Self-Harm and Suicide (1*)

Question 1

What is the definition of Self-harm?

What are other names for it?

What are the most common methods?

What can it lead to?
→ Therefore, what is important to assess for in any pt that self-harms?

Answer 1

➊ Deliberate injury to oneself, typically as a manifestation of a psychological or psychiatric disorder

➋ Self-injurious behaviour (SIB), self-mutilation, non-suicidal self-injury (NSSI), parasuicide, deliberate self-harm (DSH), self-abuse, and self-inflicted violence

➌ Cutting, Self-hitting, and Burning

➍ Suicide
→ Suicide risk

Question 2

What are the risk factors?

What are some of the reasons one may self-harm?

Answer 2

➊ • Bereavement
• Childhood abuse/trauma
• Family substance abuse
• Negative body image perceptions/Body dysmorphia
• Lack of impulse control
• Neglect
• Lack of strong family attachments

➋ • Feel better – Can release pent-up feelings or for those who feel ‘numb’ to feel something
• Communicate their emotional pain – Use wounds as a way of reaching out for help
• Feel a sense of control – They may feel powerless, lacking self-esteem. So, they use self-harm to regain control, esp. for those who’ve suffered childhood abuse
• Punish themselves – May lack self-esteem and think they’re at fault for the way they feel

Question 3

What are some of the warning signs that one is self-harming?

What are the management options?

Answer 3

➊ • Withdrawn, or quieter and more reserved than usual
• Stop participating in their regular activities
• Frequent mood changes
• Significant life event
• Unexplained cuts/scratches – Some may wear clothes inappropriate for the weather e.g. long sleeves on a hot day to hide marks

➋ • CBT – Address issues, learning to challenge negative thoughts and situations
• Dialectical BT (DBT) – Variation of CBT, designed for those with self-harming behaviours, such as self-cutting, suicidal thoughts/attempts – Aim is to help them change self-destructive behaviours
• Problem Solving Therapy (PST) – Identifying specific problems and forming alternative solutions to them – They can clearly define the problem they face, brainstorm multiple solutions, and decide on the best course of action