Article

How do Families Represent the Functions of Deliberate Self-Harm? A Comparison Between the Social Representations from Adolescents and Their Parents

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Abstract

Research has recognized the importance of understanding the social representations about the functions of deliberate self-harm, particularly in the context of clinical intervention. In addition, parents can play a relevant role in the rehabilitation of adolescents with these behaviours. However, there are few studies that focused on the description and comparison of the social representations about these functions, particularly in families. This article aimed to analyse the social representations about the functions of deliberate self-harm from adolescents and their parents. We developed two sets of analyses: first we compared the social representations from adolescents without a history of deliberate self-harm and their parents, and secondly we compared the social representations about the functions of deliberate self-harm from adolescents with a history of these behaviours and their parents' social representations. Results revealed significant differences between both groups of families, implying that the groups of participants represent the functions of deliberate self-harm differently. Overall, parents emphasized interpersonal functions and devalued intrapersonal functions. These differences were heightened in the families of adolescents with deliberate self-harm. The present article provides important insights regarding the social representations about the functions of deliberate self-harm and the differences between parents' social representations and their children experiences and social representations.

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... On the other hand, the study conducted by Bresin et al. (2013) found little diff erentiation among functions between groups. There is also a recent study (Duarte, Gouveia-Pereira, Gomes, & Sampaio, 2019) that compared the social representations about the functions of deliberate self-harm from adolescents and their parents in families of adolescents with and without a history of deliberate self-harm. Results showed that parents emphasized interpersonal functions and devalued intrapersonal functions when compared to both groups of adolescents and that these diff erences were heightened in the families of adolescents with a history of deliberate selfharm. ...
... Overall, the group of adults referenced more interpersonal functions, while both groups of adolescents gave more relevance to intrapersonal functions. These results are similar to those previously found (Batejan et al., 2015;Duarte et al., 2019), where participants without a history of deliberate selfharm considered interpersonal functions for engaging in these behaviours as more relevant than participants with a history of deliberate self-harm did. ...
... On the other hand, the focus of adolescents with a history of deliberate self-harm on intrapersonal functions is also important and consistent with previous research (e.g. Duarte et al., 2019;Klonsky, 2007). In our results, it is clear that this group of participants emphasized this type of functions, specially Aff ect Regulation. ...
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This study aimed to describe the social representations about the functions of deliberate self-harm and to compare these representations from adolescents with and without a history of deliberate self-harm and adults without a history of these behaviours. We conducted a qualitative study involving the thematic analysis of forty-one semi-structured interviews. The participants consisted of 11 adolescents with a history of deliberate self-harm, 15 adolescents without a history of deliberate self-harm and 15 adults also without a history of behaviours. The interviewees mentioned eight functions of deliberate self-harm consistent with the existing literature, namely interpersonal functions (Communication Attempt, Interpersonal Boundaries, Interpersonal Influence, and Peer Bonding) and intrapersonal functions (Affect Regulation, Anti-Dissociation, Escape Mechanism, and Self-Punishment). Also, two new functions not described in the literature were mentioned (Introspective Mechanism and Replacement of Suffering). Regarding the differences between the three groups, several disparities emerged. Overall, results revealed that the group of adults referenced more interpersonal functions, while both groups of adolescents emphasized intrapersonal functions. This study provides insight regarding the social representations about the functions of deliberate self-harm, also focusing on the differences between adolescents with and without a history of these behaviours and adults without a history of deliberate self-harm.
... Regarding the second study, literature suggests that parents do not have a clear understanding of their children deliberate selfharm behaviours (McDonald et al., 2007;Oldershaw et al., 2008) and that they tend to emphasize interpersonal functions (Duarte et al., 2019a). Hence, we hypothesize that significant differences will emerge between the social representations from parents of adolescents with and without a history of deliberate self-harm, and that parents of adolescents without these behaviours will emphasize interpersonal functions (Hypothesis 2). ...
... We will also compare the social representations from mothers and fathers since the importance of family for intervention and prevention in this context has been recognized (e.g. Arbuthnott & Lewis, 2015;Miner et al., 2016), and research has found differences between their representations (Duarte et al., 2019a). ...
Article
Introduction: The understanding of the social representations about the functions of deliberate self-harm can be an important factor for the comprehension of this phenomenon. Nonetheless, only a few studies focused on this topic and specifically on the social representations from adolescents with and without a history of deliberate self-harm and their parents. Methods: This article presents two studies that analysed these representations. Study 1 compared the social representations from 411 Portuguese adolescents (219 females and 192 males, aged 12-19 years), from which 109 reported having a history of deliberate self-harm. Study 2 focused on the comparison of the social representations from 471 parents (265 mothers and 206 fathers, aged 33-62 years) of Portuguese adolescents. Of the parents in Study 2, 120 had children with a history of deliberate self-harm. Results: In Study 1, adolescents without a history of deliberate self-harm perceived most interpersonal functions as more relevant than adolescents with a history of these behaviours, while adolescents with a history of deliberate self-harm emphasized one intrapersonal function. In Study 2, no differences were found between parents of adolescents with and without a history of deliberate self-harm. However, results revealed differences between the representations of mothers and fathers in several intrapersonal functions. Conclusions: This research provides important insight regarding the social representations about the functions of deliberate self-harm from adolescents with and without a reported history of these behaviours and their parents. The impact for clinical intervention and prevention programs is discussed.
