orientation
Most studies revealed females are
more likely to practice NSSI
behaviors when compared to
males (Whitlock, 2010;
Muehlenkamp, 2014; Whitlock et
al., 2015; and Barrocas, Hankin,
Young, & Abela, 2012).
There is “very little data are available
regarding NSSI and socioeconomic
status. Of the few studies reporting
on the SES of the participants, most
have reported that SES does not vary
between those who do and do not
engage in NSSI” (Muehlenkamp,
2014, p. 29)
NSSI behaviors have been reported
to be more common among
individuals who identify with the
LGBT community (Brown &
Pantalone, 2011; and Muehlenkamp,
2014), and further elevated among
individuals with bisexual and
questioning sexual orientation
status (Whitlock, 2010).
Knowledge Check
(True or False)
Individuals who identify as Bisexual are more likely to engage in
NSSI.
Contact Information
[email protected]
References
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Andrews, T., Martin, G., Hasking, P., & Page, A. (2014). Predictors of onset for non-suicidal self-injury within a school-based sample of adolescents. Prevention Science, 15(6), 850859.
Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. Z. (2012). Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample.
Pediatrics, 130(1), 39–45. http://doi.org/10.1542/peds.2011-2094
Berger, E., Hasking, P., & Reupert, A. (2013). Response and training needs of school staff towards student self-injury. Teaching and Teacher Education, 44, 25-34.
http://dx.doi.org/10.1016/j.tate.2014.07.013
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