Motives and Suicide Intent Underlying Hospital Treated Deliberate Self-Harm and Their Association with Repetition

AbstractObjective: The aim of this paper is to assess the level of agreement between clinical estimates of suicidal intent based entirely on information recorded in the Accident and Emergency acute assessment and Beck's Suicide Intent Scale (SIS) scores.Method: As part of the WHO/EURO Multicentre Study of Parasuicide, cases of deliberate self-harm (DSH) in Cork city hospitals were monitored. Over the period 1995-1997, the information recorded in the Accident and Emergency acute assessment was examined by a psychiatrist and, if possible on the available evidence, clinical estimates were made at three levels of suicidal intent: minimal, moderate and definite. Seventy-nine of these cases had fully completed Beck's SIS. Statistical comparison was made between the results of the SIS and the clinical estimate of suicide intent.Results: The agreement (Kappa = 0.146, p = 0.046) and concordance (Lin's concordance coefficient = 0.330, p = 0.001) between the two ratings are statistically significant but both are low. The overlap between those identified as high or low intent is low.Conclusions: These findings indicate low agreement between a clinician's rating of suicide intent based on clinical records and Beck's SIS. This is especially relevant given the increasing reliance on psychometric instruments in assessment in psychiatry. However, further investigation is necessary to clarify which is the more valid method.

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Deliberate self-harm: a comparison of first-time cases and cases with a prior history

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700014233 ◽

1995 ◽

Vol 12 (4) ◽

pp. 131-134 ◽

Cited By ~ 2

Author(s):

Kamal Gupta ◽

Kandiah Sivakumar ◽

Nigel Smeeton

Keyword(s):

Physical Violence ◽

Previous History ◽

Structured Interview ◽

Entire Group ◽

Prior History ◽

Deliberate Self Harm ◽

Suicide Intent ◽

Self Harm ◽

Death Wishes ◽

First Time

AbstractObjective: Eighty one patients admitted following deliberate self-harm were assessed using a semi-structured interview. The aim of the study was to compare clinical and social profiles of the 42 patients who had committed self harm for the first time with those of the 39 who had committed self harm in the past.Method: The patients were assessed jointly by a psychiatrist and either a community psychiatric nurse or a social worker. A description of past suicidal behaviour, socio demographic information, medical and psychiatric history were recorded. Suicide intent was assessed both from the clinical interview and rated objectively using Pierce's suicide intent scale. Psychiatric diagnoses were made using the ICD 9 classification.Results: The entire group had experienced difficulties in sustaining relationships. This problem was significantly more widespread in repeaters with increased use of physical violence in their relationship. More patients with a previous history claimed to have death wishes at the time of self harm, and asserted that they would harm themselves again compared with patients without a previous history. Clinical predictions regarding future self harming behaviour were in line with the patient's stated intentions.Conclusion: The persistent desire to commit self harm and more widespread relational difficulties amongst the patients with a previous history suggests a need for different treatment strategies and outcome measures for the two groups.

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The Association between Life Events and Suicide Intent in Self-Poisoners with and without a History of Deliberate Self-Harm: A Preliminary Study

Suicide and Life-Threatening Behavior ◽

10.1521/suli.2007.37.4.367 ◽

2007 ◽

Vol 37 (4) ◽

pp. 367-378 ◽

Cited By ~ 11

Author(s):

Catherine Crane ◽

J. Mark. G. Williams ◽

Keith Hawton ◽

Ella Arensman ◽

Heidi Hjelmeland ◽

...

Keyword(s):

Life Events ◽

Deliberate Self Harm ◽

Suicide Intent ◽

History Of ◽

Self Harm ◽

Preliminary Study

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Suicidal intent in deliberate self-harm and the risk of suicide: The predictive power of the Suicide Intent Scale

Journal of Affective Disorders ◽

10.1016/j.jad.2005.02.009 ◽

2005 ◽

Vol 86 (2-3) ◽

pp. 225-233 ◽

Cited By ~ 79

Author(s):

Louise Harriss ◽

Keith Hawton

Keyword(s):

Predictive Power ◽

Suicidal Intent ◽

Deliberate Self Harm ◽

Suicide Intent ◽

Self Harm

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Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽

10.1027/0227-5910/a000083 ◽

2011 ◽

Vol 32 (5) ◽

pp. 272-279 ◽

Cited By ~ 9

Author(s):

Allison S. Christian ◽

Kristen M. McCabe

Keyword(s):

Depressive Symptoms ◽

Undergraduate Students ◽

Cross Sectional Study ◽

Self Report ◽

Hierarchical Regression ◽

Cross Sectional ◽

Deliberate Self Harm ◽

Self Blame ◽

Self Harm ◽

The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

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Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽

10.1027/0227-5910.26.1.4 ◽

2005 ◽

Vol 26 (1) ◽

pp. 4-11 ◽

Cited By ~ 24

Author(s):

E. Kinyanda ◽

H. Hjelmeland ◽

S. Musisi

Keyword(s):

Life Events ◽

Negative Life Events ◽

Life Time ◽

Later Life ◽

Dose Effect ◽

Deliberate Self Harm ◽

Time Period ◽

Significant Difference ◽

Self Harm ◽

Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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