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Downey MK, Bishop LD, Donnan JR, Rowe EC, Harris N. A survey of educator perspectives toward teaching harm reduction cannabis education. PLoS One 2024; 19:e0299085. [PMID: 38718060 PMCID: PMC11078393 DOI: 10.1371/journal.pone.0299085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/06/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Substance use is common among youth which can adversely affect youth health. Despite the legalization of cannabis in Canada and much of the United States, there is a lack of harm reduction cannabis education in schools. In addition, educators may not feel prepared to teach students about cannabis. METHODS A cross-sectional survey explored educator perceptions toward teaching harm reduction substance use education to students in grades 4-12. Data analysis included descriptive statistics to evaluate demographic variables, ANOVAs to identify subgroup differences, and inductive thematic analysis to establish themes from open-ended responses. From the sample of 170 educators, the majority were female (77%) and worked as classroom teachers (59%). RESULTS Ninety-two percent of educators felt harm reduction was an effective approach to substance use education, and 84% stated that they would feel comfortable teaching cannabis harm reduction education to students. While 68% of educators believed they would be able to recognize if a student was under the influence of cannabis, only 39% felt certain about how to respond to student cannabis use, and just 8% felt that their current teacher training allowed them to intervene and prevent cannabis-related harms. Most educators (89%) expressed interest in harm reduction training, particularly interactive training (70%) and instructor-led lessons (51%). Online curriculum resources were preferred by 57%. Responses differed by gender and age group, with females of any age and educators under 40 reporting greater support of harm reduction approaches and more interest in training. CONCLUSION Educators expressed considerable support for harm reduction substance use education, but many felt unprepared to address this topic with students. The findings identified a need for educator training on harm reduction substance use education, so that educators can help students make informed choices around substance use, thereby promoting youth health and safety.
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Affiliation(s)
- Molly K. Downey
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Lisa D. Bishop
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, NL, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Jennifer R. Donnan
- School of Pharmacy, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Emily C. Rowe
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, St. John’s, NL, Canada
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2
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Hamza CA, Robinson K, Hasking PA, Heath NL, Lewis SP, Lloyd-Richardson E, Whitlock J, Wilson MS. Educational stakeholders' attitudes and knowledge about nonsuicidal self-injury among university students: A cross-national study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2140-2150. [PMID: 34380005 DOI: 10.1080/07448481.2021.1961782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Nonsuicidal self-injury (NSSI) is a commonly occurring, yet historically poorly understood, mental health concern among post-secondary students. The present study sought to identify the current knowledge needs of university stakeholders to inform training efforts around effective NSSI response and student support on university campuses. Participants were 1,762 university students, staff, and student-staff (77% female) from seven universities in Canada, the USA, New Zealand, and Australia. Participants completed an online survey about their attitudes and knowledge of both general mental health and NSSI. University stakeholders reported significantly greater stigma toward NSSI than mental illness in general. Student-staff reported greater perceived knowledge and comfort, and demonstrated greater knowledge of NSSI, than students and staff. Findings underscore the need for additional training and resources to reduce stigma and increase knowledge about NSSI on university campuses internationally.
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Affiliation(s)
- Chloe A Hamza
- Applied Psychology and Human Development, University of Toronto Ontario Institute for Studies in Education, Toronto, Ontario, Canada
| | - Kealagh Robinson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Penny A Hasking
- Health Sciences, School of Psychology, Curtin University, Perth, Australia
| | - Nancy L Heath
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | | | - Janis Whitlock
- Family Life Development Center, Cornell University, Ithaca, New York, USA
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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3
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Samways B. Professionals' attitudes towards people with intellectual disabilities who self-harm: A literature review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:954-971. [PMID: 34338080 PMCID: PMC9608005 DOI: 10.1177/17446295211025959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND National Institute for Health and Care Excellence (NICE, 2013) Guidance on Self-Harm states that professionals supporting people who self-harm should demonstrate compassion, respect and dignity. This literature review examines the evidence for professionals' attitudes towards people with intellectual disabilities who self-harm. METHOD Four databases (PsychInfo, IBSS, CINAHL and Medline) were systematically searched to find relevant research since 2000. RESULTS Four studies met the criteria. Attitudes of professionals supporting people with intellectual disabilities are contrasted with those of professionals in settings focused on supporting people without intellectual disabilities. Professionals supporting people with intellectual disabilities tended to display attitudes and attributions reflective of biobehavioural and psychosocial theories of self-harm, with a greater emphasis on relationships. CONCLUSION Much more research is needed which examines the attitudes of professionals supporting people with intellectual disabilities who self-harm.