... Rephrasing Powell, 9 I would then say that we have a killer cocktail of stigma, misinformation and disinformation which, as she notes, makes it so that families of those deceased in accidents related to solo breath play sometimes prefer to alter the scene prior to the police's arrival to make it look like suicide, in spite of the stigma which also exists surrounding suicide. 11 The many references of "treating AeA" (read, breath play) that can be found in the literature often equate 'treating' with making it so that the person will stop engaging in that behavior − not because the behavior is seen as a manifestation of tendencies for self-harm which is accompanied by other forms of self-harm, but because the behavior is framed as harmful in itself (even when no injuries or other forms of physical consequences occur; as for the emotional aspect of it, it was already addressed above). ...
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Expert opinion With this commentary, I wish to address a 2-fold issue around the topic of autoerotic asphyxiation (AeA): (i) that the historical trend towards the pathologization of kink and other forms of sexuality considered ‘Other’ is particularly salient in the case of AeA and is potentially harmful for AeA practitioners; (ii) that the medicalizing terms used to describe the phenomenon (including, precisely, “autoerotic asphyxiation”, can be seen as both cause of, and caused by, a disconnect between research on the topic and the community within which the practice exists. As a caveat, though that are references to partnered practices, I will focus on non-partnered practices in order to keep the focus on the auto- aspect of AeA.
... The lifetime prevalence rates in populationbased studies with adolescents range from 3% to 27.6% [2][3][4][5]. In Portugal, research that used convenience samples of adolescents concluded that DSH presented lifetime prevalence rates between 7.3% and 30% [6][7][8][9][10]. ...
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Deliberate self-harm (DSH) is a public health problem that mainly affects adolescents and young adults. Evidence suggests that multiple methods are used with a self-aggressive intent. The present article focuses on the development and factorial validation of the Inventory of Deliberate Self-harm Behaviours for Portuguese adolescents. This instrument assesses the lifetime frequency of 13 DSH methods, with and without suicidal intent. Study 1 consisted of an exploratory factor analysis with a sample of 131 adolescents with a reported history of DSH. Results revealed a three-factor structure with acceptable internal consistency: High Severity DSH, Mild Severity DSH, and Substance Use DSH. After item reduction, this structure was tested in Study 2 through a confirmatory factor analysis with an independent sample of 109 adolescents also with a history of DSH. Results showed an acceptable model fit. This instrument presents a solid structure and acceptable psychometric properties, allowing its use in further research.
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(2015) In D. Jodelet, Représentations sociales et mondes de vie. Paris, Editions des Archives contemporaines (collection Psychologie du social). Denise Jodelet centre son article sur l'examen de la notion de représentation sociale telle qu'elle est employée en psychologie sociale, sur les phénomènes et processus auxquels elle renvoie, enfin sur les questions que soulève son élaboration en concept et l'établissement d'un champ d'étude s'y rapportant spécifiquement. Denise Jodelet examines the notion of social representation in social psychology ; the phenomena and the process to which this concept refers ; finally, the questions which this concept raises and the ñeld of study which would be specifícally related to this concept. Denise Jodelet examina la noción de representación social desde el punto de vista de la psicología social ; trata los fenómenos y los procesos a los que se refíere, así como las preguntas que suscita dicho concepto ; finalmente señala el campo de estudio específico de su investigación.
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Non-suicidal self-injury (NSSI) among adolescents is gaining increasing attention in both clinical and scientific arenas. The lifetime prevalence of NSSI is estimated to vary between 7.5% to 8% for preadolescents, increasing to between 12% and 23% for adolescents. Despite the prevalence and the increasing interest in NSSI, few psychotherapeutic treatments have been designed specifically for NSSI, and no treatments have been evaluated specifically for the treatment of NSSI among adolescents. Consequently, child and adolescent clinicians are left with little evidence-based guidance for treating this challenging population. To provide some guidance, evaluations of treatments for adults with NSSI and for adolescents with related conditions, such as deliberate self-harm and borderline personality disorder, are reviewed. Clinical guidelines and resources are also discussed to assist with the gaps in the knowledge base for treatment of NSSI among adolescents.
