Article

Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adolescents

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

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.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Questionnaire of Representations About the Functions of Deliberate Self-Harm for Adolescents. This questionnaire has a version for adolescents (Duarte, Gouveia-Pereira, Gomes, & Sampaio, 2019b), which was used in the current study, and a version for adults (Duarte, Gouveia-Pereira, Gomes, & Sampaio, 2019c) that was used and is further described in Study 2. The basis for this instrument was the translation and adaptation of the second section of the Inventory of Statements About Self-Injury (Klonsky & Glenn, 2009). In addition, the questionnaire was complemented with new items and functions that emerged from the content analysis of semi-directive interviews with adolescents, as well as from the content analysis of a sample of the Portuguese written press (Duarte et al., 2019b). ...
... This questionnaire has a version for adolescents (Duarte, Gouveia-Pereira, Gomes, & Sampaio, 2019b), which was used in the current study, and a version for adults (Duarte, Gouveia-Pereira, Gomes, & Sampaio, 2019c) that was used and is further described in Study 2. The basis for this instrument was the translation and adaptation of the second section of the Inventory of Statements About Self-Injury (Klonsky & Glenn, 2009). In addition, the questionnaire was complemented with new items and functions that emerged from the content analysis of semi-directive interviews with adolescents, as well as from the content analysis of a sample of the Portuguese written press (Duarte et al., 2019b). The version for adolescents has been tested for use with Portuguese adolescents and has presented acceptable psychometric properties. ...
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.
... 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]. ...
Article
Full-text available
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.
Article
This article discusses clinical applications of three empirical articles published in the present issue of JPA, all focused on adolescent assessment in European countries. Both adolescent and non-American populations receive too little attention in the assessment literature, and these articles aim to address this problem, through research on trait reactance in Portuguese adolescents, reasons for self-harm in Portuguese adolescents, and application of the Roberts-2 with Italian adolescents. How these articles apply to actual clinical practice is discussed.
Article
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.
Article
Full-text available
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.
Article
Full-text available
(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.
Article
Full-text available
Objectives Little research has explored the full extent of the impact of self-harm on the family. This study aimed to explore the emotional, physical and practical effects of a young person's self-harm on parents and family. Design and participants We used qualitative methods to explore the emotional, physical and practical effects of a young person's self-harm on their parents and family. We conducted a thematic analysis of thirty-seven semistructured narrative interviews with parents of young people who had self-harmed. Results After the discovery of self-harm, parents described initial feelings of shock, anger and disbelief. Later reactions included stress, anxiety, feelings of guilt and in some cases the onset or worsening of clinical depression. Social isolation was reported, as parents withdrew from social contact due to the perceived stigma associated with self-harm. Parents also described significant impacts on siblings, ranging from upset and stress to feelings of responsibility and worries about stigma at school. Siblings had mixed responses, but were often supportive. Practically speaking, parents found the necessity of being available to their child often conflicted with the demands of full-time work. This, along with costs of, for example, travel and private care, affected family finances. However, parents generally viewed the future as positive and hoped that with help, their child would develop better coping mechanisms. Conclusions Self-harm by young people has major impacts on parents and other family members. Clinicians and staff who work with young people who self-harm should be sensitive to these issues and offer appropriate support and guidance for families.
Article
Full-text available
Background: Rates of nonsuicidal self-injury (NSSI) are particularly high on college campuses. Commonly endorsed reasons for NSSI include interpersonal (e.g., seeking support) and intrapersonal (e.g., affect regulation) functions. Aims: This study compared college students with and without a history of NSSI on their views of NSSI functions in order to inform gatekeeper intervention/prevention programs targeting NSSI. Method: The Inventory of Statements About Self-Injury, which assessed NSSI behavior and functions of NSSI, was completed by 367 college students (73% female, 95% white). Results: Ninety-eight participants endorsed lifetime moderate/severe NSSI, 109 endorsed minor NSSI, and 160 denied any history of NSSI. Noninjuring participants' views of NSSI functions were compared with the views held by participants with histories of NSSI. The groups did not differ in their views of the relevance of intrapersonal functions, although noninjuring individuals appeared to stress some interpersonal factors (e.g., influence) slightly more than individuals with a history of NSSI did. Conclusion: These results suggest that college students generally hold similar perceptions of the functions of NSSI. Our findings suggest intervention/prevention efforts may consider broadening the selection of gatekeepers (e.g., peers with no history of NSSI) in schools and colleges to identify at-risk students and encourage help-seeking behaviors.
