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Lindquist EG, West AE. What Do My (Online) Friends Think? A Topic Modeling Approach to Identifying Patterns of Response to Self-Injurious Behaviors on Reddit. Arch Suicide Res 2024; 28:537-553. [PMID: 36998237 DOI: 10.1080/13811118.2023.2193594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE Approximately 17% of adolescents and young adults will engage in non-suicidal self-injury (NSSI) at least once in their lifetime, leading the World Health Organization to identify self-injury as one of the top five public health concerns for adolescents. Despite the widespread prevalence of this behavior, NSSI continues to be heavily stigmatized in both medical and community settings, deterring many engaged in NSSI from seeking informal support from friends and family as well as formal psychological or psychiatric treatment. In contrast to the low rates of in-person help-seeking for NSSI, online support groups are highly utilized by those engaged in NSSI. Thus, an empirical study of responses to frequent, voluntary disclosure of NSSI on social media is needed to better understand how these communities meet the needs of those who self-injure. METHOD The current project used latent Dirichlet allocation to identify frequent and favored themes in response to self-injury content in the largest self-injury group on Reddit (over 100,000 members). Reddit, the 9th most visited website in the world, is a chat-based social media platform that has 430+ million active users and billions of site visits, with current estimates suggesting that ∼63% of the U.S. population are Reddit users. RESULTS Identified themes included: (1) recovery encouragement; (2) provision of social and instrumental support; and (3) daily realities of living with NSSI. Responses that encouraged recovery received more upvotes on Reddit than any other type of comment. CONCLUSION These results can inform evidence-based, person-centered, dimensional treatments for NSSI.
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Martin F, Ferrey A, Hobbs L, Lascelles K, van Even S, Oliver T. Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings. Child Adolesc Ment Health 2024. [PMID: 38362819 DOI: 10.1111/camh.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being. METHODS We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. RESULTS We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. CONCLUSIONS Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.
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Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Hobbs
- School of Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Thomas Oliver
- School of Social Sciences, University of the West of England, Bristol, UK
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Bilello D, Townsend E, Broome MR, Burnett Heyes S. Friendship and self-harm: a retrospective qualitative study of young adults' experiences of supporting a friend who self-harmed during adolescence. Front Psychol 2024; 14:1221661. [PMID: 38370107 PMCID: PMC10869467 DOI: 10.3389/fpsyg.2023.1221661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/11/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Self-harm amongst young people is becoming increasingly prevalent. Understanding, responding to, and supporting young people who self-harm is vital. Friends are typically the first and sometimes the only source of support sought by adolescents who self-harm. Despite their important role as confidants, friends' perspectives and experiences remain poorly understood. Methods We conducted retrospective qualitative semi-structured interviews, prompted by an adapted version of the Card Sort Task for Self-Harm (CaTS-FF), about the experiences of nine female young adults (18-20 years old) who supported a friend who self-harmed during adolescence. Data were analyzed using thematic analysis. Results Four themes were developed: (1) "I did not realize my friend was on the road to self-harm": Friends' reactions to self-harm; (2) "That's what friends do": the role of friends; (3) The impact of supporting a friend who self-harms; and (4) "They were quite formative years": reflecting on growth through the experience. Discussion The present findings highlight the complex experiences of young people supporting a friend who self-harms. Despite being willing to take on the role of a supporter, participants experienced a range of difficult emotions and consequences. The temporal transition running through the four themes reflects the evolving nature of participants' attitudes, knowledge, and friendships. Overall, results highlight the unmet needs of adolescents supporting young people who self-harm, as well as identifying potential pathways to "support the supporters" toward resilience.
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Affiliation(s)
- Delfina Bilello
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University Park, The University of Nottingham, Nottingham, United Kingdom
| | - Matthew R. Broome
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stephanie Burnett Heyes
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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Tan RHS, Shahwan S, Zhang Y, Sambasivam R, Ong SH, Subramaniam M. How do professionals and non-professionals respond to non-suicidal self-injury? Lived experiences of psychiatric outpatients in Singapore. BMC Psychol 2024; 12:14. [PMID: 38178150 PMCID: PMC10768356 DOI: 10.1186/s40359-023-01512-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND For young people who engage in non-suicidal self-injury (NSSI), receiving negative responses to their NSSI can pose a barrier to future help-seeking. This qualitative study aimed to explore helpful and unhelpful ways in which professionals and non-professionals respond to NSSI, from the perspectives of individuals with lived experiences of NSSI. METHODS Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) aged 17 to 29 years from a tertiary psychiatric hospital in Singapore, who had reported engaging in NSSI behavior in an earlier study. The interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. RESULTS Professionals' responses were organized into three main themes: 'prescribing solutions without understanding needs', 'disapproval or judgment', and 'helpful responses'. Non-professionals' responses were organized into four main themes: 'emotionally charged responses', 'avoidance and inaction', 'poor understanding of reasons for NSSI', and 'providing tangible support and acknowledging NSSI'. Participants also described how unhelpful responses negatively impacted their willingness to seek help. CONCLUSIONS Our findings provide a better understanding of responses to NSSI that are considered helpful and unhelpful, and can be used to improve existing guidelines on responding to NSSI.
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Affiliation(s)
- Rachel Hsiao Shen Tan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Say How Ong
- Department of Developmental Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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James KM, Balderrama-Durbin C, Israel E, Feurer C, Gibb BE. Self- and co-regulation of physiological activity during mother-daughter interactions: The role of adolescent non-suicidal self-injury. J Child Psychol Psychiatry 2024; 65:91-99. [PMID: 37469027 PMCID: PMC10796835 DOI: 10.1111/jcpp.13859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern that is thought to increase risk for future self-injurious behaviors, including suicide attempts. Notably, NSSI is especially prevalent among adolescents, which underscores a critical need to identify modifiable risk factors that could be targeted to reduce future risk. The current study examined self- and co-regulation of physiological responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. METHODS Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed positive and negative interaction tasks during which physiological reactivity was assessed via respiratory sinus arrhythmia (RSA). RESULTS Using Actor-Partner Interdependence Modeling (APIM), we found that adolescents with an NSSI history demonstrated a higher RSA setpoint than adolescents without this history during the negative, but not positive, interaction task. In addition, there were differences in co-regulation during the negatively valenced interaction, such that mothers of daughters with NSSI were more reactive to fluctuations in their daughters' RSA than mothers of daughters without an NSSI history. CONCLUSIONS These findings highlight intra- and interpersonal aspects of physiological dysregulation associated with NSSI that could provide promising targets of intervention to reduce future risk in adolescent girls.
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Affiliation(s)
| | | | - Elana Israel
- Binghamton University (SUNY), Department of Psychology
| | - Cope Feurer
- University of Illinois Chicago, Department of Psychiatry
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Qin Y, Wu D, Liu J, Peng J, Li C. Perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers: a qualitative study. Front Psychiatry 2023; 14:1237436. [PMID: 38148747 PMCID: PMC10750419 DOI: 10.3389/fpsyt.2023.1237436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Background The prevalence of non-suicidal self-injury among adolescents has increased over the years. Most parents, however, are poorly informed and confused about this behavior. Sharing caretaking experiences with parents in similar situations seems to be beneficial. Nevertheless, few researchers have explored the views of parents who share their caretaking experiences with peers. Aim This study aimed to investigate the perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers as well as the motivations for and barriers to this behavior. Methods This qualitative study adopted a purposive sampling method. Participants (16 mothers and 2 fathers) were recruited from the mental health center of a tertiary hospital in Chengdu, Sichuan, China. A total of 18 semistructured face-to-face individual interviews were conducted. All interviews were audio-recorded and analyzed thematically using NVivo 11. Results Three themes and nine subthemes were identified: (1) sharable caretaking experiences: reflection and transformation, self-emotional management, and diversified support; (2) motivations for sharing: empathy, reciprocity, and meaning; and (3) barriers to sharing: inadequate knowledge, low self-identity, and concerns for children. Conclusion Parents accumulate a wealth of experience during their long-term care of adolescents with repeated non-suicidal self-injury. Although most parents are willing to share their caretaking experiences with peers, there are several barriers. Therefore, in order to increase parents' motivation to share, psychological education is necessary.