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Affiliation(s)
- Beverley Samways
- Beverley Samways, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK.
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4
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Perkins N, De Riggi M, Hasking P, Heath N. Slipping through the cracks: The critical role of school principals in addressing and responding to nonsuicidal self‐injury among adolescents. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Melissa De Riggi
- Department of Education and Counseling Psychology McGill University Montreal Canada
| | | | - Nancy Heath
- Department of Education and Counseling Psychology McGill University Montreal Canada
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5
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Robillard CL, Chapman AL, Turner BJ. Learning from experience: Within- and between-person associations of the consequences, frequency, and versatility of nonsuicidal self-injury. Suicide Life Threat Behav 2022; 52:836-847. [PMID: 35385177 DOI: 10.1111/sltb.12867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/14/2021] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Behavioral models of nonsuicidal self-injury (NSSI) propose that experiencing desirable consequences following NSSI reinforces the behavior. However, these models do not specify whether experiencing more desirable consequences relative to other people (between-person), an individual's own average (within-person), or both, predicts NSSI severity. To address this gap, this study investigated the prospective, within- and between-person associations of desirable NSSI consequences with NSSI frequency (number of episodes) and versatility (number of methods). METHODS Two hundred and ten individuals (93.81% female, Mage = 22.95) with a history of NSSI completed online surveys assessing NSSI consequences, frequency, and versatility every three months for one year. RESULTS Within-person increases in desirable emotional consequences were unrelated to NSSI frequency three months later but predicted increases in NSSI versatility. Within-person increases in desirable social consequences predicted decreases in NSSI frequency three months later but were unrelated to NSSI versatility. Between-person variability in desirable consequences was unrelated to NSSI severity. CONCLUSIONS Findings were partially consistent with behavioral models of NSSI. Going forward, we recommend that: (1) behavioral models articulate the salience of within-person fluctuations in consequences; (2) research clarifies the role of social consequences; and (3) clinicians use repeated assessments of emotional consequences to identify periods of elevated NSSI risk.
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Affiliation(s)
- Christina L Robillard
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Alexander L Chapman
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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6
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Pierret ACS, Anderson JK, Ford TJ, Burn AM. Review: Education and training interventions, and support tools for school staff to adequately respond to young people who disclose self-harm - a systematic literature review of effectiveness, feasibility and acceptability. Child Adolesc Ment Health 2022; 27:161-172. [PMID: 33277965 DOI: 10.1111/camh.12436] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Self-harm among young people is a major public health concern, and whilst schools are well placed to identify and intervene with students who self-harm, the literature shows that school staff lack training and confidence in this area. This systematic review investigated the effectiveness, feasibility and acceptability of training interventions and support tools intended to equip school staff with skills and knowledge to adequately respond to students' disclosure of self-harm. METHOD References for this review were identified through systematic searches of Medline, Embase, PsycINFO, Child Development & Adolescent Studies, ERIC, ASSIA and British Education Index on with search terms 'self-harm', 'training', 'school staff' and 'young people'. Thematic synthesis was used to analyse qualitative data. RESULTS We found that all eight included studies evaluated interventions/tools that were highly effective in terms of an increase in knowledge, skills and confidence of staff in responding to self-harming youth. Acceptability was good with high levels of satisfaction and perceived benefit by staff, though data on feasibility of the interventions were lacking. Limitations of the studies included a paucity of follow-up data, and lack of data relating to student outcomes and actual changes in staff practice in schools. CONCLUSIONS The findings from this review indicate that more evidence is needed to determine the effectiveness, acceptability and feasibility of interventions/tools for school staff addressing self-harm. Further studies should focus on maintaining knowledge, confidence and comfort levels over time, and determine the feasibility of interventions/tools with different staff cohorts and across school settings, as well as address outcomes for students.
