Self harm
Searched over 200M research papers for "self harm"
Summary
10 papers analyzed
These studies suggest that self-harm is influenced by socioeconomic, psychiatric, psychological, familial, social, and cultural factors, and effective management includes psychotherapy, supportive relationships, and targeted interventions for different age groups and settings.
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Introduction
Self-harm, encompassing behaviors such as self-poisoning and self-injury, is a significant public health issue with high prevalence, particularly among adolescents and specific populations like forensic psychiatric patients. It is often associated with psychiatric disorders and carries a high risk of repetition and potential progression to suicide.
Key Insights
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Prevalence and Risk Factors
- Self-harm is prevalent among adolescents, with 5-9% reporting self-harm within the previous year in Western countries . It is also common in nonclinical populations, with about 4% of military recruits reporting a history of self-harm.
- Risk factors include psychiatric illnesses such as depression, anxiety, substance abuse, and personality disorders . Socioeconomic disadvantage and cultural factors also play a role .
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Psychosocial Interventions
- Cognitive-behavioral therapy (CBT) has shown effectiveness in reducing the repetition of self-harm compared to treatment as usual (TAU).
- Dialectical behavior therapy (DBT) is beneficial for individuals with multiple episodes of self-harm or probable personality disorders, reducing the frequency of self-harm.
- Other interventions like case management and remote contact interventions (e.g., postcards, telephone contact) have not shown significant benefits in reducing self-harm repetition.
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Clinical Characteristics and Management
- Self-harm often involves low-lethality methods and is characterized by multiple recurrent episodes. Common methods include cutting and self-poisoning .
- Effective management includes forming a trusting relationship with the patient, identifying problems jointly, ensuring crisis support, and treating underlying psychiatric conditions.
- Psychosocial assessment by mental health staff is crucial but often underutilized, with only about 53.2% of episodes receiving such assessments.
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Special Populations
- In forensic psychiatric populations, self-harm is highly prevalent, with common methods being head-banging and cutting. It is associated with neurodevelopmental and impulse-control disorders.
- Adolescents are particularly vulnerable, with self-harm being a major public health problem and a strong predictor of suicide .
Conclusion
Self-harm is a complex behavior influenced by various psychiatric, psychological, and social factors. Effective interventions, particularly CBT and DBT, can reduce the incidence and frequency of self-harm. However, there is a need for better implementation of psychosocial assessments and targeted interventions, especially for high-risk groups like adolescents and forensic psychiatric patients. Understanding the underlying mechanisms and improving prevention and treatment strategies remain critical for addressing this pervasive issue.
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