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Affiliation(s)
- Yuan Qin
- School of Nursing, Chengdu Medical College, Chengdu, China
- Chongqing Mental Health Center, Chongqing, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Jiao Liu
- School of Nursing, Zunyi Medical University, Zunyi, China
| | - Jianyan Peng
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunya Li
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Townsend ML, Matthews EL, Miller CE, Grenyer BF. Adolescent self-harm: Parents' experiences of supporting their child and help-seeking. J Child Health Care 2023; 27:516-530. [PMID: 35313747 DOI: 10.1177/13674935211062334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Self-harm in children and adolescents is a growing public health issue. Parents are forefront in identifying, responding to and supporting their child to seek help. A sequential mixed-method study which included an online survey (N = 37) and a semi-structured interview (n = 10) was conducted to understand parents' experiences of supporting and accessing help for their child. Parents (M = 45.70 years, SD = 6.18) with a child who has engaged in self-harm behaviours (M = 16.89 years, SD = 3.91) participated. Parents sought help from a range of services and perceived psychiatrists, private psychologists and friends as the most helpful and school psychologists, paediatricians, Emergency Department (ED) and the national youth mental health organisation as the least helpful. Two themes were interpreted from the qualitative data: (1) An emotional journey into the dark unknown, and (2) The promise of psychological help. A series of recommendations for other parents in similar situations, as well as health professionals were made. Parents want health professionals to provide appropriate referrals, work collaboratively with families, meaningfully connect with and validate parents, provide practical and psychological support for families and establish parent support groups. There remains a need for widely available evidence-informed resources, information and support for parents.
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Affiliation(s)
- Michelle L Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Emily L Matthews
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Caitlin E Miller
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Brin Fs Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
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Branjerdporn G, Erlich F, Ponraj K, McCosker LK, Woerwag-Mehta S. What Is Helpful and What Is Challenging for the Caregivers of Young People Receiving Interventions to Prevent Suicide? Caregivers' Perspectives-A Rapid Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1801. [PMID: 38002892 PMCID: PMC10670828 DOI: 10.3390/children10111801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
(1) Background: Suicide is a leading cause of death among young people. Preventing suicide in young people is a priority. Caregivers play a vital role in ensuring interventions for young people experiencing suicide ideation and/or attempts are implemented, and that they are maintained over time. Despite this, little is known about what caregivers find helpful and challenging in relation to suicide prevention interventions. This rapid scoping review is the first to address this gap. (2) Methods: Searches were completed on six electronic databases using keywords relating to 'suicide prevention, 'young people', and 'caregivers'. Ten studies-using both qualitative and quantitative methods, and involving >1400 carers from the United States and Europe-were selected for inclusion. (3) Results: The review shows that caregivers value interventions that are delivered by non-judgmental clinicians, that are suitable to the particular needs of their child, that are available when needed, and that support their confidence and communication. Caregivers experience difficulties with interventions that require their attendance at specific times, and that fail to recognize and/or address their own mental health needs. (4) Conclusions: The findings can be used to inform and improve the intervention design, with the aim of improving outcomes for caregivers and young people.
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Affiliation(s)
- Grace Branjerdporn
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Ferrell Erlich
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Karthikeyan Ponraj
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
| | - Laura K. McCosker
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- School of Medicine and Dentistry, Griffith University, Nathan, QLD 4111, Australia
| | - Sabine Woerwag-Mehta
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (L.K.M.); (S.W.-M.)
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (F.E.); (K.P.)
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French Á, Gaynor K, Nearchou F, Raftery S, O'Dwyer B, Hennessy E. Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals. Arch Suicide Res 2023:1-16. [PMID: 37950673 DOI: 10.1080/13811118.2023.2279524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2023]
Abstract
OBJECTIVE Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child. METHOD Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm. RESULTS There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs. CONCLUSION Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.
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Miettinen TM, Kaunonen M, Kylmä J, Rissanen ML, Aho AL. Experiences of Help from the Perspective of Parents Whose Adolescent Is Harming Themselves or Has Died by Suicide. Issues Ment Health Nurs 2023; 44:1083-1095. [PMID: 37801715 DOI: 10.1080/01612840.2023.2258211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Adolescent self-harm or suicide are emotionally difficult for parents, thus also parents need help. This qualitative descriptive study aimed to produce knowledge on the experiences of help received by Finnish parents (n = 23) whose adolescent is harming themselves or has died by suicide. The parents received diverse help for themselves, and for their self-harming adolescent or the deceased adolescent's sibling. Parents described negative experiences, but also factors that promoted their experience of help. There are many barriers to help related to the parents themselves, the adolescent, or to the social support system. Professional help should be easier to obtain and be based on the parents' individual expectations.
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Affiliation(s)
| | - Marja Kaunonen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Wellbeing Services County of Pirkanmaa, Hospital Services, General Administration, Finland
| | - Jari Kylmä
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Marja-Liisa Rissanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- South-Eastern Finland University of Applied Sciences, Health Care, Mikkeli, Finland
| | - Anna Liisa Aho
- Faculty of Social Sciences, Tampere University, Tampere, Finland
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Smith L, Hunt K, Parker S, Camp J, Stewart C, Morris A. Parent and Carer Skills Groups in Dialectical Behaviour Therapy for High-Risk Adolescents with Severe Emotion Dysregulation: A Mixed-Methods Evaluation of Participants' Outcomes and Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6334. [PMID: 37510567 PMCID: PMC10379026 DOI: 10.3390/ijerph20146334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND There is an established evidence-base for dialectical behaviour therapy for adolescents (DBT-A) in the treatment of young people with severe emotion dysregulation and related problems, including repeated self-harm and suicidal behaviours. However, few studies have reported on parental involvement in such treatments. This study aims to explore the outcomes and experiences of participants of a dedicated skills group for parents and carers embedded within an adapted DBT-A programme in the United Kingdom. METHOD This study was conducted within a specialist outpatient Child and Adolescent Mental Health Services (CAMHS) DBT programme in the National Health Service (NHS) in London. Participants were parents and carers of adolescents engaged in the DBT-A programme. Participants attended a 6-month parent and carer skills group intervention and completed self-report measures relating to carer distress, communication and family functioning, at pre-intervention and post-intervention. Following the intervention, semi-structured interviews were also completed with a subgroup of participants to explore their experiences of the skills group and how they perceived its effectiveness. Quantitative and qualitative methods were used to analyse the data collected from participants. RESULTS Forty-one parents and carers completed the intervention. Participants reported a number of statistically significant changes from pre- to post-intervention: general levels of distress and problems in family communication decreased, while perceived openness of family communication and strengths and adaptability in family functioning increased. A thematic analysis of post-intervention interviews examining participant experiences identified six themes: (1) experiences prior to DBT; (2) safety in DBT; (3) experiences with other parents and carers; (4) new understandings; (5) changes in behaviours; and (6) future suggestions. DISCUSSION Parents and carers who attended a dedicated DBT skills groups, adapted for local needs, reported improvements in their wellbeing, as well as interactions with their adolescents and more general family functioning, by the end of the intervention. Further studies are needed which report on caregiver involvement in DBT.
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Affiliation(s)
- Lindsay Smith
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Katrina Hunt
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Sam Parker
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Jake Camp
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Catherine Stewart
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Andre Morris
- National and Specialist Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
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Rheinberger D, Shand F, McGillivray L, McCallum S, Boydell K. Parents of Adolescents Who Experience Suicidal Phenomena-A Scoping Review of Their Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6227. [PMID: 37444075 PMCID: PMC10340647 DOI: 10.3390/ijerph20136227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023]
Abstract
High prevalence rates of self-harm and suicide in adolescence provide unique challenges for parents. The aim of this scoping review was to explore key gaps in our understanding of the current scientific literature on the experience of parents who have adolescent children experiencing suicide crisis or self-harm. Four academic databases were searched using three broad concepts: self-harming behaviour or suicidal crisis; adolescents or young people; and the experiences or behaviour of parents, between journal inception and March 2022. Information reporting on the parents' experience was extracted and a qualitative synthesis was conducted. Twenty-two articles met inclusion criteria and were assessed in detail. The experience of parents with an adolescent engaged in self-harm or suicidal crisis were classified into three temporal themes: discovery of the suicidal phenomena, management of suicidal phenomena, and after the suicidal phenomena had ceased. Parents caring for an adolescent experiencing self-harm or suicidal crisis experience poorer psychological wellbeing, difficulty accessing support services, and changes in the parent-child relationship. Parents desire greater support for both themselves and their child and further investigation is required to understand specifically which supports would be most appropriate at each stage.