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Affiliation(s)
- Aureliane C S Pierret
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anne-Marie Burn
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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7
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Simone AC, Hamza CA. A longitudinal examination of predictors of nonsuicidal self-injury disclosures among university students. J Clin Psychol 2021; 77:2860-2877. [PMID: 34773410 DOI: 10.1002/jclp.23277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/08/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There is a paucity of longitudinal research on predictors of disclosures of nonsuicidal self-injury (NSSI) among emerging adults. However, understanding the factors that facilitate disclosure is critical, as disclosure may serve as a first step in accessing care. To address this gap, the present study examined predictors of prospective NSSI disclosures in a postsecondary student sample. METHODS A total of 475 university students with a history of NSSI (Mage = 17.96; 74.9% women) reported on several potential predictors of NSSI disclosure, and their disclosure history at baseline and 4- and 8-month follow-ups. RESULTS It was found that 22% of students reported disclosing NSSI during the first year of university; students who had previously disclosed, and who reported greater NSSI severity, were more likely to disclose over time. CONCLUSION Results of the present study suggest that disclosures often occur in the postsecondary context, and students who disclose NSSI may engage in more severe NSSI behaviours.
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Affiliation(s)
- Ariana C Simone
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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8
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Matthews EL, Townsend ML, Gray AS, Grenyer BFS. Ideal standards for policy on student self-harm: What research and practice tells us. SCHOOL PSYCHOLOGY INTERNATIONAL 2021. [DOI: 10.1177/0143034320975846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
School communities face challenges in responding effectively to the rising incidence of student self-harm. Evidence-informed guidelines may provide a platform for schools to provide better responses and improve the outcomes of students who engage in self-harm. This paper critically reviews policies published in English targeted for schools or education settings on effective early identification and intervention for children and adolescent self-harm. A grey literature search was conducted using Start Page web search engine with a documentary analysis approach applied to review polices that met criteria. The review identified 16 policies that aim to help school and education staff to identify and respond to student self-harm. The key themes include identification and risk assessment, intervention, roles and responsibilities, as well as addressing issues surrounding evidence-based psychological education and intervention. An evidence-informed policy that addresses multiple aspects of responding to and reducing student self-harm may be a vital foundation of a school’s response to this growing public health issue. This paper outlines key points that will help inform the development of evidence-informed guidelines for schools to respond to student self-harm and presents an exemplar policy framework for use by schools.
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Affiliation(s)
| | - Michelle L. Townsend
- School of Psychology, University of Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Australia
| | | | - Brin F. S. Grenyer
- School of Psychology, University of Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Australia
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9
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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10
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Ammerman BA, Wilcox KT, O'Loughlin CM, McCloskey MS. Characterizing the choice to disclose nonsuicidal self-injury. J Clin Psychol 2020; 77:683-700. [PMID: 32869874 DOI: 10.1002/jclp.23045] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Despite nonsuicidal self-injury (NSSI) being a prevalent and problematic behavior, only approximately half of those who engage in NSSI disclose their behavior. Yet, limited research has explored the choice to disclose. This study sought to identify if NSSI characteristics, emotional distress, and perceived interpersonal obstacles discriminated between NSSI disclosure status. Exploratory aims also investigated reasons for one's disclosure decision and disclosure contextual factors. METHOD Participants included 977 undergraduate students (83% female) with a lifetime history of NSSI. RESULTS Greater NSSI intrapersonal functions, suicide risk, and significant other support, and lower depression symptoms were associated with NSSI disclosure. Exploratory results highlight perceptions of one's NSSI severity and desire to receive support in disclosure choice; intrapersonal functions and peer support were associated with the timing of disclosure. CONCLUSIONS Findings underscore the potential importance of individual attitudes toward NSSI, in addition to traditionally measured risk factors, as potential drivers in NSSI disclosure.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Kenneth T Wilcox
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | | | - Michael S McCloskey
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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11
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Gargiulo A. Narratives of Self-Harm at School: Identifying Trajectories of Intervention in Educational Contexts. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:95-111. [PMID: 33680172 PMCID: PMC7913034 DOI: 10.5964/ejop.v16i1.1883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022]
Abstract
Recent studies have shown that self-harming behaviour is increasingly widespread among adolescents, in particular at school. However, educational institutions perceive themselves unable to cope with the phenomenon, searching for protocols and guidelines to improve its management. Considering schools as useful contexts for intercepting the young malaise, this study aims at exploring the main meanings of self-harming behaviours made within the educational cultural contexts starting from the student’s narrations, in order to understand the possible trajectories of practice. In two high schools we have collected 96 narratives of self-harm written by adolescents (mean age 14; 74% females), who have been engaged in non-suicidal self-injury once in their life. The analysis of the narratives, produced with the help of a software for the automatic qualitative analysis of texts, has allowed to identify four prevalent themes organized into three sense vectors. The findings highlighted significant gender differences in the representation of the experience of self-harm between males and females, as well as the importance of meaningful relationships developed in familiar and educational contexts, which may allow the help seeking process. The emerging of culturally-shared meanings among adolescents within the investigated contexts may allow to think about possible protocols of preventive and clinical practices in schools.
