Strengths included the systematic literature review undertaken to guide the development of the interview schedule to ensure all questions were relevant, and the robust frameworks followed for qualitative analysis. Young people at risk of self-harm require strategies to support them in moments when they are experiencing distressing emotions and have an urge to self-harm. The research has highlighted that these strategies need to help young people manage distressing emotions and support them to connect with others.
An important aspect of such strategies is helping young people to become aware of their triggers, including the contexts and situations, but also the arising psychological distress that precedes their urge to self-harm.
Young people in this study identified a large number of potentially helpful strategies to manage self-harm urges, while highlighting that different strategies will work for different people, in different settings and at different times.
Through its unique findings relating to the mediating role of distressing emotions and social isolation in prompting the urge to self-harm, the potential inadequacies of mimicking strategies, and alternate activities young people engage in and find helpful when experiencing the urge to self-harm, this research highlights the importance of individual strategies that help a young person to use strategies that assist with emotion regulation and to feel more connected to others.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation, to any qualified researcher. All subjects gave written informed consent in accordance with the Declaration of Helsinki. SH and JR conceived on this project and developed the methodology. KA and AS undertook the research as part of the requirements of the Honours in Psychology La Trobe University , and along with SH interviewed all the young people, transcribed the interviews, and took a lead in undertaking the analysis with input from all the authors.
SH drafted the manuscript with substantial input from other authors who all approved the manuscript for final submission.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The investigators would like to acknowledge the young people who participated in the co-design process. Asarnow, J. Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study. Child Adolesc. Baker, T. Responses to online photographs of non-suicidal self-injury: a thematic analysis. Suicide Res. Beckman, K. Mental illness and suicide after self-harm among young adults: long-term follow-up of self-harm patients, admitted to hospital care, in a national cohort.
Bergen, H. Premature death after self-harm: a multicentre cohort study. Lancet , — Braun, V. Using thematic analysis in psychology. Brown, T. Cutting to live: a phenomenology of self-harm. Carter, G.
Royal Australian and New Zealand college of psychiatrists clinical practice guideline for the management of deliberate self-harm.
Claes, L. Self-injurious behavior: differential diagnosis and functional differentiation. Clark, T. Auckland: University of Auckland, Google Scholar. Cottrell, D. Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial.
Lancet 5, — Cox, G. Indicated psychosocial interventions for self-harm, suicidal ideation and suicide attempt in children and young people: what? Based Ment. Doyle, L. Self-harm in young people: prevalence, associated factors, and help-seeking in school-going adolescents. Health Nurs. Fergusson, D.
Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood. Fortune, S. Psychiatry Psychiatr. Fossey, E. Understanding and evaluating qualitative research. PubMed Abstract Google Scholar. Garisch, J. Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: cross-sectional and longitudinal survey data.
Child Adoles. Psychiatry Ment. Health Guan, K. Non-suicidal self-injury as a time-invariant predictor of adolescent suicide ideation and attempts in a diverse community sample. Guba, E. Fourth Generation Evaluation. Newbury Park, CA: Sage. San Francisco: Jossey-Bass. Guest, G. How many interviews are enough? An experiment with data saturation and variability. Field Methods. Harrington, R. Early adult outcomes of adolescents who deliberately poisoned themselves. Hawton, K. Deliberate self-harm in Oxford, — a time of change in patient characteristics.
Psychol Med. Interventions for self-harm in children and adolescents. Cochrane Database Syst. Hopko, D. Contemporary behavioral activation treatments for depression: procedures, principles, and progress. Joiner, T. Why People die by Suicide. Nonsuicidal self-injury, suicidal behavior, and their co-occurrence as viewed through the lens of the Interpersonal theory of suicide.
Klonsky, E. The relationship between non-suicidal self-injury and attempted suicide: converging evidence from four samples. Knorr, A. The interactive effect of major depression and nonsuicidal self-injury on current suicide risk and lifetime suicide attempts.
Knox, S. Qualitative research interviews. Koch, T. Establishing rigour in qualitative research: the decision trail. Landstedt, E. Deliberate self-harm and associated factors in year-old Swedish students. Public Health. Lawrence, D. The Mental Health of Children and Adolescents.
Canberra: Department of Health. Laye-Gindhu, A. Youth Adoles. Then, the next time you feel awful about something, you try it again — and slowly it becomes a habit. Natalie, a high-school junior who started cutting in middle school, explains that it was a way to distract herself from feelings of rejection and helplessness she felt she couldn't bear.
I guess part of me must have known it was a bad thing to do, though, because I always hid it. Once a friend asked me if I was cutting myself and I even lied and said 'no. Sometimes self-injury affects a person's body image. Jen says, "I actually liked how the cuts looked. I felt kind of bad when they started to heal — and so I would 'freshen them up' by cutting again. Now I can see how crazy that sounds, but at the time, it seemed perfectly reasonable to me.
I was all about those cuts — like they were something about me that only I knew. They were like my own way of controlling things. I don't cut myself anymore, but now I have to deal with the scars. You can't force someone who self-injures to stop.
It doesn't help to get mad at a friend who cuts, reject that person, lecture her, or beg him to stop. Instead, let your friend know that you care, that he or she deserves to be healthy and happy, and that no one needs to bear their troubles alone.
Girls and guys who self-injure are often dealing with some heavy troubles. Many work hard to overcome difficult problems. So they find it hard to believe that some kids cut just because they think it's a way to seem tough and rebellious. Tia tried cutting because a couple of the girls at her school were doing it. So I did it once.
But then I thought about how lame it was to do something like that to myself for no good reason. Next time they asked I just said, 'no, thanks — it's not for me. If you have a friend who suggests you try cutting, say what you think. Why get pulled into something you know isn't good for you? There are plenty of other ways to express who you are.
Lindsay had been cutting herself for 3 years because of abuse she suffered as a child. She's 16 now and hasn't cut herself in more than a year. There are better ways to deal with troubles than cutting — healthier, long-lasting ways that don't leave a person with emotional and physical scars.
The first step is to get help with the troubles that led to the cutting in the first place. Here are some ideas for doing that:. Although cutting can be a difficult pattern to break, it is possible. Getting professional help to overcome the problem doesn't mean that a person is weak or crazy. Therapists and counselors are trained to help people discover inner strengths that help them heal.
These inner strengths can then be used to cope with life's other problems in a healthy way. Larger text size Large text size Regular text size. What Is Cutting? Why Do People Cut Themselves? How Does Cutting Start? Here are some ideas for doing that: Tell someone.
People who have stopped cutting often say the first step is the hardest — admitting to or talking about cutting. But they also say that after they open up about it, they often feel a great sense of relief.
Choose someone you trust to talk to at first a parent, school counselor, teacher, coach, doctor, or nurse. If it's too difficult to bring up the topic in person, write a note. People who self-injure may attempt to conceal their marks, such as bruises, scabs or scars with clothing, and you may notice them wearing inappropriate clothing like long sleeves and pants in hot weather.
The diagnosis for someone who self-injures can only be determined by a licensed psychiatric professional. Self-injury behaviors can be a symptom other mental illnesses such as: personality disorders esp. The relationship between suicide and self-injury is complicated.
While people with non-suicidal self injury do not intend to completed suicide, they may cause more harm than intended, which could result in medical complications or death. In severe or prolonged cases of self-injury, a person may become desperate about their lack of control over the behavior and its addictive nature, which may lead them to true suicide attempts.
If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted. An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing. Self-injury treatment options include outpatient therapy, partial-inpatient hours a day and inpatient hospitalization.
When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended.
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