Some notes on self-injury in New Zealand:

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Some notes on self-injury in New Zealand: - Description

Prevalence. , correlates and functions. Jessica Garisch. Tamsyn Gilbertson. Robyn Langlands. Angelique O’Connell. Lynne Russell. Marc Wilson. Emma Brown. Tahlia. . Kingi. Please note . that this presentation will include discussion of . ID: 553726 Download Presentation

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Some notes on self-injury in New Zealand:




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Presentations text content in Some notes on self-injury in New Zealand:

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Some notes on self-injury in New Zealand:

Prevalence

, correlates and functions

Jessica Garisch

Tamsyn GilbertsonRobyn LanglandsAngelique O’ConnellLynne RussellMarc WilsonEmma BrownTahlia KingiPlease note that this presentation will include discussion of suicide and life-threatening behaviour

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So what are we talking about…?

Does it cover…

Overdosing?

Drinking ‘til you throw up?

Taking risks?

Accepting emotional abuse?

Depriving yourself of food?

Piercings?

Tattoos?

Brandings or scarification?

‘Mortification of the flesh’?

Slide4

So what are we talking about…?

Non-Suicidal Self-Injury (NSSI) is… (from the International Society for Study of Self-injury, 2007):

“…the deliberate, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned. It is also sometimes referred to as self-injurious behavior, non-suicidal self-directed violence, self-harm, or deliberate self-harm (although some of these terms, such as self harm, do not differentiate non-suicidal from suicidal intent).”

“As such, NSSI is distinguished from suicidal behaviors involving an intent to die, drug overdoses, and socially-sanctioned behaviors performed for display or aesthetic purposes (e.g., piercings, tattoos). Although cutting is one of the most well-known NSSI behaviors, it can take many forms including but not limited to burning, scratching, self-bruising or breaking bones if undertaken with intent to injure oneself. Resulting injuries may be mild, moderate, or severe.”

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What do we know about it…?

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What do we know about it…?

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Why do people do it…?

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Why do people do it…?

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What do we know about it…?

…In New Zealand?

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Prevalence…

2,087 ED presentations across 4 regions over 12 months, 20% repeat presentations

1

24% - Lifetime prevalence among community-based New Zealand adults

2

48% of adolescents presenting to CAMHS reported SH at initial assessment

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20% of 9,000 secondary students reported SH in previous year

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31% of 1,700 secondary students thought of SH in previous month, 20% acted on it over 5 years

5

 

(conflation between SSI and NSSI)

1

. Hatcher et al., 2009.

2

. Nada-Raja et al., 2004.

3

. Fortune et al., 2005.

4

. Fortune et al., 2010.

5

. Pryor & Jose, 02/04 to 09/09.

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Sample

N

Measure

# itemsLifetime Prevalence1. 100-level PSYC students285Sansone et al’s (1998) SHI 2278.9%/54.9%†

Prevalence…

† r=.40 with suicidal behaviour

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Sample

N

Measure

# itemsLifetime Prevalence1. 100-level PSYC students285Sansone et al’s (1998) SHI 2278.9%/54.9%†2. 16-18 year-old School students325De Leo & Heller (2004)114.8%

Prevalence…

† r=.40 with suicidal behaviour

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Sample

N

Measure

# itemsLifetime Prevalence1. 100-level PSYC students285Sansone et al’s (1998) SHI 2278.9%/54.9%†2. 16-18 year-old School students325De Leo & Heller (2004)114.8%3. 16-18 year-old School students1,162Lundh et al’s (2007) DSHI1448.7%4. 100-level PSYC students593Lundh et al’s (2007) DSHI1443.7%

Prevalence…

† r=.40 with suicidal behaviour

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Sample

N

Measure

# itemsLifetime Prevalence1. 100-level PSYC students285Sansone et al’s (1998) SHI 2278.9%/54.9%†2. 16-18 year-old School students325De Leo & Heller (2004)114.8%3. 16-18 year-old School students1,162Lundh et al’s (2007) DSHI1448.7%4. 100-level PSYC students593Lundh et al’s (2007) DSHI1443.7%5. 100-level PSYC students722Lundh et al’s (2007) DSHI (SV)739.7%‡

Prevalence…

† r=.40 with suicidal behaviour

‡ correlates .79 with the full 14-item DSHI

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The importance of Alexithymia

Self-injury is most likely when…

…one is experiencing peer victimisation AND one is highly alexithymic.

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The importance of Alexithymia 2

Self-injury is most frequent, most diverse, and most thought about when…

…one is highly perfectionistic AND highly alexithymic.

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These are all psychological, contextual and interpersonal predictors of SI

Why do those who self-injure, self-injure?

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N

Training?

NSSI client attempted Suicide?

NSSI client COMPLETED suicide

Non-NSSI client attempted Suicide?

Non-NSSI client COMPLETED suicide

Tell

active/past SI client of research?

Mental Health Nurse

88

61%

90%

49%

88%

65%

56/58%

General Practitioner

16

0%

62%

25%

88%

56%

31/25%

Social Worker

57

44%

86%

16%

72%

26%

33/32%

Clinical

Psychologist

57

77%

86%

25%

83%

30%

28/32%

Psychiatrist

1

0%

100%

0%

100%

100%

0/0%

Counsellor

32

34%

69%

9%

78%

13%

28/25%

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Interpersonal

Intrapersonal

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ISAS

subscale

Global

Mean

(SD)Most recent Mean (SD)Affect regulation4.62 (1.62)4.57 (1.74)Self-punishment4.14 (1.91)3.89 (2.15)Marking distress2.82 (2.00)2.66 (1.96)Anti-dissociation/ feeling generation2.68 (2.16)2.04 (2.25)Anti-suicide2.22 (1.98)2.02 (2.27)Self-care1.49 (1.48)1.34 (1.51)Toughness1.29 (1.53)1.04 (1.54)Interpersonal influence1.18 (1.47)0.92 (1.36)Interpersonal boundaries1.16 (1.51)0.89 (1.50)Sensation-seeking0.77 (1.21)0.52 (1.17)Autonomy0.77 (1.18)0.60 (1.17)Revenge0.68 (1.26)0.62 (1.37)Peer-bonding0.14 (0.56)0.15 (0.81)

Affect regulation was the most strongly endorsed function and, overall, intrapersonal functions were the most strongly endorsed.

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The ‘paradox of self-injury’

Self-injury worthy of help is private, but attention-seeking self-injury is public.

 How does one seek help for ‘worthy’ self-injury without becoming unworthy?

Slide29

Where next?

Towards understanding how NSSI starts, stops, and continues…

Year 9 and older

LongitudinalFunded by the Health Research Council of New ZealandTo be on our newsletter mailing list email jessica.garisch@vuw.ac.nz


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