Article
Full-text available
The behaviours of non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) are prevalent among adolescents, and an increase of rates in recent years has been postulated. There is a lack of studies to support this postulation, and comparing prevalence across studies and nations is complicated due to substantial differences in the methodology and nomenclature of existing research. We conducted a systematic review of current (2005 - 2011) empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe. Fifty-two studies fulfilling the inclusion criteria were obtained for analysis. No statistically significant differences were found between NSSI (18.0% SD = 7.3) and DSH (16.1% SD = 11.6) studies. Assessment using single item questions led to lower prevalence rates than assessment with specific behaviour checklists. Mean prevalence rates have not increased in the past five years, suggesting stabilization. NSSI and DSH have a comparable prevalence in studies with adolescents from different countries. The field would benefit from adopting a common approach to assessment to aide cross-cultural study and comparisons.
Article
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Este trabalho é uma revisão da literatura sobre a teoria das representações sociais. Tem por objetivo apresentar um entendimento global acerca da teoria e do fenômeno das representações sociais e da relação entre indivíduo e grupo na teoria, mais especificamente as relações entre representações sociais e individuais e as relações entre representações sociais e comportamento. Tomam-se como base estudos empíricos e ensaios teóricos publicados na literatura científica internacional. Conclui-se que a teoria possui características que a aproximam de um paradigma de pesquisa e indica-se a relevância de investigar de modo mais aprofundado os efeitos de contextos interacionais com objetos sociais e relações entre pensamento social e individual
Article
With the increased awareness about deliberate self-harm, the understanding of its social representations can be important for clinical intervention and prevention. However, there is still a lack of instruments to assess the social representations of the functions of these behaviors. This research focuses on the validation of the Questionnaire of Representations of the Functions of Deliberate Self-Harm for adolescents with and without a history of these behaviors. The basis for this questionnaire was the translation and adaptation of the Inventory of Statements About Self-Injury. To access adolescents’ social representations, we conducted semidirective interviews and an analysis of the Portuguese written press, which complemented the questionnaire with new items and functions. Study 1 consisted of an exploratory factor analysis with a sample of 434 adolescents. Results revealed a 2-factor structure of interpersonal and intrapersonal dimensions. After item reduction, the factorial analysis of the independent functions showed acceptable psychometric values. This structure was corroborated in Study 2 by a confirmatory factor analysis with a new sample of 405 adolescents, which revealed an acceptable model fit. This questionnaire presents a relatively solid structure and is based on acceptable psychometric properties, which allows its use in future research.
Article
The present article focuses on the validation of the Questionnaire of Social Representations about the Functions of Deliberate Self-Harm for adults. The understanding of the social representations about deliberate self-harm can be relevant for clinical intervention and prevention. However, there is still a lack of instruments to assess these representations. The basis for this instrument was the translation of the Inventory of Statements About Self-Injury. To complement this instrument, we conducted semi-directive interviews with adults without deliberate self-harm and analysed the Portuguese written press. Results from these studies complemented the questionnaire with new items and functions. Study 1 consisted of an exploratory factor analysis with a sample of 462 adults. Results revealed a two-factor structure of interpersonal and intrapersonal dimensions. After item reduction, the factorial analysis of the independent functions was also acceptable. This structure was then corroborated in Study 2 by a confirmatory factor analysis with a new sample of 474 adults, revealing an acceptable model fit. This questionnaire presents a relatively solid structure and is based on acceptable psychometric properties, which allows its use in future research.
Article
We examined how family functioning and emotion regulation strategies relate to both a history of nonsuicidal self-injury (NSSI) and recovery from NSSI. Participants were 272 adolescents aged between 12 and 18 years (M = 14.50 years, SD = 1.46 years), of whom 17.6% reported a history of NSSI. As expected, poor family functioning was associated with engagement in NSSI. Among the emotion regulation variables, higher use of self-blame and lower use of refocus on planning was associated with NSSI. Self-blame and refocus on planning also mediated the relationship between family functioning and NSSI. Similarly, better family functioning and adaptive emotion regulation were related to recovery, while maladaptive emotion regulation was negatively related to recovery. Adaptive emotion regulation moderated the relationship between family functioning and NSSI recovery. We discuss how family-based interventions combined with emotion regulation education may help deter NSSI engagement.
Article
Non-suicidal self-injury (NSSI) in adolescence has been increasing steadily over the past several decades. Mental health professionals frequently address NSSI solely within an individual context. Behaviorally focused therapy is the norm for treating NSSI in adolescents, but existence of the behavior as a larger manifestation of structural family problems is missing from this modality of therapy. Although short-term outcomes display a reduction or cessation of NSSI, long-term efficacy is still not proven for behaviorally focused therapies. Addressing the function of NSSI in a family context will help shift the perspective of clinicians from behavioral, individual therapy to structural family therapy.