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Affiliation(s)
- Demee Rheinberger
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia; (F.S.); (L.M.); (K.B.)
- Tyree Foundation Institute of Health Engineering, University of New South Wales, Sydney, NSW 2052, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia; (F.S.); (L.M.); (K.B.)
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia; (F.S.); (L.M.); (K.B.)
| | - Sonia McCallum
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2600, Australia;
| | - Katherine Boydell
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia; (F.S.); (L.M.); (K.B.)
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Zhao YL, Liu ZH, Li YY, Liu DL, Yi JN. The lived experiences of parents providing care to young people who self-harm: A meta-aggregative synthesis of qualitative studies. Int J Ment Health Nurs 2023; 32:402-419. [PMID: 36408959 DOI: 10.1111/inm.13095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/22/2022]
Abstract
Self-harm, which affects the whole family system, is an international public health concern. Empirical evidence supports the efficacy of interventions incorporating a family/parent training component for self-injurious thoughts and behaviours, and a quantitative synthesis of these empirical studies has been undertaken and updated. A qualitative synthesis of the experiences of parents whose child self-harms remains limited. This report aimed to systematically review qualitative research about the experiences, preferences, and expectations of parents whose children self-harmed. A comprehensive search was conducted across ten databases and four grey literature sources, along with the manual search of reference lists and relevant websites. Study screening, data extraction, and quality appraisal were all performed by two independent researchers. Twenty-four articles, two of which were mixed-methods studies, were included and analysed using a meta-aggregation approach. Five synthesized findings were identified: initial negative reactions to the discovery of their child's self-harm, the ongoing impact of self-harm on parents and the wider family, parents' various coping strategies, parents' negative experiences with mental health professionals expectations, and the lack of and need for psychoeducational resources. Our review finds that parents express keen interest in engaging with the treatment process, and our results support family-based therapy. However, with the overwhelming emotions most parents experience, clinicians should approach them with sensitivity, empathy and finesse. Psychoeducational self-help resources should also be made readily available to parents who are reluctant to seek help.
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Affiliation(s)
- Yan-Li Zhao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zhi-Hua Liu
- Psychotherapy Department, Zhengzhou Eighth People's Hospital, Zhengzhou, China
| | - Ying-Ying Li
- Hematology Department, Henan Provincial People's Hospital, Zhengzhou, China
| | - Dong-Ling Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Jing-Na Yi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Juel A, Erlangsen A, Berring LL, Larsen ER, Buus N. Re-constructing parental identity after parents face their offspring's suicidal behaviour: An interview study. Soc Sci Med 2023; 321:115771. [PMID: 36801752 DOI: 10.1016/j.socscimed.2023.115771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/28/2022] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Parents are affected when their offspring engages in non-fatal suicidal behaviour. Although research exists on parents' mental and emotional state when they realise this behaviour, relatively little attention has been devoted to exploring how their parental identity is affected. PURPOSE To explore how parents re-constructed and negotiated their parental identity after realising that their offspring was suicidal. METHOD A qualitative exploratory design was adopted. We conducted semi-structured interviews with 21 Danish parents who self-identified as having offspring at risk of suicidal death. Interviews were transcribed, analysed thematically and interpreted by drawing on the interactionist concepts of negotiated identity and moral career. FINDINGS Parents' perspectives on their parental identity were conceptualised as a moral career encompassing three distinct stages. Each stage was negotiated through social interaction with other people and the wider society. Entry into the first stage, disrupted parental identity, occurred when parents realised that they could lose their offspring to suicide. At this stage, parents trusted their own abilities to resolve the situation and keep their offspring safe and alive. This trust was gradually undermined by social encounters, which caused career movement. In the second stage, impasse, parents lost faith in their ability to help their offspring and to change the situation. Whereas some parents gradually resigned entirely to impasse, others regained their trust in their own abilities through social interaction in the third stage, restored parental agency. CONCLUSION Offspring's suicidal behaviour disrupted parents' self-identity. Social interaction was fundamental if parents were to re-construct their disrupted parental identity. This study contributes with knowledge about the stages characterising the reconstructive process of parents' self-identity and sense of agency.
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Affiliation(s)
- A Juel
- Psychiatric Research Unit, Psychiatry Region Zealand, Fælledvej 6, 4, 4200 Slagelse, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark Copenhagen, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000 Odense, Denmark.
| | - A Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, S850, Baltimore, MD 21205, USA; Center of Mental Health Research, Building 63, The Australian National University, Canberra ACT 2601, Australia; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, 2900 Hellerup, Denmark.
| | - L L Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, Fælledvej 6, 4, 4200 Slagelse, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000 Odense, Denmark.
| | - E R Larsen
- Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000 Odense, Denmark; Mental Health Department Odense, University Clinic, Mental Health Service, J. B. Winsløws Vej 18, 5000 Odense, Denmark.
| | - N Buus
- Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000 Odense, Denmark; School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health, Monash University, Clayton, Victoria, Australia.
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Vafaei T, Samavi SA, Whisenhunt JL, Najarpourian S. An investigation of self-injury in female adolescents: a qualitative study. QUALITY & QUANTITY 2023; 57:1-24. [PMID: 36816810 PMCID: PMC9923642 DOI: 10.1007/s11135-023-01632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
This study aimed to investigate the phenomenon of self-injury among female adolescents. The research was qualitative, and the sampling method was purposive non-random; the sample size was 20 Iranian girl adolescents aged 13-15 years who had experienced non-suicidal self-injury. Data were collected through semi-structured interviews. The data analysis process was performed during three coding steps (open, axial, selective), through which the basic codes and categories were identified. Study results indicate that the main factors in adolescents' self-injury were individual or psychological (thoughts, emotions, and behaviors) and social (peers, family, communication with different gender, communication with others, media/cyberspace, school, and economic). In the former, the role of emotions was remarkable, while in the latter, the family played a key role. Further, results revealed that communication within the family was an important motivating and sustentative factor in adolescents' self-injury. The results can help counselors in working with adolescents who self-injure; results can also be used in the development and implementation of treatment plans.
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Affiliation(s)
- Tayebeh Vafaei
- Department of Counseling, University of Hormozgan, Bandar Abbas, Iran
| | | | - Julia L. Whisenhunt
- Department of Counseling, Higher Education, and Speech-Language Pathology, University of West Georgia, Carrollton, GA USA
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16
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James KM, Balderrama-Durbin C, Kobezak HM, Recchia N, Foster CE, Gibb BE. Dynamics of Affective Reactivity during Mother-Daughter Interactions: The Impact of Adolescent Non-Suicidal Self-Injury. Res Child Adolesc Psychopathol 2023; 51:597-611. [PMID: 36607473 DOI: 10.1007/s10802-022-01011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is an alarming public health concern that is particularly widespread among adolescents. The current study examined affective responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed two interaction tasks: one positive and one negative. During these interactions, facial affect was assessed via electromyography (EMG). Results of Actor-Partner Interdependence Modeling (APIM) revealed several intra- and interpersonal disruptions in affect during both tasks among dyads in which the adolescent had an NSSI history. Findings suggest deficits in both self- and co-regulation of facial affect during mother-daughter interactions involving dyads in which the adolescents reports NSSI. Ultimately, if replicated and extended in longitudinal research, these disruptions may prove to be promising targets of intervention to reduce risk for future NSSI in adolescent girls.
