Understanding Self-Harm

1. UnderstandingSelf-Harm “Skin has a good memory. Skin is like the ground we walk on every day; you can read a whole history in it if you know how to look.” - Kettlewell, 1999 MERVE AĞAN 1730407

2. OUTLINE • What is self- harmbehavior? • Common forms • Prevalence • Why do people do it? • How can one stop ? • References

3. What is self- harm behavior? • Any behavior where the intent is to deliberately hurt oneselfwithout suicidal intent. • The methods of it : self- injuryand self- poisoning • The location of self- harm are often areas of the body that are easily hidden and concealed from the detection of others. http://www.howardleague.org/fileadmin/howard_league/user/pdf/SP/Self-injury_by_David_F._Duffy.pdf

4. Forms of self- harm • Cutting or burning • Taking overdoses • Hitting oneself, walls, or hard objects • Pulling hair or picking skin • Trichotillomania (Hair-Pulling Disorder) • Excoriation (Skin-Picking Disorder ) • Self-strangulation http://www.howardleague.org/fileadmin/howard_league/user/pdf/SP/Self-injury_by_David_F._Duffy.pdf

5. Prevalence • Common among young people • Age of onset between 14- 24 • Hard to know true prevalence as it’s very secretive • But, it is known that more common in females than males- may be due to ; • More females report whereas males likely underreport Jacobson, CM et al. (2007) The Epidemiology and Phenomenology of Non-Suicidal Self-Injurious Behavior Among Adolescents: A Critical Review of the Literature, Archives of Suicide Research, 11: 2, 129 — 147

6. Prevalence conducted a systematic review of current (2005 - 2011) empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe Average Prevalence of Self-harm (NSSI and DSH) by Year of Study Muehlenkampet al.Child and Adolescent Psychiatry and Mental Health 2012 6:10   doi:10.1186/1753-2000-6-10

7. Causes of self- harm • Biological factors • Neurotransmitters • Environmental factors • Psychological factors • False cognitive beliefs • Mental disorders

8. Biological Factors (Neurotransmitters) Serotonin Model(Duffy, D. F., 2009) Deficientin normal levels of serotonin which cause irritability may result in aggressive and impulsive behavior including self-injury http://www.howardleague.org/fileadmin/howard_league/user/pdf/SP/Self-injury_by_David_F._Duffy.pdf

9. Biological Factors (Neurotransmitters) Endorphin Model • Low endorphin level in individuals with self-harm • During self- harm the brain release endorphins • Whose effect are similar to morphine • Lead to; • Decreasing the sensation of the pain • Cause pleasant physical sensation ‘‘ RUSH’’ • Trigger the dopamine reward pathwaysuggesting a biological cause for “addictive patterns” http://www.cedu.niu.edu/~shumow/itt/doc/selfinjury.pdf

10. Environmental factors • Individuals who experienced traumatic abuse • most notably childhood sexual abuse or rape  • Family relationship difficulties • Peer relationship break up / difficulties • SH behavior in other students / the media • Exam pressure • Time of change (new school, parents split etc.) • Receive attention from other people http://www.cedu.niu.edu/~shumow/itt/doc/selfinjury.pdf

11. Psychological factors http://www.slideshare.net/pookyh/self-harm-16143627?qid=3a8c9619-bc49-4944-905b-b28e97a7b060&v=default&b=&from_search=8

12. False cognitive beliefs • For example : feeling of loss of control http://www.slideshare.net/pookyh/self-harm-16143627?qid=3a8c9619-bc49-4944-905b-b28e97a7b060&v=default&b=&from_search=8

13. False cognitive beliefs(Cont’d) • For example: cope with emotion http://www.slideshare.net/pookyh/self-harm-16143627?qid=3a8c9619-bc49-4944-905b-b28e97a7b060&v=default&b=&from_search=8

14. False cognitive beliefs(Cont’d) • For example : feeling of punishment http://www.slideshare.net/pookyh/self-harm-16143627?qid=3a8c9619-bc49-4944-905b-b28e97a7b060&v=default&b=&from_search=8

15. Mental disorders • People diagnosed as having certain types of mental disorder are much more likely to self- harm • Such mentaldisorders : • Depression • Bipolar • Borderline personality disorder • Eating Disorder • Substance abuse • PTSD • Anxietydisorder http://www.riverviewbehavioralhealth.com/self-injury/effects-symptoms-signs

16. Mental disorders (Cont’d) In one survey of a sample of the British population,people with current symptoms of a mental disorder were up to 20 times more likely toreport having harmed themselves in the past (Meltzer et al., 2002) Meltzer, H., Lader, D., Corbin, T., et al. (2002a) Non-Fatal Suicidal Behaviour Among Adults aged16 to 74 in Great Britain. London: The Stationery Office

17. Different interventions for stopping • Accept reality and find ways to make the present moment more tolerable • Identify feelings and talk them out rather than acting on them • Distract themselves from feelings of self- harm (for example: counting to ten, waiting 15 minutes, saying ‘‘ NO’’ or ‘‘ STOP’’ • Develop better social skills • Hospitalization http://www.slideshare.net/ashihabeddin/deliberate-self-harm

18. REFERENCES Duffy, D. F. (2009). Self- injury. Retrievedfrom: http://www.howardleague.org/fileadmin/howard_league/user/pdf/SP/Selfinjury_by_David_F._Duffy.pdf Knigge,J. Self injuryforteachersRetrievedfrrom: http://www.cedu.niu.edu/~shumow/itt/doc/selfinjury.pdf Meltzer, H., Lader, D., Corbin, T., et al. (2002) Non-Fatal Suicidal Behaviour Among Adults aged16 to 74 in Great Britain. London: The Stationery Office Muehlenkampet al. (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm.Child and Adolescent Psychiatry and Mental Health,6 :10. RiverwiewBehavioralHealth. Self- harmcauses, symptomsandsigns. Retrievedfrom: http://www.riverviewbehavioralhealth.com/self-injury/effects-symptoms-signs   Jacobson, CM et al. (2007) The Epidemiology and Phenomenology of Non-Suicidal Self-InjuriousBehavior Among Adolescents: A Critical Review of the Literature, Archives of Suicide Research, 11: 2, 129 — 147.