Article
Mental health counselors are facing increased demand to treat both adolescents and adults who present with repetitive non-suicidal self-injurious behaviors, yet there are few empirically supported treatments or general treatment guidelines available. I will review the research on problem-solving and dialectical behavior therapy, two cognitive-behavioral treatments that have the most empirical support for reducing self-injurious behavior. I conclude by providing specific treatment recommendations drawn from the literature that can be of use to mental health counselors working with individuals who self-injure.
Article
The study aims to determine the prevalence of self-harm (SH) and related psychosocial factors in a large sample of Portuguese adolescents. A total of 1713 pupils, aged 12 to 20 years, completed an anonymous questionnaire in a school setting. 7.3% reported at least one episode of SH: rates were three times higher for females than males. Almost half reported repeated SH, most commonly self-cutting. Anxiety, depression and substance abuse were linked to SH, and particularly repeated SH. Anxiety, trouble with the police, and exposure to SH or suicide of others, were independently associated with SH in both genders. These findings indicate that SH is a public health concern in Portugal as in other European countries.
Article
Nonsuicidal self-injury is receiving increasing attention in empirical and clinical realms. Indeed, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders designated nonsuicidal self-injury as a condition that requires further study, which signals possible future official adoption. Despite growing interest in this perplexing phenomenon, much remains unknown about why nonsuicidal self-injury occurs, including fundamental features of its etiology and underlying mechanisms. In addition, no evidence-based interventions that directly target this maladaptive behavior currently exist. The recently developed, empirically supported four-function model posits that nonsuicidal self-injury is maintained by four distinct reinforcement processes. In this review, we used the four-function model to guide the understanding of important unanswered questions and suggest much-needed studies for future research in the field of self-injury.
Article
In this paper we examine the association of aid exchange with attachment in two sets of mother-daughter relationships—student women and their mothers (139 pairs) and these same middle-aged mothers and their mothers (110 pairs). In each case both partners are respondents. Each pair is categorized by the pattern of aid exchange—high reciprocity, low reciprocity, mother dependent, daughter dependent. Attachment reflects emotional dependence. Mothers reported greater attachment than daughters in the older pairs. There was a main effect for aid pattern on attachment in older pairs; high reciprocity relationships displayed greater attachment than other aid patterns. In the younger pairs, there was an interaction effect of aid pattern and generation on attachment. Mothers and daughters perceived attachment differently in nonreciprocal relationships but not in reciprocal relationships; the dependent partner reported less attachment. Different results for the two sets of intergenerational relationships are discussed in terms of individual and relationship development.
Article
Self-harm is a growing health problem. Nurses in a variety of healthcare settings play a central role in the care of people who self-harm. Their professional attitudes towards these people are essential for high-quality care. This review aims to develop insight into nurses' attitudes towards self-harm as they exist in contemporary nursing practice. A literature search was conducted in four databases, and a total of 15 relevant articles were found. This review indicates that negative attitudes towards self-harm are common among nurses. The influence of nurses' age, gender and work experience remains unclear. Healthcare setting and qualification level appear to be influencing factors. Education can have a positive influence on nurses' attitudes towards self-harm, especially when it includes reflective and interactive components. It is demonstrated in this review that a major change is needed regarding nurses' attitudes. To realize this change, nurses need to be trained and educated adequately concerning self-harm. They need time and resources to build a therapeutic relationship with people who harm themselves so they can offer high-quality care for this vulnerable group.
Article
Objective The U.K. has one of the highest rates of self harm in Europe at 400 per 100,000 of population. Paramedics and emergency staff may be the first professionals encountered, therefore understanding their views and approaches to care is crucial. The aim of this study was to systematically review published quantitative literature relating to paramedic and emergency workers’ perceptions and experiences of caring for people who self harm. Methods Databases including CINAHL®, MEDLINE®, OVID ® and Psych INFO® were searched, PRISMA guidelines were followed, and two researchers independently screened titles, abstracts and full papers against a priory eligibility criteria. Data synthesis was achieved by extracting and descriptively analysing study characteristics and findings. Results 16 studies met inclusion criteria; one included ambulance staff, all used questionnaires. Training, policies and guidelines improved staff knowledge and confidence in caring for people who self harm. Limited access to training was reported, ranging from 75% to 90% of staff not receiving any. Limited departmental procedures to guide staff were also reported. Staff in acute settings exhibited increased feelings of negativity, becoming less positive closer to front line care. Recent studies report positive attitudes amongst emergency staff. Discussion Despite guidelines indicating need for education and policies to guide staff in self harm care, there is limited evidence of this happening in practice. The lack of literature including paramedics suggests a gap in our understandings around care for self harm. This gap warrants greater attention in order to improve care for patients who self harm in their first point of contact.
