The impact of child maltreatment on the risk of deliberate self-harm among adolescents: A population-wide cohort study using linked administrative records

Adolescents exposed to maltreatment have an elevated risk of deliberate self-harm (DSH). The aim of this study was to investigate longitudinally the effects of the number, timing, and type of maltreatment allegations on adolescent risk of having a DSH-related hospital admission, using linked data in Western Australia. A total of 351,372 children born between 1986 and 2000 were followed from birth up to the year 2010. Cox regression models were utilized, while controlling for a range of psychosocial covariates. Compared to children without allegations of maltreatment, children with unsubstantiated allegations only (aHR = 1.04, 95%CI: 1.00–1.08, p < .01) and children with a substantiated allegation (aHR = 1.10, 95%CI: 1.06–1.15, p < .001) all had significantly increased risk of DSH in adolescence. Among children with a substantiated allegation of maltreatment, the greater the number of allegations, the longer the exposure to maltreatment, and the more types of maltreatment experienced by a child, the higher the child's risk of DSH. However, this dose–response pattern was not found among children with unsubstantiated allegations only. This study calls for the early identification of children who are vulnerable to maltreatment, the better identification of the duration and severity of maltreatment experiences, and the provision of continued care and support, to reduce the child's DSH risk in adolescence.     

Mandated Psychological Assessments for Suicide Risk in a College Population: A Pilot Study

This study was conducted to evaluate the impact of a protocol mandating psychological assessment of college students exhibiting specific signs of suicide risk and/or nonsuicidal self-harm. Thirty-seven current and former students who had been documented as at risk completed a structured interview in person or by phone. Outcomes suggest this protocol identifies students at risk for suicide, with 27% having made an attempt at some point in their lives and 50% having been suicidal at the time the report was written. The majority of participants endorsed the value of this intervention.     

Self-Harm: A Challenge for Pastoral Care

Deliberate self-harm (DSH) has received a considerable deal of recent publicity in the press and through the creation of a National Inquiry into Self-Harm and Young People, and there are grounds for believing that it is on the increase. Little is known about how DSH impacts upon schools or how teachers and support staff respond. This paper begins with seven extracts from 34 research interviews undertaken in 2003/4, which illustrate the experiences of DSH in educational contexts. The complex nature of DSH is examined, and the challenges that it poses for pastoral casework, the pastoral curriculum and the school as a community are considered. Issues raised include the need for training and support for teachers, problems of confidentiality and the boundaries between professional and personal involvement. The paper ends by considering the implications for schools that wish to make better pastoral and curricular provision in response to this disturbing phenomenon.     

Child Self-protection: Concerns About Classroom Approaches

Schools should never become complacent about the quality of care they offer their pupils. The situation described by Felicity Fletcher-Campbell illustrates the need for careful review of how the needs of every group of pupils in a school are met. A small minority of pupils are ‘looked after’ by the local authority. Their educational experiences are frequently as negative and traumatic as their domestic experiences. Drawing on research recently completed by the National Foundation for Educational Research, this article describes ways in which schools can support pupils who are in the care system.     

An exploration around peer support for secondary pupils in Scotland with experience of self-harm

ABSTRACT

Literature highlights friends as a main support for young people who self-harm, yet limited research explores specific supports offered by friends, or any help required to provide successful support. This research aimed to determine how friends support young people who self-harm; what friends could further do; and additional help needed to be a supportive friend. An interpretative phenomenological analysis approach was used to explore participants’ lived experiences. Qualitative data were gathered from secondary pupils in Scotland via semi-structured interviews. Findings indicated that friends provide support by being directly there for young people, providing distractions and taking responsibility. Friends could consider young people’s perspectives more, initiate conversations about self-harm and spend more time with young people. Supportive friends speak to others for reassurance and would like additional people to provide support. Implications for practice included highlighting support provided by friends, normalising the term ‘self-harm’ and providing peer support training for friends.     

Does shame influence nonsuicidal self-injury among college students? An investigation into the role of shame,negative urgency,and brooding

College students experience high levels of life stress that put them at increased risk for nonsuicidal self-injury (NSSI). It is important to understand which vulnerabilities put students most at risk, in order to inform treatment in college counseling centers. This study investigated the joint contributions of specific vulnerabilities to lifetime history and frequency of NSSI among a sample of undergraduates (50% reported a history of NSSI). Results showed shame-proneness was uniquely associated with NSSI frequency beyond other negative emotions. Negative urgency and brooding exacerbated this effect. This study provides insights into the contributions of specific vulnerabilities to NSSI and implications for practice.     

Nonsuicidal Self-Injury: Characteristics,Functions, and Strategies

Nonsuicidal self-injury (NSSI) is a significant issue among college students but few resources are available to college mental health professionals. This article consolidates extant knowledge on NSSI from the empirical and clinical literature, including common NSSI characteristics (rates, methods, demographics, and concomitants), intrapersonal and social functions, and NSSI's relation to suicide. Practical strategies for assessing NSSI among students are presented, as are empirically informed treatments. With this knowledge, college mental health professionals will have a theoretical and practical understanding of NSSI and will be better equipped to work with students who self-injure.