Transcript Deliberate Self Harm

Deliberate
Self Harm
Prof Craig Jackson
Head of Psychology
health.bcu.ac.uk/craigjackson
Deliberate Self Harm
Behavioural Markers
Female:Male ratio. 2:1
15-21 largest age group
At risk:
Female
Isolated
Negative life events
Pre-existing psychiatric conditions
Familial history
Intolerable stress
Impulsive, immature, aggressive personality
Additional Conditions
High levels of dissociation ("going numb")
Borderline Personality Disorder
Substance abuse disorders
Post-Traumatic Stress Disorder
Antisocial Personality Disorder (int. explosive)
Eating Disorders
Mood Disorders
Deliberate Self Harm
Deliberate Self Harm
Art form
Follie a deux
Celebrity cache
Deliberate Self Harm
Deliberate Self Harm
Mechanics
Cutting
Forearms
Wrists
Genitalia
Burning
Banging
Pills / Toxins
Sharps
4% of English hospital admissions (Carroll 2006)
Fifth biggest cause of admissions
Use of an rubbers or friction to burn skin
Burning with heat, chemicals or cigarettes
Bruising
Pulling fingernails and toenails
Refusing to take needed medications
Hitting self
Banging one's head
Ingesting sharp or toxic objects
Picking scabs / keeping wounds from healing
Deep scratching
Inserting objects into body openings
Inserting needles or sharp objects under the skin
Some forms of hair-pulling
Tooth-pulling
Bone-breaking
Carving symbols, names or images
Premeditation
Prohibits sympathy
Saving pills / blades
Avoiding detection
Long sleeves
Bandage / dressing stockpiles
Prepared excuses
Deliberate Self Harm
Motivation 1
• Cry for help
• Attention seeking
• Coping strategy
• Destruction
• Escapism
• Control & Mastery
• Punish others
Loved ones
Family
Failing relationships
Motivation 2
• Negative self-esteem
• Hypersensitivity to rejection
• Supressed anger and sadness
• Chronic Anxiety
• Relationship problems
• Poor functioning in school, home or work
• More common in females than males
• Typical onset is at puberty
• History of physical and/or sexual abuse
• Average to high intelligence
• Middle to upper-class background
Motivation 3
• Feels "empty" and isolated
• Drug or alcohol abuse
• Early history of medical illness or surgical
procedures requiring hospitalization
• Imprisonment or institutionalization in drug
treatment centres
• Inability to express or tolerate negative feelings
• Poor academic performance or truancy
• Has a background of emotional neglect
Secondary Gain
Factitious Injury
Feigned physical / psychological symptoms
Aimed to receive medical / psychological care
Mostly female, many working in healthcare
Don't confront without good evidence
Supportive confrontation
Aware of role of behaviour in illness
Offer psychological help
Patients may stop but usually move on