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Affiliation(s)
- Kiera M James
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA. .,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA.
| | | | - Holly M Kobezak
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Nicolette Recchia
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Claire E Foster
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Brandon E Gibb
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
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17
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Zhao Y, D Dela Rosa R, Zhang Q, Zhao W, Xu H, Wang R, Ma L. Lived experiences of parents providing care to young people who self-harm: a protocol for a meta-aggregative synthesis of qualitative studie. BMJ Open 2022; 12:e065489. [PMID: 36038177 PMCID: PMC9438063 DOI: 10.1136/bmjopen-2022-065489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The self-harm of young people can cause tremendous distress to their parents/carers and impair parents' ability to provide care. At the same time, parents play an essential role in supporting their child during the management and treatment of self-harm. The synthesis of evidence about parental experiences and needs can inform mental health practice and the development of interventions to provide better care to young people who self-harm and their parents. METHODS AND ANALYSIS A comprehensive search will be conducted across several information sources, including multiple electronic databases (eg, PubMed, Embase, CINAHL, PsycINFO, ProQuest, CNKI, Wanfang, VIP and SinoMed), grey literature, the websites of specific organisations and hand-searched reference lists of all the relevant studies. Qualitative studies published in English or Chinese and focusing on the lived experiences of parents whose child self-harms will be included. Two reviewers will independently screen all the retrieved articles according to the flow diagram proposed by PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two independent reviewers will then appraise the methodological quality of all the included articles using the JBI (Joanna Briggs Institute) critical appraisal checklist for qualitative research. The meta-aggregation approach will be used to synthesise the findings of the included qualitative studies, and the level of confidence in the synthesised findings will be assessed using the Confidence in the Qualitative synthesised finding approach. ETHICS AND DISSEMINATION No additional ethical clearance is required since this review is a secondary analysis of published primary studies. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations. PROSPERO REGISTRATION NUMBER CRD42021265525.
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Affiliation(s)
- Yanli Zhao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Qiushi Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Zhao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Xu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui Wang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ling Ma
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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18
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Mughal F, Troya MI, Dikomitis L, Tierney S, Corp N, Evans N, Townsend E, Chew-Graham CA. The experiences and needs of supporting individuals of young people who self-harm: A systematic review and thematic synthesis. EClinicalMedicine 2022; 48:101437. [PMID: 35783485 PMCID: PMC9249546 DOI: 10.1016/j.eclinm.2022.101437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED Self-harm in young people is a serious international health concern that impacts on those providing informal support: the supporting individuals of young people. We aimed to highlight the experiences, views, and needs of these supporting individuals of young people. We conducted a systematic review and thematic synthesis: PROSPERO CRD42020168527. MEDLINE, PsycINFO, EMBASE, AMED, CINAHL, ASSIA, and Web of Science were searched from inception to 6 May 2020 with citation tracking of eligible studies done on 1 Oct 2021. Primary outcomes were experiences, perspectives, and needs of parents, carers, or other family members of young people aged 12-25. Searches found 6167 citations, of which 22 papers were included in synthesis. Supporting individuals seek an explanation for and were personally affected by self-harm in young people. It is important that these individuals are themselves supported, especially as they negotiate new identities when handling self-harm in young people, as they attempt to offer support. The GRADE-CERQual confidence in findings is moderate. Recommendations informed by the synthesis findings are made for the future development of interventions. Clinicians and health service providers who manage self-harm in young people should incorporate these identified unmet needs of supporting individuals in a holistic approach to self-harm care. Future research must co-produce and evaluate interventions for supporting individuals. FUNDING FM was supported by a NIHR School for Primary Care Research GP Career Progression Fellowship (SCPR-157 2020-20) to undertake this review and is now funded by a NIHR Doctoral Fellowship (NIHR300957). CCG is part-funded by the NIHR Applied Research Collaboration West Midlands.
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Affiliation(s)
- Faraz Mughal
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
- Corresponding author.
| | | | - Lisa Dikomitis
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Nadia Corp
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Nicola Evans
- School of Medicine, Keele University, Keele ST5 5BG, United Kingdom
| | - Ellen Townsend
- School of Psychology, University of Nottingham, United Kingdom
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Ammerman BA, Park Y, O'Loughlin CM. Disclosure of suicidal thoughts and behaviors: The impact of suicide event type. J Clin Psychol 2022; 78:2456-2469. [PMID: 35466401 DOI: 10.1002/jclp.23357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Despite its importance, limited work has investigated the nuances of suicidal thoughts and behavior self-disclosure. The present study aimed to examine potential differences in self-disclosure based on whether an individual has disclosed suicidal thinking versus behavior. METHODS Two hundred and four participants having disclosed their suicidal thoughts or behaviors completed a battery of online questionnaires assessing several key aspects of disclosure (i.e., disclosure recipient, perceived helpfulness of disclosure, impact on treatment seeking), as it pertained to both one's first and overall disclosure experiences. RESULTS Individuals who disclosed a suicide attempt, versus ideation, were more likely to have disclosed to a formal support (i.e., health professional) and to seek professional help following disclosure. No significant group differences in perceived helpfulness of experiences were found. CONCLUSION It may be beneficial to increase opportunities for disclosure of suicidal thinking. Overall, disclosures were perceived as helpful and may not impede future help-seeking behavior.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Yeonsoo Park
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
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20
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Townsend ML, Jain A, Miller CE, Grenyer BFS. Prevalence, Response and Management of Self-harm in School Children Under 13 Years of Age: A Qualitative Study. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-021-09494-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractResearch suggests that the incidents of self-harm among young people are increasing and age of onset of self-harm is decreasing. There is limited understanding of how widespread the problem of self-harm among younger school students is, and how schools respond to these incidents. This study used an in-depth qualitative approach to understand self-harm in children under 13, and how elementary schools respond including typical actions, support for the child and parental involvement. School psychologists in New South Wales, Australia (n = 17; 78% females), completed in-depth interviews detailing types of self-harm, prevalence and frequency, and how these incidents were managed, including student intervention approaches and participation of parents. Thematic analysis of interviews was conducted. Psychologists estimated the prevalence of self-harm in their schools was 6.5% and was increasing, with an average age of onset of 10.8 years. Self-harm was most often understood as a coping mechanism associated with anxiety, stress and being bullied. Six themes emerged from the interviews. School psychologists reported that self-harm occurs less frequently in primary school children than high school children, but noted these behaviours still require early intervention. Participants felt they were limited in the support they can provide students who self-harm, and wanted more training for all school staff and parents in identifying and responding to student self-harm. School psychologists are important in identification and management of self-harm, and they report they need further support in helping children who are engaging in self-harm behaviours. Upskilling teachers and parents may assist in reducing rates of self-harm among children.
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21
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Giles EM, Cross AS, Matthews RV, Lacey JH. Disturbed families or families disturbed: a reconsideration. Eat Weight Disord 2022; 27:11-19. [PMID: 33721219 PMCID: PMC8860793 DOI: 10.1007/s40519-021-01160-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/25/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The relationship between anorexia nervosa (AN) and family disturbance has been a subject of debate since its first description. What began as a clear view of the pathologically disturbed family causing AN has become ever more complex over the decades. OBJECTIVE The aim of this review is to explore the literature to examine the changes and evolution of clinical opinion around family dysfunction and AN over the last 20 years. METHODS A narrative review of heterogeneous studies in peer-reviewed publications sourced from the major databases, including PubMed and ScienceDirect, to illuminate the topic of family distress and AN by highlighting the conflicting and complementary ways it has been studied. RESULTS This review has highlighted the complexity of the relationship between anorectic sufferers and their families. It has explored the literature about parental burden, emotions and cognitive mechanisms together with parental attitudes about weight and shape. It is clear that there is no consistent psycho-social pathology in families which has been shown to be causative. However, over the last twenty years, research has highlighted the distress and family dysfunction caused by having to look after an anoretic child with poor mentalisation skills, insecure attachment and emotion dysregulation. CONCLUSION The area has become clearer over the last 20 years; research suggests a bi-directional relationship between AN and family dysfunction, with difficult dynamics becoming entrenched within the family. This is best addressed, the consensus suggests, by specialist family therapy and carer skills interventions. Longitudinal research is needed to definitively answer the question with rigorous scientific certainty. EMB RATING Level V. LEVEL OF EVIDENCE Level I: Evidence obtained from: at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies. Level II: Evidence obtained from well-designed controlled trials without randomization. Level III: Evidence obtained from well-designed cohort or case-control analytic studies. Level IV: Evidence obtained from with multiple time series analysis such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence. Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
| | | | | | - J Hubert Lacey
- Schoen Clinic Newbridge, Birmingham, UK.