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Affiliation(s)
- Anna Gargiulo
- Department of Humanities, University of Naples Federico II, Naples, Italy
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12
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. How Do Families Represent the Functions of Deliberate Self-Harm? A Comparison between the Social Representations from Adolescents and Their Parents. Arch Suicide Res 2020; 24:173-189. [PMID: 30537902 DOI: 10.1080/13811118.2018.1545713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Research has recognized the importance of understanding the social representations about the functions of deliberate self-harm, particularly in the context of clinical intervention. In addition, parents can play a relevant role in the rehabilitation of adolescents with these behaviors. However, there are few studies that focused on the description and comparison of the social representations about these functions, particularly in families. This article aimed to analyze the social representations about the functions of deliberate self-harm from adolescents and their parents. We developed two sets of analyses: first we compared the social representations from adolescents without a history of deliberate self-harm and their parents, and secondly we compared the social representations about the functions of deliberate self-harm from adolescents with a history of these behaviors and their parents' social representations. Results revealed significant differences between both groups of families, implying that the groups of participants represent the functions of deliberate self-harm differently. Overall, parents emphasized interpersonal functions and devalued intrapersonal functions. These differences were heightened in the families of adolescents with deliberate self-harm. The present article provides important insights regarding the social representations about the functions of deliberate self-harm and the differences between parents' social representations and their children experiences and social representations.
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13
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Brown RC, Fischer T, Goldwich DA, Plener PL. "I just finally wanted to belong somewhere"-Qualitative Analysis of Experiences With Posting Pictures of Self-Injury on Instagram. Front Psychiatry 2020; 11:274. [PMID: 32372983 PMCID: PMC7186324 DOI: 10.3389/fpsyt.2020.00274] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is a common phenomenon among adolescents, but is often not disclosed due to fear of stigmatization. Social media is frequently used to publish photos of NSSI and share experiences with NSSI. Objectives of this study were to find out more about the motivation for publishing NSSI content and to investigate the effect that sharing this content on social media has on young people. In the current study, we interviewed N=59 participants (mean age = 16.7 years [SD = 1.2 years]; 72.9% female), who had all posted NSSI content within the past month on the social media platform Instagram. Semi-structured interviews were conducted via the Instagram messaging app. Interviews were analyzed qualitatively, assisted by the Software Atlas.ti 7. Participants were asked about their motivation for and their experiences with posting NSSI content online. Motivations for posting pictures online were mainly social (connecting, disclosure, communicating), while self-focused reasons like documenting NSSI or recovery were also mentioned. All participants reported having received positive reactions (being offered help, connecting, receiving empathy), as well as negative comments (harassment, being misunderstood) to their own NSSI content by other Instagram users. Participants' reactions to other users' NSSI content on Instagram was often identification with the content or being triggered, but also wanting to offer help or sometimes even being deterred from NSSI. None of the participants mentioned successful referral to professional help through their online NSSI activity. One target for future interventions could therefore be social media, or other online platforms, where adolescents might be more easily reached. Mental health practitioners should be aware of their clients' online activity and encourage reflection upon positive and negative effects of viewing or sharing NSSI content online.
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Affiliation(s)
- Rebecca C Brown
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | | | | | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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Glennon SD, Viola SB, Blakely AO. Increasing school personnel's self‐efficacy, knowledge, and response regarding nonsuicidal self‐injury in youth. PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sara D. Glennon
- Department of Psychological ServicesCypress–Fairbanks Independent School DistrictHouston Texas
| | - Shannon B. Viola
- Department of Arts and SciencesUniversity of Houston‐VictoriaVictoria Texas
| | - Alane O. Blakely
- Department of Psychological ServicesCypress–Fairbanks Independent School DistrictHouston Texas
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15
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Robinson J, Clarke A. Commentary: Adolescent self-harm prevention and intervention in secondary schools: a survey of staff in England and Wales - a reflection on Evans et al. (2019). Child Adolesc Ment Health 2019; 24:239-241. [PMID: 32677212 DOI: 10.1111/camh.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2019] [Indexed: 11/27/2022]
Abstract
Self-harm (SH) continues to be a worldwide concern among adolescents and there is a great need for programming aimed at reducing SH in adolescents. Evans and colleagues discuss the opinions of school staff from a representative sample of secondary schools across England and Wales regarding their school's current prevention and intervention practices in responding to self-harm and how this should be addressed in future practice. The most salient points include the high prevalence of SH internationally, the existing barriers to SH prevention and intervention and possible solutions to these barriers. There is clearly an urgent need for high quality, evidence-based interventions that can be embedded in school settings, and have the capacity to overcome both the individual and structural barriers to supporting these vulnerable young people.
