Article

Deliberate self harm in adolescents: self report survey in schools in England.

Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford.
BMJ (online) (Impact Factor: 16.38). 12/2002; 325(7374):1207-11.
Source: PubMed

ABSTRACT To determine the prevalence of deliberate self harm in adolescents and the factors associated with it.
Cross sectional survey using anonymous self report questionnaire.
41 schools in England.
6020 pupils aged 15 and 16 years.
Deliberate self harm.
398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem.
Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk.

3 Followers
 · 
123 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Self-poisoning and self-injury have widely differing incidences in hospitals and in the community, which has led to confusion about the concept of self-harm. Categorising self-harm simply by a method may be clinically misleading because many hospital-attending patients switch from one method of harm to another on subsequent episodes. The study set out to determine the frequency, pattern, determinants and characteristics of method-switching in self-harm episodes presenting to the general hospital. The pattern of repeated self-harm was established from over 33,000 consecutive self-harm episodes in a multicentre English cohort, categorising self-harm methods as poisoning, cutting, other injury, and combined methods. Over an average of 30 months of follow-up, 23% of people repeated self-harm and one-third of them switched method, often rapidly, and especially where the person was male, younger, or had self-harmed previously. Self-poisoning was far less likely than other methods to lead on to switching. Self-harm episodes that do not lead to hospital attendance are not included in these findings but people who self-harmed and went to hospital but were not admitted from the emergency department to the general hospital, or did not receive designated psychosocial assessment are included. People in the study were a mix of prevalent as well as incident cases. Method of self-harm is fluctuating and unpredictable. Clinicians should avoid false assumptions about people׳s risks or needs based simply on the method of harm. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 04/2015; 180:44-51. DOI:10.1016/j.jad.2015.03.051 · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Epidemiological research supports an association between aggression and self-harm through data on the frequency with which individuals exhibit both behaviours. Unbiased evidence, however, is needed to draw conclusions about the nature and extent of co-occurrence. Systematic review of published studies was undertaken to evaluate whether or not the frequency with which aggression and self-harm co-occur is beyond that which would be expected by chance. Outcome measures included: (a) between-group differences on a standardised aggression/self-harm measure - the groups defined by scores on a measure of the other behaviour; (b) correlations between the two behaviours; (c) co-occurrence rates in populations defined by the presence of either behaviour; (d) co-occurrence rates in populations not defined by either behaviour. Odds ratios were calculated for studies presenting complete frequency data. 123 studies, some yielding more than one type of result, met the inclusion criteria. Most case-control studies found elevated levels of aggression in self-harming populations (or self-harm in aggressive populations) compared to controls. The majority of correlational, co-occurrence rate, and odds ratio data found aggression and self-harm to be associated. Results were subject to descriptive synthesis only and thus, unable to report an overall effect size. Evidence suggests that aggression and self-harm frequently co-occur. Such evidence necessitates more theoretical discussion and associated research on the source and nature of co-occurrence. Nonetheless, individuals who present with one behaviour may be considered an 'at-risk' group in terms of exhibiting the other. Such evidence holds implications for practice (e.g. risk assessment). Copyright © 2015. Published by Elsevier B.V.
    Journal of Affective Disorders 12/2014; 175C:325-350. DOI:10.1016/j.jad.2014.12.051 · 3.71 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introdução A Perturbação de Hiperatividade com Défice de Atenção (PHDA) é uma perturbação do sistema nervoso central que apresenta um quadro sintomático diversificado. Surge na infância e é caracterizada por impulsividade, hiperatividade e elevadas dificuldades em manter a atenção. Atualmente, tendo em conta o contexto profissional e o desafio que esta perturbação representa, torna-se pertinente saber entender e ensinar estas crianças, de forma adequada, com recurso a estratégias/práticas educativas e comportamentais diversificadas, de modo a promover o seu sucesso académico. Objetivos A presente investigação pretende dar resposta a três objetivos: 1) Averiguar qual o grau de informação, formação e experiência dos docentes do 1º Ciclo para lecionarem em turmas de alunos com PHDA; 2) Averiguar quais as características que mais perturbam a vida escolar dos alunos com PHDA; e 3) Conhecer os métodos e as estratégias a que os professores recorrem para procurar superar essas dificuldades. Metodologia Solicitou-se autorização a três Agrupamentos de Escolas da região Centro de Portugal, garantindo-se o anonimato e a confidencialidade das respostas dos docentes. Adaptámos um inquérito por questionário autoadministrado (Filipe, 2011), a partir de um instrumento da autoria da equipa de Défices de Atenção do CADin. Após a aplicação piloto a 10 professores, a versão final foi administrada a 102 professores do 1º Ciclo do Ensino Básico dos três Agrupamentos, 16 homens e 86 mulheres (M = 43.90; DP = 8.50 anos). O questionário comporta questões fechadas e apresenta adequada fiabilidade. Resultados Os resultados indicam que mais de 70% dos docentes já lecionaram em turmas com alunos com PHDA diagnosticada por especialistas, sendo a formação inicial e contínua sobre esta perturbação insuficiente. O número de psicólogos escolares por agrupamento é apontado por 97.1% dos docentes como insuficiente, não permitindo um acompanhamento dos alunos. O “Défice de Atenção” foi apontado como a característica dos alunos com PHDA que mais perturba a vida escolar. Entre os fatores que provocam maior desadaptação evidenciam-se, por ordem decrescente: 1) pouca persistência e baixa motivação; 2) não aceitar e respeitar as regras; 3) ter comportamentos agressividade/oposição; 4) dificuldades de aprendizagem; 5) baixa autoestima. Quanto à possibilidades de intervenção, apontaram-se as seguintes estratégias (ordem decrescente): 1) encaminhamento para um técnico especializado; 2) encaminhamento para o Apoio Educativo/Educação Especial; 3) contacto mais próximo com a família; 4) persistência e coerência na introdução de adaptações e estratégias; 5) adaptação da forma como o professor apresenta os conteúdos na sala de aula. Conclusões Os dados apurados relativamente ao conhecimento e às práticas/estratégias utilizadas em crianças com PHDA revelam que, seria de todo fundamental, os docentes possuírem formação específica, quer no curso de formação inicial quer na formação contínua, assim como maior conhecimento das práticas/estratégias “validadas” e aconselhadas por diferentes autores, no sentido de promover um maior sucesso no processo ensino/aprendizagem destas crianças. Em termos globais, a literatura é unânime em afirmar que a intervenção deve ser multicomponencial e incluir três grandes vetores: a criança, a família e a escola, associados à medicação sempre que necessário (Barkley, 2006; Parker, 2003; Reimers & Brunger, 1999).
    Revista de Enfermagem Referência 01/2014; 11(3):44. · 0.10 Impact Factor

Full-text (2 Sources)

Download
7 Downloads
Available from
Apr 2, 2015