- St Georges, University of London, London, UK.
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22
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Taş Torun Y, Gul H, Yaylali FH, Gul A. Intra/interpersonal Functions of Non-suicidal Self-injury in Adolescents with Major Depressive Disorder: The Role of Emotion Regulation, Alexithymia, and Childhood Traumas. Psychiatry 2022; 85:86-99. [PMID: 34932437 DOI: 10.1080/00332747.2021.1989854] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: This study examines non-suicidal self-injury (NSSI) behavior, its functions and associated factors like childhood trauma, alexithymia, empathy, and emotion regulation, in adolescents suffering from depression.Method: The study sample consisted of 67 adolescents; 11 boys (mean age = 14.94 ±1.45) and 56 girls (mean age = 14.72 ±1.48), all with major depressive disorder. Standard tests and measurements were used for data collection, including Beck Depression Inventory for identifying depression symptoms; Brief Symptom Inventory for screening psychiatric symptoms; Inventory of Statements About Self Injury (ISAS) to identify the lifetime frequency and functions of NSSI in subjects; Childhood Trauma Questionnaire to evaluate sexual, physical, and emotional abuse plus childhood neglect; Toronto Alexithymia Scale to assess difficulties in identifying and/or describing feelings; Basic Empathy Scale to measure empathy levels within the framework of basic emotions; and the Difficulty of Emotion Regulation Scale to determine the awareness and clarity of emotional response.Results: It was found that 64.1% of adolescents studied have had at least one NSSI to date. The most frequent intrapersonal functions associated with NSSI were Affect Regulation and Marking Distress, and the most common interpersonal functions were Toughness and Interpersonal Boundaries. According to a correlation analysis with ISAS scores, Affect Regulation was associated with obsession-compulsion, anxiety, difficulty identifying feelings and clarity scores. Marking Distress, generating a physical sign of feeling awful, was positively associated with Paranoid Ideation scores and negatively associated with Emotional Neglect scores. The Interpersonal Boundaries was positively associated with Childhood Physical Abuse and Impulse scores.Conclusions: NSSI is realized by different functions in the intrapersonal and interpersonal areas in adolescents with depression. Emotion regulation abilities, alexithymia, and childhood trauma are also associated factors or functions of NSSI.
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Boussat ML, Fourcade L, Mourouvaye M, Grandclerc S, Moro MR, Lachal J. [Qualitative study of parents' experience after their teen's suicide attempt]. Encephale 2021; 48:390-396. [PMID: 34538622 DOI: 10.1016/j.encep.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/23/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Suicidal attempts are frequent during adolescence and concern the whole family, particularly parents whose role is crucial in provision of therapeutic support. Yet very few studies have been performed bearing on their lived experience. In this study, we will analyze the experience of parents after the suicidal attempt of their adolescent. PARTICIPANTS & METHODS Qualitative study based on semi-structured interviews of 13 parents of teenagers followed in child and adolescent psychiatry for suicidal behavior. Interview included 5 to 6 open and conversational questions. We analyzed interviews, after transcription, using the Interpretative Phenomenological Analysis approach. RESULTS The parents' wellness and behavior are directly affected by their child's mental status. When they are informed of the suicidal attempt, they feel very deep sadness, in a form of initial distress which is part of the grieving process regarding their image of idealized parents. They feel anger against the teenager, their anger is also directed against family members and close friends as well as against caregivers. Given the uncertainty, they doubt their own educative and empathetic competences, and lack confidence in their capacity for providing help. They express their need for help and support with regard to understanding their child's suicidal attempt, with regard to the emotional turmoil they experience and in reinforcing their competencies as carers. CONCLUSION It appears that parents are extremely touched by their teenager suicidal attempt. They need a personal follow up, including familial medical care but also a personal space of support. Parents group, as well as psycho educative intervention, are also welcomed to give efficient method to lift their child.
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Affiliation(s)
- M L Boussat
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France
| | - L Fourcade
- APHP, Hôpital Necker, Department of Child and Adolescent Psychiatry, 75015 Paris, France
| | - M Mourouvaye
- APHP, Hôpital Necker, Department of Child and Adolescent Psychiatry, 75015 Paris, France
| | - S Grandclerc
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Établissement public de santé mentale ERASME, pôle de psychiatrie de l'enfant et de l'adolescent, 92160 Antony, France
| | - M-R Moro
- APHP, Hôpital Cochin, Maison de Solenn, 75014 Paris, France; Université de Paris, PCPP, 92100 Boulogne-Billancourt, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - J Lachal
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, 63000 Clermont-Ferrand, France.
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Laestadius LI, Craig KA, Campos-Castillo C. Perceptions of Alerts Issued by Social Media Platforms in Response to Self-injury Posts Among Latinx Adolescents: Qualitative Analysis. J Med Internet Res 2021; 23:e28931. [PMID: 34383683 PMCID: PMC8386397 DOI: 10.2196/28931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/22/2021] [Accepted: 07/05/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is growing interest in using social media data to detect and address nonsuicidal self-injury (NSSI) among adolescents. Adolescents often do not seek clinical help for NSSI and may adopt strategies to obscure detection; therefore, social media platforms may be able to facilitate early detection and treatment by using machine learning models to screen posts for harmful content and subsequently alert adults. However, such efforts have raised privacy and ethical concerns among health researchers. Little is currently known about how adolescents perceive these efforts. OBJECTIVE The aim of this study is to examine perceptions of automated alerts for NSSI posts on social media among Latinx adolescents, who are at risk for NSSI yet are underrepresented in both NSSI and health informatics research. In addition, we considered their perspectives on preferred recipients of automated alerts. METHODS We conducted semistructured, qualitative interviews with 42 Latinx adolescents between the ages of 13 and 17 years who were recruited from a nonprofit organization serving the Latinx community in Milwaukee, Wisconsin. The Latinx population in Milwaukee is largely of Mexican descent. All interviews were conducted between June and July 2019. Transcripts were analyzed using framework analysis to discern their perceptions of automated alerts sent by social media platforms and potential alert recipients. RESULTS Participants felt that automated alerts would make adolescents safer and expedite aid before the situation escalated. However, some worried that hyperbolic statements would generate false alerts and instigate conflicts. Interviews revealed strong opinions about ideal alert recipients. Parents were most commonly endorsed, but support was conditional on perceptions that the parent would respond appropriately. Emergency services were judged as safer but inappropriate for situations considered lower risk. Alerts sent to school staff generated the strongest privacy concerns. Altogether, the preferred alert recipients varied by individual adolescents and perceived risks in the situation. None raised ethical concerns about the collection, analysis, or storage of personal information regarding their mental health status. CONCLUSIONS Overall, Latinx adolescents expressed broad support for automated alerts for NSSI on social media, which indicates opportunities to address NSSI. However, these efforts should be co-constructed with adolescents to ensure that preferences and needs are met, as well as embedded within broader approaches for addressing structural and cultural barriers to care.