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic., Australia
| | - Alison Clarke
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic., Australia
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16
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adolescents. J Pers Assess 2019; 102:405-414. [DOI: 10.1080/00223891.2018.1557667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eva Duarte
- CIE-ISPA, ISPA–Instituto Universitário, Lisbon, Portugal
| | | | - Hugo Santos Gomes
- CIPsi-Psychology Research Center, Victims, Offenders and Justice System Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Daniel Sampaio
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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17
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Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractThe present article focuses on the validation of the Questionnaire of Social Representations about the Functions of Deliberate Self-Harm for adults. The understanding of the social representations about deliberate self-harm can be relevant for clinical intervention and prevention. However, there is still a lack of instruments to assess these representations. The basis for this instrument was the translation of the Inventory of Statements About Self-Injury. To complement this instrument, we conducted semi-directive interviews with adults without deliberate self-harm and analysed the Portuguese written press. Results from these studies complemented the questionnaire with new items and functions. Study 1 consisted of an exploratory factor analysis with a sample of 462 adults. Results revealed a two-factor structure of interpersonal and intrapersonal dimensions. After item reduction, the factorial analysis of the independent functions was also acceptable. This structure was then corroborated in Study 2 by a confirmatory factor analysis with a new sample of 474 adults, revealing an acceptable model fit. This questionnaire presents a relatively solid structure and is based on acceptable psychometric properties, which allows its use in future research.
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18
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Mo PKH, Ko TT, Xin MQ. School-based gatekeeper training programmes in enhancing gatekeepers' cognitions and behaviours for adolescent suicide prevention: a systematic review. Child Adolesc Psychiatry Ment Health 2018; 12:29. [PMID: 29930701 PMCID: PMC5992649 DOI: 10.1186/s13034-018-0233-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/02/2018] [Indexed: 12/03/2022] Open
Abstract
Suicide is a leading cause of death in adolescence. School provides an effective avenue both for reaching adolescents and for gatekeeper training. This enables gatekeepers to recognize and respond to at-risk students and is a meaningful focus for the provision of suicide prevention. This study provides the first systematic review on the effectiveness of school-based gatekeeper training in enhancing gatekeeper-related outcomes. A total of 815 studies were identified through four databases (Ovid Medline, Embase, PsycINFO and ERIC) using three groups of keywords: 'school based', 'Suicide prevention programme' and 'Gatekeeper'. Fourteen of these studies were found to be adequate for inclusion in this systematic review. The improvement in gatekeepers' knowledge; attitudes; self-efficacy; skills; and likelihood to intervene were found in most of the included studies. Evidence of achieving improvement in attitudes and gatekeeper behaviour was mixed. Most included studies were methodologically weak. Gatekeeper training appears to have the potential to change participants' knowledge and skills in suicide prevention, but more studies of better quality are needed to determine its effectiveness in changing gatekeepers' attitudes. There is also an urgent need to investigate how best improvements in knowledge and skills can be translated into behavioural change.