Article
Full-text available
Research has identified more than a dozen functions of non-suicidal self-injury (NSI), but the conceptual and empirical overlap among these functions remains unclear. The present study examined the structure of NSI functions in two large samples of patients receiving acute-care treatment for NSI. Two different measures of NSI functions were utilized to maximize generalizability of findings: one sample (n = 946) was administered the Inventory of Statements About Self-injury (ISAS; Klonsky and Glenn in J Psychopathol Behav Assess 31:215-219, 2009), and a second sample (n = 211) was administered the Functional Assessment of Self-Mutilation (FASM; Lloyd et al. in Self-mutilation in a community sample of adolescents: descriptive characteristics and provisional prevalence rates. Poster session at the annual meeting of the Society for Behavioral Medicine, New Orleans, LA, 1997). Exploratory factor analyses revealed that both measures exhibited a robust two-factor structure: one factor represented Intrapersonal functions, such as affect regulation and anti-dissociation, and a second factor represented Social functions, such as interpersonal influence and peer bonding. In support of the two-factor structure's construct validity, the factors exhibited a pattern of correlations with indicators of NSI severity that was consistent with past research and theory. Findings have important implications for theory, research, and treatment. In particular, the two-factor framework should guide clinical assessment, as well as future research on the implications of NSI functions for course, prognosis, treatment, and suicide risk.
Article
Full-text available
Nonsuicidal self-injury (NSSI) and suicidal ideation (SI) are both distressing and quite common, particularly in youth. Given the relationship between these two phenomena, it is crucial to learn how we can use information about NSSI to understand who is at greatest risk of suicidal thoughts. In this study, we investigated how characteristics of nonsuicidal self-injury related to SI among treatment-seeking adolescents and young adults. Data were collected during routine program evaluation for a self-injury treatment program. Correlations between recent SI and NSSI characteristics were calculated for adolescent and young adult patients (N = 1502). Low severity methods of NSSI (e.g. banging) were more strongly associated with SI than high severity methods (e.g. breaking bones). SI was associated with intrapersonal (automatic) NSSI functions. SI was associated with some indices of NSSI severity, such as number of methods and urge for NSSI, but not with others, such as age of onset. This study provides a valuable opportunity to expand our knowledge of suicide risk factors beyond those that may apply broadly to self-injurers and to non-injurers (e.g., depression, substance use) to NSSI-related factors that might be specifically predictive of suicidal thoughts among self-injurers. Findings inform clinical risk assessment of self-injurious youth, a population at high risk of suicidal thoughts and behaviors, and provide further insight into the complex NSSI/suicide relationship.
Article
Full-text available
Although teachers and other school staff encounter adolescents who self-injure, the behaviour evokes strong reactions. We (a) validated a measure of attitudes towards self-injury, (b) examined knowledge, confidence, and education needs regarding self-injury, and (c) explored the relationship between attitudes and responses to self-injury among 501 secondary school teachers and other school staff. Three factors reflecting participants’ attitudes were extracted. Experience was related to knowledge and confidence regarding self-injury, but not to attitudes. Thematic analysis of open-ended questions indicated a desire for education and resources. Implications for teacher education and school policies to support teachers in addressing self-injury are discussed.
Article
Full-text available
To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries. Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed. Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment. These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
Article
Full-text available
This study examined the experiences of counsellors in training working with clients who present with non-suicidal self-injury (NSSI) as a basis for understanding how trainees react to and resolve the challenges presented by difficult counselling cases. A qualitative data analysis using consensual qualitative research [Hill, C.E., Knox, S., Thompson, B.J., Nutt Williams, E., Hess, S.A., & Ladany, N. (2005). Consensual qualitative research: An update. Journal of Counseling Psychology, 52, 196–205; Hill, C.E., Thompson, B.J., & Nutt Williams, E. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572] was conducted on 12 transcribed interviews of Master's level trainees who had recently worked with at least one client who self-injured. Three general themes were reflected by the data. Specific to NSSI the findings revealed that trainees created an intuitive model of NSSI that reflected some understanding of the phenomenon despite little or no prior exposure to it. With regard to the work involved in these challenging cases, trainees reported a number of personal struggles and tasks that they needed to resolve while trying to be helpful to these clients. These tasks included managing their emotional reactivity and resolving ethical and confidentiality issues. Engaging in these two tasks heightened their feelings of uncertainty yet also focused them to be highly intentional in their work. Whereas supervision often serves novices well when they struggle, participants reported that supervision only partly alleviated the difficulties they faced. Implications and limitations of these findings are discussed.