Book
La première édition de La psychanalyse, son image et son public était une thèse. Cette seconde édition est, je l’espère, un livre. De l’une à l’outre j’ai modifié le style, le mode d’exposition des faits et des idées, éliminé des indications techniques et théoriques qui n’intéressaient qu’un cercle restreint de spécialistes ou qui sont devenues monnaie courante. Ce travail de réécriture correspond, bien entendu, aussi à une évolution personnelle et intellectuelle vis-à-vis des rites d’initiation universitaire et de la science. Lors de sa parution, la thèse a provoqué un malaise. Des psychanalystes surtout ont vu d’un mauvaise œil la tentative de prendre la psychanalyse comme objet quelconque d’étude et de la situer dans la société. 2 J’ai été frappé alors, et je le suis toujours, par le fait que les détenteurs d’un savoir, scientifique ou non, croient avoir le droit de tout étudier — et en définitive de tout juger — mais estiment inutile, voire pernicieux, de rendre compte des déterminismes dont ils sont le lieu, des effets qu’ils produisent, bref d’être étudiés à leur tour et de regarder le miroir qu’on leur tend en conséquence. Ils y voient une immixtion intolérable dans leurs propres affaires, une profanation de leur savoir — veut-on qu’il reste sacré ? — et réagissent, suivant leur tempérament, avec mépris ou mauvaise humeur. Ceci est vrai de la plupart des scientifiques, ceci est même vrai des marxistes. C’est pourquoi nous n’avons pas de sociologie de la science, ni du marxisme, ni de la psychanalyse. Je me suis cependant aperçu qu’en dix ans, du moins en ce qui concerne la psychanalyse et les psychanalystes, les attitudes ont beaucoup changé dans un sens favorable à un travail tel que celui-ci. 3 Au centre de ce livre est le phénomène des représentations sociales. Depuis la première édition, de nombreuses études tant de terrain que de laboratoire lui ont été consacrées. Je pense notamment à celles de Chombart de Lauwe, Hertzlich, Jodelet, Kaës d’un côté et à celles d’Abric, Codol, Flament, Henry, Pêcheux, Poitou de l’autre. Elles ont permis de mieux saisir sa généralité et de mieux comprendre son rôle dans la communication et la genèse des comportements sociaux. Mon ambition était cependant plus vaste. Je voulais redéfinir les problèmes et les concepts de la psychologie sociale à partir de ce phénomène, en insistant sur sa fonction symbolique et son pouvoir de construction du réel. La tradition behavioriste, le fait que la psychologie sociale se soit bornée à étudier l’individu, le petit groupe, les relations informelles, ont constitué et continuent à constituer un obstacle à cet égard. Une philosophie positiviste qui n’accorde d’importance qu’aux prédictions vérifiables par l’expérience et aux phénomènes directement observables s’ajoute à la liste des obstacles. 4 Cette tradition et cette philosophie empêchent, à mon avis, le développement de la psychologie sociale au-delà des limites qui sont les dermes aujourd’hui. Quand on s’en rendra compte et que l’on osera franchir ces limites, les représentations sociales, j’en suis convaincu, prendront dans cette science la place qui est la leur. En outre, elles seront un facteur de renouvellement des problèmes et clés concepts de la philosophie qui doit sous-tendre le travail scientifique. Là encore, les jeux ne sont pas faits. Au contraire ils sont à refaire et la crise que traverse la psychologie sociale le montre à l’évidence. 5 Il y va de l’intérêt de bien d’autres domaines de recherche concernant la littérature, l’art, les mythes, les idéologies et le langage. Enfermés dans des cadres dépassés, prisonniers de préjugés quant au pecking order des sciences, les chercheurs dans ces domaines se privent des moyens que, dans son état actuel, la psychologie sociale met à leur disposition. En France notamment ils se réclament, sous l’emprise du structuralisme, d’une orthodoxie saussurienne, tout en oubliant ce que Ferdinand de Saussure a entrevu avec précision : « La langue est un système de signes exprimant des idées, et, par là, comparable à récriture, à l’alphabet des sourds-muets, aux rites symboliques, aux formes de politesse, aux signaux militaires, etc. Elle rat seulement le plus important de ces systèmes. On peut donc concevoir une science qui étudie la vie des signes au sein de la vie sociale ; elle formerait une partie de la psychologie sociale et par conséquent de la psychologie générale ; nous la nommerons sémiologie (du grec semeïon, « signe »). Elle nous apprendrait en quoi consistent les signes, quelles lois les régissent. » Mais le lecteur n’a pas à se soucier de ce passé, de cet état de la science, des projets flottant autour du livre. Pas plus que je ne m’en soucie. En faisant l’étude d’abord, en lui donnant forme ensuite, je me suis enrichi et j’ai eu du plaisir. Tout ce que je souhaite c’est que, en lisant ce livre, il lui arrive la même chose.