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Affiliation(s)
- Linnea I Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Katherine A Craig
- Department of Sociology, University of Colorado Boulder, Boulder, CO, United States
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Zhang H, Chen B, Pan C, Zhang A. To evaluate the serum cortisol, salivary cortisol, and serum interleukin-1 B level in patients of chronic periodontitis with smoking and stress and without smoking and stress. Medicine (Baltimore) 2021; 100:e26757. [PMID: 34397819 PMCID: PMC8341332 DOI: 10.1097/md.0000000000026757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
The role of cognitive, social and biological factors in the etiology of chronic periodontitis has been reported.The aim of this study was to evaluate the salivary cortisol level and interleukin-1 B level in patients of Chronic periodontitis in smokers and stress and nonsmokers without stress.The design of study randomized, prospective, double-blinded, and prospective study.The total sample size was comprised of 600 subjects between the ages of 20 and 50 years. The sample size was divided into 300 males and 300 females. Out of 600 subjects, 200 subjects comprised of subjects with chronic periodontitis with positive depression level with a history of smoking (Group I), 200 subjects comprised of subjects with chronic periodontitis without depression and without smoking (Group II), and 200 subjects who were taken as the control group comprised of healthy subjects without chronic periodontitis, without depression level, and no smoking history (Group III). Salivary cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA).The result showed that there was a positive correlation between morning and evening salivary cortisol level in all the groups with correlation coefficient. There was significant higher value of salivary cortisol in Group I patients when compared with Group II and Group III. However, when the comparison of salivary cortisol levels was done between the Group II and Control group, the result showed nonsignificant P value.It is suggested that stress is positively correlated with the salivary cortisol levels in smokers and nonsmokers.
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Affiliation(s)
- Haiou Zhang
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Bocheng Chen
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Chenyu Pan
- Department of Stomatology, The 928th Hospital of PLA Joint Logistic Support Force, Haikou, Hainan, China
| | - Ansheng Zhang
- Department of Stomatology, XI’AN International Medical Center Hospital, Xi’an, ShaanXi, China
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Hasking P, Lewis SP, Bloom E, Brausch A, Kaess M, Robinson K. Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources. SCHOOL PSYCHOLOGY INTERNATIONAL 2020. [DOI: 10.1177/0143034320974414] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI.
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Affiliation(s)
| | | | - Elana Bloom
- Student Services Department, Lester B Pearson School Board, Quebec, Canada
| | - Amy Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kealagh Robinson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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Park Y, Mahdy JC, Ammerman BA. How others respond to non‐suicidal
self‐injury
disclosure: A systematic review. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/casp.2478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Yeonsoo Park
- Department of Psychology University of Notre Dame Notre Dame Indiana USA
| | - Jasmine C. Mahdy
- Department of Psychology University of Guelph Guelph Ontario Canada
| | - Brooke A. Ammerman
- Department of Psychology University of Notre Dame Notre Dame Indiana USA
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Shepherd V. An exploration around peer support for secondary pupils in Scotland with experience of self-harm. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2020. [DOI: 10.1080/02667363.2020.1772726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Victoria Shepherd
- Highland Council Psychological Service, Highland Council, Scotland, UK
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Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
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Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
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An evaluation of the skills group component of DBT-A for parent/guardians: a mixed methods study. Ir J Psychol Med 2020:1-9. [PMID: 31973788 DOI: 10.1017/ipm.2019.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous research indicates that dialectical behaviour therapy for adolescents (DBT-A) is effective in treating emotionally dysregulated adolescents with self-harm and/or suicidal ideation. As part of the DBT-A programme, parents attend the weekly skills group with their child. However, few studies have evaluated parental outcomes in DBT-A. This multi-site study aims to explore the outcomes and experiences of parents who participated in a 16-week DBT-A programme in Ireland. METHODS This study was conducted in community-based child and adolescent mental health services (CAMHS) in the national public health system in Ireland. Participants were parent/guardians of adolescents attending a DBT-A programme in their local CAMHS. Participants attended the group skills component of the DBT-A programme. This study utilised a mixed methods approach where both quantitative and qualitative data were collected from participants. Self-report measures of burden, grief and parental stress were completed at pre-intervention, post-intervention and 16-week follow-up. Qualitative written feedback was obtained at post-intervention. The data were analysed using multi-level linear mixed-effects models and content analysis. RESULTS One hundred participants (76% female) took part in this study. Significant decreases were reported for objective burden, subjective burden, grief and parental stress from pre- to post-intervention (p < 0.01). Participants reported that the skills component of DBT-A was useful in meeting their own needs and the needs of their child. DISCUSSION DBT-A shows promise for parents as well as their adolescent child. Future studies should evaluate changes to family relationships following completion of the programme and also include controlled comparison groups.
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Fu X, Yang J, Liao X, Lin J, Peng Y, Shen Y, Ou J, Li Y, Chen R. Parents' Attitudes Toward and Experience of Non-Suicidal Self-Injury in Adolescents: A Qualitative Study. Front Psychiatry 2020; 11:651. [PMID: 32760298 PMCID: PMC7373789 DOI: 10.3389/fpsyt.2020.00651] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/23/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is prevalent in adolescents and brings a series of serious consequences to their well-being. However, little is known about parents' attitude toward NSSI in Chinese adolescents. The study aims to investigate the parents' attitudes toward and perceptions of adolescents who have engaged in NSSI behaviors, and the impact of NSSI on their parents. METHODS Purposive sampling was used in the study. The biological parents of adolescents with NSSI were recruited from the psychiatric ward of a tertiary hospital in China. Semi-structured interviews were conducted which contained three aspects, that is the history of NSSI, the process of seeking or maintaining help and the impacts on the family. Each interview typically lasted 40-50 min. All of the interviews were audio-recorded. Their responses were analyzed by the thematic analysis. RESULTS Twenty participants completed the interview, consisting of 16 mothers and 4 fathers. Three themes and eight sub-themes were extracted: (1) the attitudes to children's NSSI behaviors (ignorance, shame, and stereotype); (2) coping strategies of parents (the initial response to adolescents' NSSI, and the way of help-seeking); (3) the impacts on family (altered parenting and communication styles, limited personal lives, and increased psychological pressure). CONCLUSION The results showed that parents lack the knowledge about NSSI and its treatment and are suffering great emotional stress. It is recommended to expand the popularization of knowledge of NSSI in adolescents and more interventions adapted to China's sociocultural climate are required for the well-being of parents and NSSI in adolescents.
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Affiliation(s)
- Xi Fu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China.,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,XiangYa Nursing School, Central South University, Changsha, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,XiangYa Nursing School, Central South University, Changsha, China
| | - Xiaoli Liao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,XiangYa Nursing School, Central South University, Changsha, China
| | - Jingjing Lin
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yao Peng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yidong Shen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianjun Ou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China.,XiangYa Nursing School, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,XiangYa Nursing School, Central South University, Changsha, China
| | - Runsen Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. How Do Families Represent the Functions of Deliberate Self-Harm? A Comparison between the Social Representations from Adolescents and Their Parents. Arch Suicide Res 2020; 24:173-189. [PMID: 30537902 DOI: 10.1080/13811118.2018.1545713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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 behaviors. 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 analyze 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 behaviors 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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Spillane A, Matvienko-Sikar K, Larkin C, Arensman E. How do people experience a family member's high-risk self-harm? An interpretative phenomenological analysis. Arch Suicide Res 2020; 24:280-302. [PMID: 30734665 DOI: 10.1080/13811118.2019.1574248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Few studies have explored the impact self-harm has on family members, with none specifically focusing on physical and psychosomatic responses following a family member's high-risk self-harm Therefore, this study aims to explore the health impact of experiencing a family member's high-risk self-harm. Participants represented family members of consecutive cases of self-harm, who were recruited from the Suicide Support and Information System - A Case-Control Study (SSIS-ACE). Qualitative interviews were conducted with 9 participants whose family member presented to a large tertiary hospital in Ireland with high-risk self-harm. Interpretative phenomenological analysis was conducted. Qualitative findings indicated 4 superordinate themes in relation to experiences following a family member's presentation to hospital following an episode of high-risk self-harm (1) implications for health and well-being; (2) process of meaning-making; (3) feelings of responsibility and (4) challenges with support network. Participants consistently experienced adverse health impacts including vomiting, hypertension, and depression. The findings imply that caring for their own and their family members' well-being, together with challenges with accessing health services underscores the importance of family members being proactively contacted by healthcare professionals to alleviate these detrimental health effects.