Article
Full-text available
Fifty teachers completed a survey to investigate knowledge, self-perceived knowledge, and attitudes regarding self-injury (SI). Teachers were aware of basic facts concerning SI; however, 78% underestimated prevalence, and only 20% felt knowledgeable. Attitudes were mixed, with 48% finding the idea of SI horrifying; however, 68% disagreeing that SI was “often manipulative.” Principal components analysis indicated that perceived knowledge emerged as a separate construct from attitudes toward SI. Years of teaching experience was related to self-perceived knowledge, but not to attitudes. In addition, 74% of teachers reported having a personal encounter with SI, and 62% felt that SI is increasing in the schools. Qualitative analysis of open-ended questions revealed a strong desire for further knowledge and training. Results indicate that teachers’ perceptions are not consistent with studies of SI in clinical settings but are consistent with recent research in community and school samples. The need for teacher education about SI is emphasized.
Article
Full-text available
Aims: To gain insight into counsellors' experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors' perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n = 8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.
Article
Full-text available
Background Self-harm is prevalent in adolescence. It is often a behaviour without verbal expression, seeking relief from a distressed state of mind. As most adolescents who self-harm do not seek help, the nature of adolescent self-harm and reasons for not disclosing it are a public health concern. This study aims to increase understanding about how adolescents in the community speak about self-harm; exploring their attitudes towards and experiences of disclosure and help-seeking. Methods This study involved 30 qualitative individual interviews with ethnically diverse adolescents aged 15–16 years (24 females, 6 males), investigating their views on coping with stress, self-harm and help-seeking, within their own social context in multicultural East London. Ten participants had never self-harmed, nine had self-harmed on one occasion and 11 had self-harmed repeatedly. Verbatim accounts were transcribed and subjected to content and thematic analysis using a framework approach. Results Self-harm was described as a complex and varied behaviour. Most participants who had self-harmed expressed reluctance to talk about it and many had difficulty understanding self-harm in others. Some participants normalised self-harm and did not wish to accept offers of help, particularly if their self-harm had been secretive and ‘discovered’, leading to their referral to more formal help from others. Disclosure was viewed more positively with hindsight by some participants who had received help. If help was sought, adolescents desired respect, and for their problems, feelings and opinions to be noticed and considered alongside receiving treatment for injuries. Mixed responses to disclosure from peers, family and initial sources of help may influence subsequent behaviour and deter presentation to services. Conclusions This study provides insight into the subjective experience of self-harm, disclosure and help-seeking from a young, ethnically diverse community sample. Accounts highlighted the value of examining self-harm in the context of each adolescent’s day-to-day life. These accounts emphasised the need for support from others and increasing awareness about appropriate responses to adolescent self-harm and accessible sources of help for adolescents.
Article
Full-text available
Non-suicidal self-injury (NSSI) is defined as the repetitive deliberate destruction of one's body tissue without suicidal intent and is frequently repetitive. The aim of this study was to examine the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. The ISAS was administered to 529 high school students who had performed at least one NSSI behavior. The internal consistency and test-retest reliability of the scale were examined; for construct validity, the relationship between the Turkish form of the ISAS and various criteria scales was examined, and confirmatory factor analysis (CFA) was conducted. Consistent with previous research, factor analysis of the functions scale confirmed the good-fit of the original's 2-dimension model (c²=243; s.d. = 59; NCI (c²/sd) = 4; RMSEA = 0.08 (.07-.09); CFI=0.97; NFI=0.97). In order to test the scale for construct validity, the Brief Symptom Inventory and Suicide Probability Scale were administered to participants, in addition to the ISAS, and the correlations with clinical constructs (e.g., suicidality, depression, anxiety) were in the expected direction. Also the reliability analysis revealed that the ISAS subscales demonstrated high internal consistency. In the light of the findings, it was concluded that the Turkish version of ISAS could be used as a reliable and valid tool in assessing non-suicidal self-injury in research and treatment contexts.