Article
Deliberate self-harm (DSH), commonly defined as the intentional, direct and non-suicidal destruction of one's body, appears to be common across both clinical and non-clinical populations. A recently developed measure of functions of DSH, the Inventory of Statements About Self-Injury (ISAS), was examined to test its two-factor model within a sample of members of online social networks. The approach adopted was to fit data from the scale to the Rasch measurement model, which is increasingly used to develop and/or assess scales. Two hundred and one (n = 201) participants aged over 18 years of age, who had engaged in DSH in the last 12 months, were recruited from online social networks’ DSH peer support groups to complete an online survey. An exploratory factor analysis supported interpersonal and intrapersonal factors based on 13 function domains. Furthermore, both factors demonstrated satisfactory fit to the Rasch model. Some local dependency was detected, and when addressed, it impacted on the alpha coefficient level for intrapersonal factor. This study is the first independent psychometric investigation of ISAS, further supporting the scale authors’ psychometric evaluations. Additional validation across different DSH samples is recommended.
Article
Bases for a developmental approach to the nature and functions of mother-child and father-child relationships are considered in connection with research findings from studies of middle-childhood and adolescent subjects and their parents. The framework for the review was derived from two sources: (1) recent conceptualizations of close relationships and (2) implications in general theories of socialization regarding different contributions of mothers and fathers to development during middle childhood and adolescence. Relationships between offspring and their mothers were found to contrast with father-offspring relationships in both middle childhood and adolescence, and differences appear to become more pronounced in some areas as a function of maturational changes associated with the transition to adolescence. The analysis points to the inadvisability of considering relationships with parents to be monolithic and a-developmental. In addition, it makes clear the need for a developmental theory of relationships to serve as a guide to further research on the linkages between ontogenetic change in individuals and the relationships of which they are a part.
Article
The goal of this study was to understand how friends and family members view and respond to non-suicidal self-injury (NSSI). A sample of college undergraduates read fictional vignettes and indicated why they thought the person engaged in NSSI and how they would respond to the situation. Participants were able to differentiate NSSI from accidental injury and suicide attempts. However, beyond this, there was little differentiation among functions. In terms of responses, participants indicated that they would attempt to maintain the safety of the individual if they observed NSSI directly and would provide emotional support if told about it later. These results suggest that observers may lack understanding of the functions of NSSI, but respond with support.
Article
Etiological models of nonsuicidal self-injury (NSSI) suggest interpersonal features may be important to understand this behavior, but social functions and correlates have not been extensively studied. This study addresses existing limitations by examining interpersonal correlates and functions of NSSI within a stratified random sample of 1,243 predominantly Caucasian college students (mean age = 21.52, SD = 4.15 years). Participants completed an anonymous online survey assessing NSSI features, perceived social support, and disclosure experiences. Approximately 15% of the students endorsed NSSI. Interpersonal reasons were endorsed proportionally more often for initiating rather than repeating the behavior. Individuals with repetitive NSSI reported significantly lower perceived social support from family members and fewer individuals to seek advice from than single-act and control participants. Fifty-nine percent had disclosed their NSSI, but rarely to mental health professionals. Conversations with others about NSSI were rated as being mostly unhelpful. These results emphasize the importance of interpersonal features and functions of NSSI, suggesting treatments should focus on strengthening interpersonal bonds alongside emotion regulation. Improving responses to disclosures of NSSI is needed to promote communication about this behavior and perceived helpfulness of such conversations.
Article
Studied family communication as reported by both parents and male and female adolescents in 32 nuclear families. Significant generational differences between parents and adolescents were observed, with parents reporting more favorably about communication in their family system. Mothers, as compared with fathers, reported more openness with both adolescents, a fact substantiated by the adolescents. Parents felt greater difficulty in communicating with sons than with daughters. From the adolescents' viewpoint, male adolescents felt more restraint with their fathers, whereas adolescent females felt barriers to free expression with their mothers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In order to assess the frequency and correlates of self-injurious behavior (SIB), 569 Portuguese adolescents aged 12 to 20 years completed questionnaires assessing SIB and psychopathological symptoms. Almost 28% (n = 158) reported a lifetime history of SIB and nearly 10% had performed it in the previous month. The most frequently injured body parts were arms, hands and nails. Most of the self-injurers admit that "now and then" they feel some "mild" to "moderate" pain during SIB. Most of them admitted using these behaviors to avoid/suppress negative feelings, painful images or memories, to punish themselves and to avoid doing something bad. Positive emotions increased significantly after SIB. The self-injurer group reported more psychopathological symptoms. SIB appears to be a common phenomenon with specific functions in adolescence and this must be addressed by clinicians and educational professionals.