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Izon E, Berry K, Law H, Au-Yeung K, French P. “I don’t know how to fix it and sometimes it’s so overwhelming” Identifying the barriers and facilitators for family caregivers supporting someone at high-risk of psychosis: A qualitative study. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2019. [DOI: 10.1080/17522439.2019.1688858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Emma Izon
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Katherine Berry
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
| | - Heather Law
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Karmen Au-Yeung
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul French
- Department of Research and Innovation, Pennine Care NHS Foundation Trust, Lancashire, UK
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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Social representations about the functions of deliberate self-harm: Adolescents and parents. J Adolesc 2019; 73:113-121. [PMID: 31102879 DOI: 10.1016/j.adolescence.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 11/21/2022]
Abstract
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.
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Tschan T, Lüdtke J, Schmid M, In-Albon T. Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group. Child Adolesc Psychiatry Ment Health 2019; 13:15. [PMID: 30923561 PMCID: PMC6419840 DOI: 10.1186/s13034-019-0275-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/28/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescents' nonsuicidal self-injury (NSSI) leads to distress that affects the whole family system, and siblings are reported to suffer from disrupted family communication and functioning. So far, no studies have examined the quality of relationships between adolescents with NSSI and their siblings. The aim of the present study was to examine the sibling relationship quality of adolescents with NSSI, adolescents with other mental disorders without NSSI (clinical controls, CC), and adolescents without current or past experience of mental disorders (nonclinical controls, NC). METHODS 139 female adolescents aged 13-20 years (mean age = 16.18 years, SD = 1.62, NSSI: n = 56, CC: n = 33, NC: n = 50) and 73 siblings aged 10-28 years (mean age = 16.88 years, SD = 4.02, 60.3% female) participated. Self-report measures were used to assess psychopathology and sibling relationship quality. RESULTS Siblings reported a wide range of negative emotional and familial consequences, such as feeling left alone with their sister's issues or a distressing family situation, as a result of their sister's NSSI. Siblings of adolescents with NSSI experienced significantly more coercion in the relationship with their sister compared to CC (d = 1.08) and NC (d = 0.67) siblings, indicating an imbalance of dominance and control in their relationship. Further, adolescents with NSSI reported significantly less warmth and empathy in the sibling relationship and higher rivalry scores between their siblings and themselves than NC adolescents, suggesting higher levels of parental favoritism among parents of adolescents with NSSI compared to NC parents (d = 0.93). Among siblings of adolescents with NSSI, high levels of warmth, conflict, and empathy were significantly associated with internalizing problems. For adolescents with NSSI a significant association was found between internalizing problems and coercion and externalizing problems and similarity. CONCLUSIONS Given the negative impact of NSSI on siblings' emotional well-being and family life, efforts should be made to offer siblings psychoeducation and support to help them cope with the emotional and familial consequences of their sister's NSSI. Given adequate support, siblings can in turn be a source of emotional support for their sister.
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Affiliation(s)
- Taru Tschan
- 0000 0001 0087 7257grid.5892.6Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Janine Lüdtke
- 0000 0004 1937 0642grid.6612.3Department of Child and Adolescent Psychiatry, University of Basel, 4056 Basel, Switzerland
| | - Marc Schmid
- 0000 0004 1937 0642grid.6612.3Department of Child and Adolescent Psychiatry, University of Basel, 4056 Basel, Switzerland
| | - Tina In-Albon
- 0000 0001 0087 7257grid.5892.6Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Ostbahnstraße 12, 76829 Landau, Germany
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adolescents. J Pers Assess 2019; 102:405-414. [DOI: 10.1080/00223891.2018.1557667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eva Duarte
- CIE-ISPA, ISPA–Instituto Universitário, Lisbon, Portugal
| | | | - Hugo Santos Gomes
- CIPsi-Psychology Research Center, Victims, Offenders and Justice System Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Daniel Sampaio
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractThe 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.
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Wijana MB, Enebrink P, Liljedahl SI, Ghaderi A. Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents. BMC Psychiatry 2018; 18:371. [PMID: 30477463 PMCID: PMC6258142 DOI: 10.1186/s12888-018-1947-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/02/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress. RESULTS From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups. CONCLUSIONS The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group. TRIAL REGISTRATION This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).
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Affiliation(s)
- Moa Bråthén Wijana
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Pia Enebrink
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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41
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An interpretative phenomenological analysis of young people's self-harm in the context of interpersonal stressors and supports: Parents, peers, and clinical services. Soc Sci Med 2018; 212:120-128. [PMID: 30029090 DOI: 10.1016/j.socscimed.2018.07.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/28/2018] [Accepted: 07/13/2018] [Indexed: 11/21/2022]
Abstract
RATIONALE Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options. OBJECTIVE To explore young women's experience of self-harm in the context of interpersonal stressors and supports. METHOD Fourteen adolescent females (13-18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken. RESULTS Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling 'stupid to self-harm'); and 7) 'Empty promises' - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking. CONCLUSION Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports, and emotions. These results have implications for improving support from both informal and clinical sources.
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42
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Curtis S, Thorn P, McRoberts A, Hetrick S, Rice S, Robinson J. Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E950. [PMID: 29747476 PMCID: PMC5981989 DOI: 10.3390/ijerph15050950] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/24/2018] [Accepted: 05/03/2018] [Indexed: 11/16/2022]
Abstract
Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12⁻28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to feelings of shame and guilt. This highlights the need for accessible resources that seek to alleviate parents’ distress, influence the strategies implemented to manage the young person’s self-harm behaviour, reduce self-blame of family members, and increase the likelihood of parental help seeking.
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Affiliation(s)
- Sophie Curtis
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Pinar Thorn
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Alison McRoberts
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia.
| | - Sarah Hetrick
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
- Department of Psychological Medicine, Faculty of Health and Medical Sciences, The University of Auckland, Auckland 1010, New Zealand.
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
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43
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Stewart A, Hughes ND, Simkin S, Locock L, Ferrey A, Kapur N, Gunnell D, Hawton K. Navigating an unfamiliar world: how parents of young people who self-harm experience support and treatment. Child Adolesc Ment Health 2018; 23:78-84. [PMID: 32677335 DOI: 10.1111/camh.12205] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-harm in young people is a common reason for contact with clinical services. However, there is little research focusing on parents' perspectives of care following self-harm. The aim of this study was to explore parents' experiences of treatment and support for the young person and for themselves. METHODS A qualitative design was used to explore parents' perspectives. Semi-structured narrative interviews were conducted across the UK with 37 parents of young people who had self-harmed. Thematic analysis was undertaken to identify themes relating to how parents experienced the help and treatment received. RESULTS Parents reported differing reactions to contact with helping services. Many found these helpful, particularly in keeping the young person safe, developing a trusting relationship with the young person, encouraging skills in managing self-harm and giving them an opportunity to talk about and find solutions to their difficulties. They spoke about the importance of practical help including prompt access to care, the right intensity of care, practical strategies and information and support. Some aspects of services were perceived as unhelpful, particularly a judgmental approach by professionals, lack of early access to treatment, inadequate support or failure to listen to the perspective of parents. CONCLUSIONS Parents' views highlight the need for clinicians to consider carefully the perspective of parents, involving them wherever possible and providing practical help and support, including written information. The need for training of clinicians in communicating with young people and parents following self-harm is also highlighted.
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Affiliation(s)
- Anne Stewart
- Central Oxon CAMHS, Oxford Health NHS Foundation Trust, Oxford, OX3 7LQ, UK.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Sue Simkin
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
| | - Louise Locock
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Anne Ferrey
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
| | - Navneet Kapur
- Centre for Suicide Prevention, University of Manchester and Manchester Mental Health and Social Care Trust, Manchester, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Keith Hawton
- Department of Psychiatry, Centre for Suicide Research, University of Oxford, Warneford Hospital, Oxford, UK
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Whitlock JL, Baetens I, Lloyd-Richardson E, Hasking P, Hamza C, Lewis S, Franz P, Robinson K. Helping schools support caregivers of youth who self-injure: Considerations and recommendations. SCHOOL PSYCHOLOGY INTERNATIONAL 2018. [DOI: 10.1177/0143034318771415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged.