Article
Full-text available
This chapter is dedicated to a review of literature, theories, and a nascent empirical study germane to the role of the media on nonsuicidal self-injury (NSSI). We begin with a review of the forms of mass communication available daily to most individuals within and outside of the United States followed by a brief discussion of empirical linkages between media exposure and NSSI, aggression, and suicide. We then present preliminary findings from our study of the links between self-injury and media and examine several of the key theoretical mechanisms through which media and the Internet may influence youth behavior. Finally, we discuss implications for clinical practice and community-based intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs.
Article
Full-text available
Non-suicidal self-injury (NSSI) is a growing concern among professionals working with youth. The present study investigated the self-reported confidence, knowledge, and attitudes regarding NSSI among 155 high school teachers (51 men, 104 women). More than half of the teachers (60%) responded that they found the idea of NSSI “horrifying.” When asked about their own levels of confidence in dealing with NSSI, 67% said that they would feel comfortable if a student spoke to them about NSSI; however, only 43% felt knowledgeable about this behavior. Years of teaching experience was found to be positively associated with disagreement that individuals who self-injure are manipulative. Male teachers reported more negative attitudes than female teachers. Implications for school mental health professionals are discussed. KeywordsNon-suicidal self-injury–Self-injurious behavior–Adolescents–Attitudes–Knowledge–High school teachers
Article
Full-text available
The present study reports the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess the functions of non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. The ISAS was administered to 235 young adults from a college population who had performed at least one NSSI behavior. Consistent with previous research, ISAS functions comprised two factors representing interpersonal and intrapersonal functions. In addition, the ISAS factors exhibited excellent internal consistency and expected correlations with both clinical constructs (e.g., borderline personality disorder, suicidality, depression, anxiety) and contextual variables (e.g., tendency to self-injure alone). Findings support the reliability and validity of the ISAS. The ISAS may be useful in research and treatment contexts as a comprehensive measure of NSSI functions.
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
Full-text available
The aim of the study was to illuminate interpretative repertoires that jointly construct the interaction between adult women who self-harm and professional caregivers in psychiatric inpatient care. Participant observations and informal interviews were conducted among six women who self-harm and their professional caregivers in two psychiatric inpatient wards, and analysed using the concept of interpretative repertoires from the discipline of discursive psychology. The analysis revealed four interpretative repertoires that jointly constructed the interaction. The professional caregivers used a "fostering repertoire" and a "supportive repertoire" and the women who self-harmed used a "victim repertoire" and an "expert repertoire." The women and the caregivers were positioned and positioned themselves and people around them within and among these interpretative repertoires to make sense of their experiences of the interaction. It was necessary to consider each woman's own life chances and knowledge about herself and her needs. The participants made it clear that it was essential for them to be met with respect as individuals. Professional caregivers need to work in partnership with individuals who self-harm-experts by profession collaborating with experts by experience. Caregivers need to look beyond behavioural symptoms and recognise each individual's possibilities for agency.
Article
Full-text available
Nonsuicidal self-injury (NSSI) is a growing public health problem among adolescents and young adults. The Inventory of Statements About Self-Injury (ISAS) is a self-report measure designed to assess NSSI behaviors and functions. The current study examines the one-year test-retest reliability of the ISAS in a sample of young adult self-injurers. Results indicate that the ISAS behavioral and functional scales demonstrate good stability over one year. For the behavioral scales, test-retest correlations ranged from .52 (biting) to .83 (burning), with a median of .68. For the functional scales, test-retest correlations were .60 for the superordinate intrapersonal functions scale and .82 for the superordinate interpersonal functions scale. Regarding individual functions, test-retest correlations ranged from .35 (affect regulation) to .89 (peer bonding), with a median of .59. Findings suggest the ISAS has good test-retest reliability and contributes to the growing literature on the psychometric properties of the ISAS.