Article
The rate and predictors of parental detection of youth self-harm behavior and relationship with help-seeking were examined in 7,036 parent-child dyads from the 1999 and 2004 surveys of Mental Health of Children and Young People in Great Britain. Youth self-harm behavior was reported by 463 (6.6%) children and adolescents but only 190 (2.7%) of the parents (κ = 0.30). Reports were more accurate if parents were from majority White ethnicity, were mothers of girls, experienced psychological distress themselves, or if children were older or had emotional/behavioral problems. Parental detection of youth self-harm was associated with increased likelihood of professional help-seeking.
Article
Self-reported attachment styles with mother, father, best friend, and romantic partner were assessed longitudinally across adolescence. Three cohorts (ages 13, 16, and 19 years; N=373) from a community sample were followed across 2 years. There was only one change in attachment styles with age: the oldest adolescents were more dismissive than the younger. Adolescents were more secure with mother than with father, and most dismissive and fearful with father. Boys were more dismissing than girls, who were more fearful with a romantic partner (n=158). Across time, attachment insecurity with father was associated with insecurity with a best friend. Attachment insecurity with a romantic partner was associated primarily with insecurity with friend, but changes over time tended to be associated with insecurity with mother. Results support the view of a differentiated hierarchy of attachment figures in adolescence, with the quality of parental attachment contributing to close extra-familial relationships.
Article
Adolescents and young adults (three age groups: 12–15, 16–19, and 20–28 years) reported their use of parents, and peers to fulfill attachment functions (proximity-seeking, safe haven, and secure base.) The use of each target figure varied with age and attachment function. Mothers were an important source of security across this age range. They were used as secure base consistently more than fathers or peers for all age groups, and regardless of whether or not participants had romantic partners; but were used less for proximity and safe haven by the two older groups. Best friends were used most and more than others as a safe haven; but were used less by young adults (vs. early adolescents) and by older adolescents with romantic partners. Romantic partners were used most and more than others for proximity; but were used less by early adolescents than by older participants. Fathers were selected less than other targets for all attachment functions. Those with romantic partners turned to them more than to others, and young adults selected their romantic partners as much as friends for safe haven. Those insecurely attached to mother turned to her less and to romantic partners more than did those securely attached. Implications for developmental changes in adolescent attachments are discussed.
Article
We explored mothers’ and fathers’ time spent with their adolescents and found that mothers reported spending more time with their adolescents than did fathers. Developmental patterns were found for some aspects of time involvement, with both mothers and fathers reporting higher involvement with younger adolescents. Ratings of time-spent were not associated with adolescents’ self-reported emotional/behavioral problems. Both mothers and fathers agreed that mothers had more responsibility for adolescents’ discipline, daily care, and recreational activities. Mothers and fathers reported comparable levels of satisfaction with this arrangement. Mothers, and to a lesser extent fathers, reported greater satisfaction with the division of labor when fathers showed higher levels of responsibility for adolescents’ activities. Satisfaction with the division of labor was inversely related to interparental conflict. Few differences were found based on adolescent gender for any of these variables. Results are discussed within the context of mother–child and father–child relationships and family functioning.
Article
Although research into adolescent suicide and mental health has identified links between maladaptive parent-adolescent relationships and poor adolescent adjustment, there are few studies comparing nonclinical adolescents’ perceptions of these relationships to those of clinical groups. This study used a content analysis methodology to assess the quality and nature of 115 parent-adolescent relationships. Dependent variables derived to assess the relationship with mothers and fathers were: overall quality of the relationship; and amount of communication and conflict. Analyses revealed that nonclinical controls reported better relationships with their parents, with these relationships being characterised by more communication and less conflict than those of the clinical groups. Self-harmers experienced the least satisfactory relationships with their parents, and more conflict with their mothers than the other groups. Contrary to expectation, no sex effects were found. However, there was a trend for girls to report more frequent communication with mothers. The value of this study lies in the use of qualitative methodology that draws directly upon the adolescents’ perceptions of their relationships. Additionally, the detail and nature of these data offer mental health professionals the opportunity for greater understanding of the adolescent’s world, with the increased possibility for maximally effective prevention and intervention strategies.
Article
Nonsuicidal self-injury (NSSI) is a prevalent but perplexing behavior problem in which people deliberately harm themselves without lethal intent. Research reveals that NSSI typically has its onset during early adolescence; most often involves cutting or carving the skin; and appears equally prevalent across sexes, ethnicities, and socioeconomic statuses. Less is known about why people engage in NSSI. This article presents a theoretical model of the development and maintenance of NSSI. Rather than a symptom of mental disorder, NSSI is conceptualized as a harmful behavior that can serve several intrapersonal (e.g., affect regulation) and interpersonal (e.g., help-seeking) functions. Risk of NSSI is increased by general factors that contribute to problems with affect regulation or interpersonal communication (e.g., childhood abuse) and by specific factors that influence the decision to use NSSI rather than some other behavior to serve these functions (e.g., social modeling). This model synthesizes research from several different areas of the literature and points toward several lines of research needed to further advance the understanding of why people hurt themselves.