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Affiliation(s)
- Janis L. Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, USA
| | | | | | | | - Chloe Hamza
- Ontario Institute for Studies in Education at the University of Toronto, Canada
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Lindgren BM, Svedin CG, Werkö S. A Systematic Literature Review of Experiences of Professional Care and Support Among People Who Self-Harm. Arch Suicide Res 2018; 22:173-192. [PMID: 28426393 DOI: 10.1080/13811118.2017.1319309] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Self-harm is an increasing phenomenon among young people, with potentially fatal outcomes. Patient's perceptions of treatment and support are poorly documented. The aim was to synthesise the experiences of those who self-harm, with special reference to professional care and support by family, friends, and the school system. A systematic review of the literature was conducted. Following retrieval of 1,623 abstracts, 14 studies were included in the final analysis, 11 of which are reported here. Two quantitative studies as well as 1 mixed method study on self-care could not be reported on here due to word limitations. Adult people who self-harm described the importance of quality in the caring relationship and a tailored care designed for each individual. There is a need for more studies into adolescents who self-harm but of importance is the adolescents' need for support from the adult world. A positive relationship between patient and healthcare professional can be crucial in motivating continued treatment of people who self-harm. A major priority is radical improvement in the attitudes of healthcare personnel.
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46
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Abstract
Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers’ capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men’s help-seeking as well as care givers’ behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups (n = 13) were used with “high-risk suicide” groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: “negotiating ways to ask for, offer and accept help without compromising masculinity”; “making and sustaining contact with men in psychological distress”; and “navigating roles responsibilities and boundaries to support men in psychological distress.” Approaches to suicide prevention need to take account of how masculine norms shape men’s willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men’s help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men’s lives.
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Affiliation(s)
- Aisling Keohane
- 1 Institute of Technology Carlow-Science and Health, Carlow, Ireland
| | - Noel Richardson
- 1 Institute of Technology Carlow-Science and Health, Carlow, Ireland
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Johnson DR, Ferguson K, Copley J. Residential staff responses to adolescent self-harm: The helpful and unhelpful. Clin Child Psychol Psychiatry 2017; 22:443-454. [PMID: 28135831 DOI: 10.1177/1359104516689378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescent self-harm is prevalent in residential and secure care and is the cause of distress to those harming themselves, to the staff caring for them and for other young people living with them. This article sought service user views on what staff supports were effective and what were counter-productive in order to improve the care offered to young people. Seven young people living in residential or secure care were interviewed. Thematic analysis was used to elicit key themes. Global themes of safety and care were elicited. The young people understood and accepted that the role of staff was to provide these. Within these themes, they noted numerous responses that had both helpful and unhelpful effects, including increased observation, removal of means and extra collaborative support. Service users made numerous recommendations to increase the helpful effects of staff support. Young people provided informed and helpful guidance on how best to care for them. Their views can help mental health professionals and care staff increase their helpful responses making them more effective and less counter-productive. This study is a rare representation of the views of young people in residential and secure care and how to respond to their self-harm behaviour.
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Affiliation(s)
- Dan R Johnson
- 1 Psychology Department, Kibble Education and Care Centre, UK
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48
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Jacob J, De Francesco D, Deighton J, Law D, Wolpert M, Edbrooke-Childs J. Goal formulation and tracking in child mental health settings: when is it more likely and is it associated with satisfaction with care? Eur Child Adolesc Psychiatry 2017; 26:759-770. [PMID: 28097428 PMCID: PMC5489638 DOI: 10.1007/s00787-016-0938-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 12/27/2016] [Indexed: 11/25/2022]
Abstract
Goal formulation and tracking may support preference-based care. Little is known about the likelihood of goal formulation and tracking and associations with care satisfaction. Logistic and Poisson stepwise regressions were performed on clinical data for N = 3757 children from 32 services in the UK (M age = 11; SDage = 3.75; most common clinician-reported presenting problem was emotional problems = 55.6%). Regarding the likelihood of goal formulation, it was more likely for pre-schoolers, those with learning difficulties or those with both hyperactivity disorder and conduct disorder. Regarding the association between goal formulation and tracking and satisfaction with care, parents of children with goals information were more likely to report complete satisfaction by scoring at the maximum of the scale. Findings of the present research suggest that goal formulation and tracking may be an important part of patient satisfaction with care. Clinicians should be encouraged to consider goal formulation and tracking when it is clinically meaningful as a means of promoting collaborative practice.
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Affiliation(s)
- Jenna Jacob
- Child Outcomes Research Consortium, Evidence Based Practice Unit, University College London and the Anna Freud Centre, 21 Maresfield Gardens, NW3 5SD, London, UK
| | - Davide De Francesco
- Evidence Based Practice Unit, University College London and the Anna Freud Centre, London, UK
| | - Jessica Deighton
- Evidence Based Practice Unit, University College London and the Anna Freud Centre, London, UK
| | - Duncan Law
- London and South East CYP-IAPT Learning Collaborative, Hosted by the Anna Freud Centre, London, UK
| | - Miranda Wolpert
- Child Outcomes Research Consortium, Evidence Based Practice Unit, University College London and the Anna Freud Centre, 21 Maresfield Gardens, NW3 5SD, London, UK.
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, University College London and the Anna Freud Centre, London, UK
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Whitlock J, Lloyd-Richardson E, Fisseha F, Bates T. Parental Secondary Stress: The Often Hidden Consequences of Nonsuicidal Self-Injury in Youth. J Clin Psychol 2017; 74:178-196. [PMID: 28493555 DOI: 10.1002/jclp.22488] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 12/22/2016] [Accepted: 03/22/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aims to deepen understanding of the effects on parents of having a self-injuring child by (a) analyzing differences in dimensions of caregiver strain between caregivers of youth with nonsuicidal self-injury (NSSI+) and parents of youth with no known mental health history (MH-); (b) identifying factors that contribute to caregiver strain; and (c) examining parent outcome expectancies. METHOD Participants were 196 NSSI+ parents and 57 MH- parents. Quantitative measures of psychosocial variables, parent mental health and support variables, and child self-injury characteristics were assessed in relation to caregiver strain, and NSSI+ parental expectancies were assessed via mixed methods. RESULTS Parents with a NSSI+ youth were more likely to exhibit all forms of objective and subjective strain than parents of youth with no mental health challenges. Despite this, many parents expressed beliefs that their child would experience personal growth as a result of their NSSI experience. CONCLUSION Findings reveal the important role of mindful parenting practices and informal social support.
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50
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Spillane A, Larkin C, Corcoran P, Matvienko-Sikar K, Arensman E. What are the physical and psychological health effects of suicide bereavement on family members? Protocol for an observational and interview mixed-methods study in Ireland. BMJ Open 2017; 7:e014707. [PMID: 28363930 PMCID: PMC5387930 DOI: 10.1136/bmjopen-2016-014707] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Research indicates that experiencing the suicide of a relative can have a significant impact on family members' emotional health. However, research incorporating the impact of suicide bereavement on family members' physical health is sparse. This paper details the protocol for a mixed-methods study of suicide-bereaved family members. The study will primarily examine the physical and mental health needs of those bereaved by suicide. A secondary objective of the study is to describe the support service needs of family members bereaved by suicide. METHODS AND ANALYSIS A mixed-methods approach, using semistructured interviews and self-report questionnaires, will be used. Interviews will be conducted with a group of 15-20 relatives who experienced suicide bereavement. This protocol will follow the COREQ checklist criteria for the reporting of qualitative research interviews. Thematic analysis will be used to examine experiences and impact of bereavement on psychological and physical health. Self-report quantitative data on well-being will be analysed using descriptive statistics. ETHICS AND DISSEMINATION Ethical approval to conduct this study has been granted from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Pseudonyms will be given to participants to protect anonymity. It will be explained to participants that participation in the study is voluntary and they have to right to withdraw at any time. The findings of this research will be disseminated to regional, national and international audiences through publication in peer-reviewed international journals and presentations at scientific conferences. This research also forms part of a PhD thesis.
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Affiliation(s)
- Ailbhe Spillane
- Department of Epidemiology and Public Health, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | | | - Paul Corcoran
- Department of Epidemiology and Public Health, Cork, Ireland
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | | | - Ella Arensman
- Department of Epidemiology and Public Health, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
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