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Deliberate Self Harm

Deliberate Self Harm. Prof Craig Jackson Head of Psychology health.bcu.ac.uk/craigjackson. Deliberate Self Harm. Behavioural Markers Female:Male ratio. 2:1 15-21 largest age group At risk: Female Isolated Negative life events Pre-existing psychiatric conditions

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Deliberate Self Harm

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  1. Deliberate Self Harm Prof Craig Jackson Head of Psychology health.bcu.ac.uk/craigjackson

  2. Deliberate Self Harm Behavioural Markers Female:Male ratio. 2:1 15-21 largest age group At risk: Female Isolated Negative life events Pre-existing psychiatric conditions Familial history Intolerable stress Impulsive, immature, aggressive personality

  3. Additional Conditions High levels of dissociation ("going numb") Borderline Personality Disorder Substance abuse disorders Post-Traumatic Stress Disorder Antisocial Personality Disorder (int. explosive) Eating Disorders Mood Disorders

  4. Deliberate Self Harm

  5. Deliberate Self Harm

  6. Art form

  7. Follie a deux

  8. Celebrity cache

  9. Deliberate Self Harm

  10. Deliberate Self Harm

  11. Mechanics Cutting Forearms Wrists Genitalia Burning Banging Pills / Toxins Sharps 4% of English hospital admissions (Carroll 2006) Fifth biggest cause of admissions

  12. Use of an rubbers or friction to burn skin Burning with heat, chemicals or cigarettes Bruising Pulling fingernails and toenails Refusing to take needed medications Hitting self Banging one's head Ingesting sharp or toxic objects Picking scabs / keeping wounds from healing Deep scratching Inserting objects into body openings Inserting needles or sharp objects under the skin Some forms of hair-pulling Tooth-pulling Bone-breaking Carving symbols, names or images

  13. Premeditation Prohibits sympathy Saving pills / blades Avoiding detection Long sleeves Bandage / dressing stockpiles Prepared excuses

  14. Deliberate Self Harm

  15. Motivation 1 • Cry for help • Attention seeking • Coping strategy • Destruction • Escapism • Control & Mastery • Punish others • Loved ones • Family • Failing relationships

  16. Motivation 2 • Negative self-esteem • Hypersensitivity to rejection • Supressed anger and sadness • Chronic Anxiety • Relationship problems • Poor functioning in school, home or work • More common in females than males • Typical onset is at puberty • History of physical and/or sexual abuse • Average to high intelligence • Middle to upper-class background

  17. Motivation 3 • Feels "empty" and isolated • Drug or alcohol abuse • Early history of medical illness or surgical procedures requiring hospitalization • Imprisonment or institutionalization in drug treatment centres • Inability to express or tolerate negative feelings • Poor academic performance or truancy • Has a background of emotional neglect • Secondary Gain

  18. Factitious Injury Feigned physical / psychological symptoms Aimed to receive medical / psychological care Mostly female, many working in healthcare Don't confront without good evidence Supportive confrontation Aware of role of behaviour in illness Offer psychological help Patients may stop but usually move on

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