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Affiliation(s)
- Phoenix K. H. Mo
- 0000 0004 1937 0482grid.10784.3aDivision of Behavioral Health and Health Promotion, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong
| | - Ting Ting Ko
- 0000 0004 1937 0482grid.10784.3aFaculty of Medicine, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong
| | - Mei Qi Xin
- 0000 0004 1937 0482grid.10784.3aDivision of Behavioral Health and Health Promotion, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong
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Resilience to Interpersonal Stress: Why Mattering Matters When Building the Foundation of Mentally Healthy Schools. HANDBOOK OF SCHOOL-BASED MENTAL HEALTH PROMOTION 2018. [DOI: 10.1007/978-3-319-89842-1_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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20
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Batejan KL, Swenson LP, Jarvi SM, Muehlenkamp JJ. Perceptions of the Functions of Nonsuicidal Self-Injury in a College Sample. CRISIS 2016; 36:338-44. [PMID: 26502784 DOI: 10.1027/0227-5910/a000332] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Rates of nonsuicidal self-injury (NSSI) are particularly high on college campuses. Commonly endorsed reasons for NSSI include interpersonal (e.g., seeking support) and intrapersonal (e.g., affect regulation) functions. AIMS This study compared college students with and without a history of NSSI on their views of NSSI functions in order to inform gatekeeper intervention/prevention programs targeting NSSI. METHOD The Inventory of Statements About Self-Injury, which assessed NSSI behavior and functions of NSSI, was completed by 367 college students (73% female, 95% white). RESULTS Ninety-eight participants endorsed lifetime moderate/severe NSSI, 109 endorsed minor NSSI, and 160 denied any history of NSSI. Noninjuring participants' views of NSSI functions were compared with the views held by participants with histories of NSSI. The groups did not differ in their views of the relevance of intrapersonal functions, although noninjuring individuals appeared to stress some interpersonal factors (e.g., influence) slightly more than individuals with a history of NSSI did. CONCLUSION These results suggest that college students generally hold similar perceptions of the functions of NSSI. Our findings suggest intervention/prevention efforts may consider broadening the selection of gatekeepers (e.g., peers with no history of NSSI) in schools and colleges to identify at-risk students and encourage help-seeking behaviors.
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Affiliation(s)
| | - Lance P Swenson
- 1 Psychology Department, Suffolk University, Boston, MA, USA
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Hasking PA, Heath NL, Kaess M, Lewis SP, Plener PL, Walsh BW, Whitlock J, Wilson MS. Position paper for guiding response to non-suicidal self-injury in schools. SCHOOL PSYCHOLOGY INTERNATIONAL 2016. [DOI: 10.1177/0143034316678656] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Around the world, school staff are increasingly expressing concern about nonsuicidal self-injury (NSSI) and how best to address this behavior in the school setting. However, there is a notable lack of informed guidance for schools, and clear inconsistencies in the practices school staff adopt. In this position paper we draw on our collective research and clinical expertise to provide best-practice guidelines for addressing NSSI in school settings. We outline the importance of a school protocol, and the key features all school protocols should contain. We also focus on how schools can minimize contagion of NSSI within their school environment. We believe these guidelines will be an important starting point for schools interested in developing an evidence-based approach to addressing NSSI.
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Affiliation(s)
| | | | - Michael Kaess
- Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
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De Riggi ME, Moumne S, Heath NL, Lewis SP. Non-Suicidal Self-Injury in Our Schools: A Review and Research-Informed Guidelines for School Mental Health Professionals. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516645563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Non-suicidal self-injury (NSSI), the immediate and deliberate destruction of one’s own body tissue, without suicidal intent, and not for purposes that are socially accepted, is a critical concern for youth in schools. Despite significant scholarly advances and increasing clinical awareness of NSSI, many school mental health professionals (MHPs) continue to report feeling ill equipped to support students who self-injure, and emphasize a need for formal education about NSSI and its management in schools. Thus, the first part of this article summarizes current NSSI research on prevalence, age of onset, gender differences, functions, risk factors, and associations with suicide. Emerging from this review, the second part offers research-informed recommendations for MHPs managing NSSI in schools, including guidelines for (a) identifying students at elevated risk of self-injury, (b) developing a protocol for school personnel’s initial response to student self-injury, (c) first-level assessment of NSSI, and (d) managing critical issues related to NSSI contagion and online activity.
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Hasking P, Rees CS, Martin G, Quigley J. What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers. BMC Public Health 2015; 15:1039. [PMID: 26453187 PMCID: PMC4600263 DOI: 10.1186/s12889-015-2383-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/05/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is associated with significant adverse consequences, including increased risk of suicide, and is a growing public health concern. Consequently, facilitating help-seeking in youth who self-injure is an important goal. Although young people who disclose their NSSI typically confide in peers and family, it is unclear how this disclosure and related variables (e.g. support from family and friends, coping behaviours, reasons for living) affect help-seeking over time. The aim of this study was to advance understanding of the impact of disclosure of NSSI by young people and to investigate these effects over time. METHODS A sample of 2637 adolescents completed self-report questionnaires at three time points, one year apart. RESULTS Of the sample, 526 reported a history of NSSI and 308 of those who self-injured had disclosed their behaviour to someone else, most commonly friends and parents. CONCLUSIONS Overall, we observed that disclosure of NSSI to parents facilitates informal help-seeking, improves coping and reduces suicidality, but that disclosure to peers might reduce perceived social support and encourage NSSI in others. We discuss these findings in light of their clinical and research implications.