Article
Full-text available
For people who self-injure, the internet can provide an anonymous environment where users feel safe to divulge feelings and experiences which are not usually socially sanctioned. However, internet users can encourage each other to engage in self-destructive behaviour. This qualitative study aimed to simulate a typical search an adolescent might perform if he/she was looking for support and information about self-injury. The aim was to determine whether the resulting content was helpful or harmful. Seven queries - ‘cutting’, ‘self injury’, ‘self-injury’, ‘self harm’, ‘self-harm’, ‘self-mutilation’, and ‘self mutilation’ - were entered into www.google.com and each link from the first webpage from each search was opened and judged for relevancy. Thirty-nine links were analysed and grouped into five categories: websites (n=5); webpages (n=11); book results (n=8); news results (n=11); and other (n=4). Examination of the quality and content of the links obtained from our search showed mainly recovery oriented, supportive information about self-injury. Despite this positive outcome, more specific searches such as ‘pro-self-injury’ would likely result in less encouraging results. Mental health professionals should be aware that their self-injuring clients have probably used the internet for support and information, and consider how this use might impact on therapy. Mental health professionals could use the results of this study to recommend quality internet sites to their clients.
Article
Full-text available
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
Full-text available
Parents' perspectives on self-harm are considered important, but have not been explored. To gain perspective of parents of adolescents who self-harm on: (a) history of self-harm and health service provision; (b) their understanding and ability to make sense of self-harm behaviour; (c) emotional and personal impact; and (d) parent skills as carer and hope for the future. Interpretative phenomenological analysis was applied to semi-structured interviews with 12 parents of adolescents receiving treatment for self-harm in community child and adolescent mental health services. Parents commonly suspected and spotted self-harm prior to disclosure or service contact; however, communication difficulties and underestimating significance led to delays in addressing the behaviour. Parents struggled to understand and cope with self-harm. Parents require advice and support from outside services to help them manage self-harming behaviour and its personal impact. This study suggests parents are early to spot signs of self-harm, indicating their key role in reaching young people in the community who remain unknown to health services.
Article
Full-text available
Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
Article
Full-text available
The 2 studies reported here use observational data from message boards to investigate how adolescents solicit and share information related to self-injurious behavior. Study 1 examines the prevalence and nature of these message boards, their users, and most commonly discussed topics. Study 2 was intended to explore the correlations between content areas raised for discussion. Both studies were intended to shed light on the role of message boards in spreading information about self-injurious practices and influencing help-seeking behavior. More than 400 self-injury message boards were identified. Most are populated by females who describe themselves as between 12 and 20 years of age. Findings show that online interactions clearly provide essential social support for otherwise isolated adolescents, but they may also normalize and encourage self-injurious behavior and add potentially lethal behaviors to the repertoire of established adolescent self-injurers and those exploring identity options.
Article
Full-text available
This paper reports the findings of a qualitative study that used a hermeneutic phenomenological methodology to develop insights into the experience of parents of young people who engage in self-harming behaviour. Six mothers (and one father who accompanied his wife) participated in the study. Findings reveal that mothers experienced guilt and shame, and that these feelings shaped their reactions and responses. These mothers described experiencing emotional dilemmas, such as the degree to which they could be responsible, uncertainty about how to understand self harm, and the best course of action to take with their child. They also encountered difficulties in combating the negative emotional effects for themselves and other family members. Findings provide insights that can help nurses and family health workers to understand and assist parents with greater effectiveness; by maintaining a non-judgemental stance, acknowledging the difficulties of their experiences, encouraging confidence in their parenting abilities, and promoting effective stress management strategies.
Article
Full-text available
The purpose of this study was to describe self-mutilation from the perspectives of self-mutilating adolescents. A qualitative descriptive design was adopted. Self-mutilating adolescents were asked to write descriptions of their self-mutilation. Data analysis revealed three major categories: descriptions of the factors contributing to self-mutilation, descriptions of the act of self-mutilation, and descriptions of the sequels of self-mutilation. This study adds to our understanding of self-mutilation and the experiences of self-mutilating adolescents. In nursing practice and education, self-mutilation should be discussed based on existing knowledge to make nurses more familiar with it. Nurses should understand this phenomenon as a challenge for developing effective nursing practices.
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.
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
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
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
This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed using thematic analysis. Counsellors’ experiences were characterised by a number of themes, including the nature of self-harm, in terms of severity and vividness of description, stopping self-harm, incorporating social norms and therapeutic outcome, and organisational issues around balancing expectations from the agency, managing risk, and the counsellors’ own working. Findings suggest that working with clients who self-harm raises significant challenges for counsellors in relation to organisational policy and/or context, the impact that working with this client group may have on the therapist themselves, while the issue of stopping self-harm, and how this might be communicated to the client, raises implications for the therapeutic relationship. Here, the supervisory relationship may offer an invaluable resource.