Article
The purpose of this qualitative descriptive study was to explore parental views on how to help adolescents who self-mutilate. Self-harm, including self-mutilation, is common among adolescents. However, parental conceptions of helping adolescents who self-mutilate have rarely been investigated in nursing science. Qualitative descriptive design. Four parents of self-mutilating adolescents were interviewed in depth. Qualitative content analysis was applied. Three main categories emerged: a description of an adolescent who self-mutilates and descriptions of ways to help self-mutilating adolescents and ways to help their parents and family. An adolescent who self-mutilates appears externally to feel very well, but inside feels lonely and inferior to others. Help may include an adolescent helping herself by performing some activities alone or in relation to other people and an adolescent receiving help from a safe and trusting human relationship. Such a relationship can be with anyone who knows about the self-mutilation and is of utmost importance, but a caring attitude is particularly expected from adults. Factors that facilitate helping were identified as well as those considered help-hindering or helpful. Help that had been provided to parents and the family included factors considered helpful and unhelpful. Adolescents who self-mutilate try to help themselves, but are in need of external, probably professional help. Parents are in need of information about self-mutilation as a phenomenon to be able to help their children. Help for self-mutilating adolescents as perceived by their parents also includes help for the whole family. The findings of this study could assist health care professionals in approaching and helping both self-mutilating adolescents and their parents.
Article
The question of why some people do things that are intentionally harmful to themselves continues to puzzle scientists, clinicians, and the public. Prior studies have demonstrated that one fairly extreme, direct form of self-harm, non-suicidal self-injury (NSSI), is maintained by both automatic (i.e., intrapersonal) as well as social (i.e., interpersonal) reinforcement. However, the majority of theoretical and empirical papers on this topic focus almost exclusively on the automatic functions. The purpose of this paper is to provide a more comprehensive analysis of the social functions of NSSI. Evidence is presented supporting the notion that NSSI is maintained by social reinforcement in at least a substantial minority of instances. Moreover, an elaborated theoretical model of the social functions of NSSI is outlined that proposes that this behavior represents a high intensity social signal used when less intense communication strategies fail (e.g., speaking, yelling, crying). The model further proposes that NSSI can serve not only as a signal of distress that is reinforced primarily by the caregiving behavior it elicits from others, but that it also can serve as a signal of strength and fitness that is reinforced by warding off potential threats (e.g., peer victimization), and in some cases can strengthen affiliation with others. Support for this theoretical model is drawn from diverse literatures including psychology, evolutionary biology, and cultural anthropology. The paper concludes with specific recommendations for empirical tests of the proposed model of the social functions of NSSI, as well as other harmful behaviors such as alcohol and drug use.
Article
For people who self-harm, there is growing evidence to suggest that services and treatment outcomes can be adversely affected by healthcare staffs' stigmatising attitudes and behaviours. To date, the empirical literature has tended to focus on the attitudes of experienced healthcare professionals working with adults who self-harm. Additionally, there has been few theory or model-driven studies to help identify what healthcare students think and feel about young people who self-harm. The aim of the present study was to explore the way healthcare and non-healthcare students think and feel about adolescent self-harm behaviour using Corrigan et al.'s [Corrigan, P.W., Markowitz, F.E., Watson, A., Rowan, D., Kubiak, M.A., 2003. An attribution model of public discrimination towards people with mental illness. Journal of Health and Social Behaviour 44, 162-179] attribution model of public discrimination towards people with mental illness. The study was a questionnaire-based, cross-sectional, survey that consisted of two hypothetical vignettes. Two universities in England, United Kingdom. One hundred and eighty-four final-year students, covering health (medicine, nursing, clinical psychology) and non-health care (physics) professions. Students were presented with vignettes describing a young female who self-harms. Attributions of controllability were experimentally manipulated across the vignette conditions and students were asked to complete self-report questionnaires measuring attitudes towards self-harm, familiarity with self-harm and social desirability. Consistent with the public discrimination model, students who believed that a young person was responsible for their self-harm reported higher feelings of anger towards them. Anger, in turn, was associated with a belief in the manipulatory nature of the self-harm and with less willingness to help. Perceived risk was found to be associated with higher levels of anxiety and increased support for the use of coercive and segregatory strategies to manage self-harming behaviour. Gender and student type were important influences on public stigma, with both men and medical students reporting more negative attitudes towards self-harm. This study provides evidence that a number of factors may adversely affect the care and treatment received by young people who self-harm, namely: students' causal attributions, the gender and profession of healthcare students, and familiarity with self-harm behaviour. To improve the effectiveness of service provision and treatment outcomes for people who self-harm, it is important that health care service providers and teaching institutions consider the implications of these factors when developing staff and services, and base interventions on theoretical models of stigma and discrimination.