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Affiliation(s)
- Penelope Hasking
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
- Department of Psychiatry, Monash University, Melbourne, Australia.
| | - Clare S Rees
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Graham Martin
- Centre for Clinical Psychiatry and Neuroscience, The University of Queensland, Queensland, Australia.
| | - Jessie Quigley
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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“We’re Working in the Dark Here”: Education Needs of Teachers and School Staff Regarding Student Self-Injury. SCHOOL MENTAL HEALTH 2013. [DOI: 10.1007/s12310-013-9114-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Berger E, Hasking P, Martin G. 'Listen to them': Adolescents' views on helping young people who self-injure. J Adolesc 2013; 36:935-45. [PMID: 24011109 DOI: 10.1016/j.adolescence.2013.07.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/12/2013] [Accepted: 07/17/2013] [Indexed: 11/25/2022]
Abstract
Non-suicidal self-injury (NSSI) among adolescents is a significant problem, yet the majority do not seek professional help. Parents and teachers are arguably most in contact with young people, and are critical in identifying and referring adolescent self-injurers. This study explored what adolescents believe parents and teachers can do to help young people who self-injure. A school-based sample of 2637 students (aged 12-18 years) completed a self-report questionnaire. Adolescents believe having non-judgemental parents and teachers to talk to, improved parent-child relationships, referral to professionals, reduced school pressures, and student education, are pivotal to helping young self-injurers. However, many adolescents, particularly those exposed to NSSI, were unsure about whether parents and teachers could do anything to help. These finding have important implications for educational programs that prepare parents and teachers to address adolescent NSSI.
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Jarvi S, Jackson B, Swenson L, Crawford H. The impact of social contagion on non-suicidal self-injury: a review of the literature. Arch Suicide Res 2013; 17:1-19. [PMID: 23387399 DOI: 10.1080/13811118.2013.748404] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In this review, we explore social contagion as an understudied risk factor for non-suicidal self-injury (NSSI) among adolescents and young adults, populations with a high prevalence of NSSI. We review empirical studies reporting data on prevalence and risk factors that, through social contagion, may influence the transmission of NSSI. Findings in this literature are consistent with social modeling/learning of NSSI increasing risk of initial engagement in NSSI among individuals with certain individual and/or psychiatric characteristics. Preliminary research suggests iatrogenic effects of social contagion of NSSI through primary prevention are not likely. Thus, social contagion factors may warrant considerable empirical attention. Intervention efforts may be enhanced, and social contagion reduced, by implementation of psychoeducation and awareness about NSSI in schools, colleges, and treatment programs.
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Affiliation(s)
- Stephanie Jarvi
- Department of Psychology, Suffolk University, Boston, Massachusetts 02114, USA.
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Muehlenkamp JJ, Claes L, Quigley K, Prosser E, Claes S, Jans D. Association of training on attitudes towards self-injuring clients across health professionals. Arch Suicide Res 2013; 17:462-8. [PMID: 24224678 DOI: 10.1080/13811118.2013.801815] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED The objective of this study was to evaluate associations between self-injury training and attitudes across different health care professions. In the study, 342 psychologists, social workers, psychiatric, and medical nurses were recruited from 12 hospitals in Belgium. Participants completed a confidential questionnaire assessing attitudes, perceived knowledge/competence in self-injury, and prior self-injury training. Professionals with training reported more positive empathy, less negative attitudes, and greater perceived knowledge/competence, which was related to positive attitudes. Mental health providers had more positive attitudes than medical professionals. CONCLUSIONS Attitudes towards self-injuring patients are multifaceted and vary across health professions. Training on self-injury should be incorporated into the educational curriculum of all health care professions.