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
People who have experienced self-harm report dissatisfaction with the care provided by statutory services. This review provides a critical exploration of the evidence examining the attitudes of healthcare professionals across both mental health and medical settings towards people who self-harm. It also explored in detail service users perceptions of care. A literature search conducted via electronic databases and cross-matching reference lists produced 19 papers that met the inclusion criteria. A thematic analysis of the literature indicated six key areas which contributed to the development of attitudes defined as positive or negative towards people who self-harm. Negative attitudes and experiences of care were associated with lack of education and training, the impact of differences in perceptions of health professionals' role and the influence of clinical culture as well as how self-harm was perceived as a health need. More positive attitudes were associated with a greater understanding of experiences of self-harm and improved training. However, the nature of care reported by service users indicates that there are still significant improvements needed to the attitudes in health settings to ensure they receive a high-quality service.
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 aim of this study was to investigate representations of non-suicidal self-injury (NSSI) in popular media. Forty-one motion pictures were viewed, coded, and analyzed. NSSI was correlated with mental illness, child maltreatment, and substance abuse. NSSI was generally portrayed as severe, habitual and covert. Further, depictions of NSSI were often sensationalized and featured prominently. NSSI was less likely to be associated with completed suicide than other psychological factors, but more closely associated with suicide than NSSI is in the community. Although NSSI was associated with psychiatric illness, few characters were receiving psychiatric care at the time of NSSI. However a significant proportion received support after engaging in NSSI. The portrayal of NSSI is generally accurate regarding correlates and function, but is inaccurately associated with suicide. Implications of the relatively accurate portrayal of NSSI are discussed in light of the potential for imitation, and the possibility of using cinematherapy to promote effective problem resolution.
Article
Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined. Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were 'to get relief from a terrible state of mind' followed by 'to die', although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime. Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.
IBM® SPSS® Amos™ 22 user’s guide. Amos Development Corporation
  • J L Arbuckle
Análise de equações estruturais
  • J Maroco
Maroco, J. (2010). An alise de equações estruturais: Fundamentos te oricos, software e aplicações [Structural equation analysis: Theoretical, software and applications]. Pêro Pinheiro: Report Number.
IBMV R SPSSV R Amos TM 22 user's guide. Amos Development Corporation
  • J L Arbuckle
Arbuckle, J. L. (2013). IBMV R SPSSV R Amos TM 22 user's guide. Amos Development Corporation. Retrieved from http://www.sussex.ac.uk/ its/pdfs/SPSS_Amos_User_Guide_22.pdf
Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries
  • R Brunner
  • M Kaess
  • P Parzer
  • G Fischer
  • V Carli
  • C W Hoven
  • D Wasserman
Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C. W., … Wasserman, D. (2013). Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, 55(4), 337-348. doi:10.1111/jcpp.12166
Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the inventory of statements about self-injury (ISAS) scale. Behaviour Change
  • R Kortge
  • T Meade
  • A Tennant
Kortge, R., Meade, T., & Tennant, A. (2013). Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the inventory of statements about self-injury (ISAS) scale. Behaviour Change, 30(1), 24-35. doi:10.1017/bec.2013.3
An alise de equaç~ oes estruturais: Fundamentos te oricos, software e aplicaç~ oes
  • J Maroco
Maroco, J. (2010). An alise de equaç~ oes estruturais: Fundamentos te oricos, software e aplicaç~ oes [Structural equation analysis: Theoretical, software and applications]. P^ ero Pinheiro: Report Number.
What is the link? The relationship between non-suicidal self-injury and social media
  • N Reddy
  • L Rokito
  • J Whitlock
Reddy, N., Rokito, L., & Whitlock, J. (2016). What is the link? The relationship between non-suicidal self-injury and social media. In Information Brief Series, Cornell Research Program on Self-injury and Recovery. Ithaca, NY: Cornell University.
Representaç~ oes sociais, representaç~ oes individuais e comportamento. Revista Interamericana de Psicolog ıa
  • J F R Wachelke
  • B B V Camargo
Wachelke, J. F. R., & Camargo, B. B. V. (2007). Representaç~ oes sociais, representaç~ oes individuais e comportamento. Revista Interamericana de Psicolog ıa/Interamerican Journal of Psychology, 41(3), 379-390.