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Affiliation(s)
- Jennifer J Muehlenkamp
- a Department of Psychology , University of Wisconsin-Eau Claire , Eau Claire , Wisconsin , USA
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Baetens I, Claes L, Muehlenkamp J, Grietens H, Onghena P. Differences in psychological symptoms and self-competencies in non-suicidal self-injurious Flemish adolescents. J Adolesc 2012; 35:753-9. [DOI: 10.1016/j.adolescence.2011.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 07/14/2011] [Accepted: 11/05/2011] [Indexed: 10/14/2022]
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An Examination of the Scope and Nature of Non-Suicidal Self-Injury Online Activities: Implications for School Mental Health Professionals. SCHOOL MENTAL HEALTH 2011. [DOI: 10.1007/s12310-011-9065-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Heath NL, Baxter AL, Toste JR, McLouth R. Adolescents’ Willingness to Access School-Based Support for Nonsuicidal Self-Injury. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2010. [DOI: 10.1177/0829573510377979] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a prevalent behaviour among youth. School is an opportune setting for intervention with this population, but it is unknown how many youth who engage in NSSI would be willing to access school-based support. The current study surveyed 7,126 middle and high school students. Those that indicated that they engaged in NSSI ( n = 654; 168 boys, 486 girls) responded to follow-up questions regarding the behaviour and willingness to participate in a school-based support program for NSSI. Self-injurers who responded that they would be willing to access help at school ( n = 88; 13.5% of the sample) and a matched group of those who would not be willing were compared on a number of variables. Willingness to access school-based support did not differ by gender or ethnicity but differed between middle and high school students. On indices of NSSI and worries about safety, the adolescents willing to access support reported that they used more methods of injury as well as increased worries about safety in their neighbourhood and sexual harassment.
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Affiliation(s)
| | | | | | - Rusty McLouth
- McLouth Research and Consulting, Kansas City, Missouri, United States
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Muehlenkamp JJ, Walsh BW, McDade M. Preventing non-suicidal self-injury in adolescents: the signs of self-injury program. J Youth Adolesc 2009; 39:306-14. [PMID: 19756992 DOI: 10.1007/s10964-009-9450-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 09/03/2009] [Indexed: 12/01/2022]
Abstract
Non-suicidal self-injury (NSSI) continues to be a problem among youth and there is a great need for programming aimed at reducing NSSI in adolescents. The signs of self-injury program is the first known NSSI school-based prevention program for adolescents that attempts to increase knowledge, improve help-seeking attitudes and behaviors, and decrease acts of NSSI. A total of five schools implemented the program in selected classrooms (n = 274 adolescents; 51.5% female, mean age = 16.07 years) that consisted of predominantly Caucasian (73%) adolescents. Researchers collected pre-post evaluation surveys of the program and feasibility interviews were conducted with the school guidance personnel who ran the program. Results indicated the prevention program did not produce iatrogenic effects, increased accurate knowledge and improved help-seeking attitudes and intentions among students. No significant changes were found in regards to self-reported formal help-seeking actions. Feasibility responses indicate the program is user-friendly and well received by school personnel. The data offer preliminary evidence that the program may be an effective prevention program for schools.
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Affiliation(s)
- Jennifer J Muehlenkamp
- Department of Psychology, 227 Hibbard Hall, University of Wisconsin-Eau Claire, Eau Claire, WI, 54702-4004, USA.
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Whitlock J, Eells G, Cummings N, Purington A. Nonsuicidal Self-Injury in College Populations: Mental Health Provider Assessment of Prevalence and Need. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2009. [DOI: 10.1080/87568220902794366] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Muehlenkamp JJ, Williams KL, Gutierrez PM, Claes L. Rates of non-suicidal self-injury in high school students across five years. Arch Suicide Res 2009; 13:317-29. [PMID: 19813109 DOI: 10.1080/13811110903266368] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
It is believed that the rate of non-suicidal self-injury (NSSI) among high school students is increasing. However, no known research has examined the rates of NSSI among non-clinical, high school samples of adolescents across several years. The current study utilized archival data from five academic years [2001 to 2005 (N = 1393)] to address this limitation by examining the lifetime prevalence rates of NSSI in urban high school students within the Midwestern United States. Results indicate a significant difference in rates across years by gender. Females showed a significant increase in their rates of NSSI compared to males, who showed a significant decline, during the last 3 years of the study. Implications of these findings for school personnel and directions for future research discussed.
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Affiliation(s)
- Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin 54702, USA.
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Whitlock J, Muehlenkamp J, Eckenrode J. Variation in Nonsuicidal Self-Injury: Identification and Features of Latent Classes in a College Population of Emerging Adults. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2008; 37:725-35. [DOI: 10.1080/15374410802359734] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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