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At least 1,117 records · Page 62Linked to original sources
PubMed1995

Changes in self-destructiveness of borderline patients in psychotherapy. A prospective follow-up.

Thirty-seven female inpatients with borderline personality disorder were followed prospectively for up to 5 years to assess changes in two forms of self-destructiveness: suicidal behavior/ideation, and self-harm behavior/ideation. It was found that suicidal behavior declined significantly at 1-, 2-, 3-, 4-, and 5-year follow-up; self-harm behavior showed trends but no significant decline over 5 years. Ideation (both suicidal ideation and self-harm) did not decline notably. Three alternate courses of self-harm behavior are identified: "fluctuating," "consistently low," and "steadily declining." The majority of patients fell in the fluctuating category. The fluctuating group showed higher baseline dysphoria than did the consistently low group, while the latter reported higher baseline drug use. Intercorrelations showed that self-harm behavior and suicidal behavior were not associated, nor were suicidal behavior and suicidal ideation. Clinical and research implications are discussed.

Adolescent↗
PubMed1994

Correlates of interventions with self-injurious behaviour.

A review was conducted of published intervention research on the self-injurious behaviour (SIB) of individuals with severe or profound mental retardation. The review comprised articles published between 1980 and 1990. Thirty-eight biodemographic and environmental variables were investigated, with type of SIB and intervention type considered primary variable classes. Efficacy was also investigated as an additional variable. Cross-tabulations were performed on selected variables with 24 significant and five marginally significant results obtained. These results indicated that there were possible biases in treatment approaches, problems in compliance with standards of practice, and differential efficacy levels related to certain variable types. Findings were discussed in relation to establishing a prototype for successful SIB interventions.

Behavior Therapy↗
PubMed1995

Self-injurious behaviour. Psychopathological and nosological characteristics in subtypes of self-injurers.

This study explored the symptoms of self-injurious behaviour (SIB) in a consecutive sample of 54 mostly female psychiatric inpatients. The phenomenological analysis presented SIB as quite a uniform syndrome that starts latest in early adulthood, is often committed impulsively, is used in the function of releasing tension and occurs in patients with eating and psychoactive substance use but also schizophrenic disorders. The quality of mood preceding SIB was best characterized as dysphoria and was qualitatively not different from patients' longstanding affective traits. Two subgroups were differentiated, those with borderline personality disorder and those without; there was some evidence that patients with borderline personality disorder present a quite homogeneous core group of SIB, whereas others show a higher variety of psychopathological features. The hypothesis is proposed that poor affect regulation is the underlying psychopathological dimension.

Adolescent↗
PubMedDate not supplied

Adaptations of mouthguards for patients with special needs.

The adaptations and applications of mouthguard appliances are many and varied, with uses ranging from protective to therapeutic. These modifications serve the individual needs of patients. This requires problem-solving based on combining form and function with the skills of the dentist.

Burns, Chemical↗
PubMed1996

Managing patients with deliberate self harm admitted to an accident and emergency observation ward.

OBJECTIVE: To review the case records of patients admitted to an accident and emergency (A&E) observation ward following deliberate self harm. METHODS: The hospital notes of 568 patients admitted during one year following episodes of deliberate self harm were reviewed. The study was retrospective. RESULTS: The majority of these patients had taken an overdose and were between 18 and 35 years of age. Most patients were admitted to the observation ward after midnight or in the evening and were subsequently managed by an A&E based deliberate self harm team. Only 20% of admissions required evaluation by a psychiatrist. Most patients were discharged the next day without further follow up. CONCLUSIONS: The use of a specialised A&E based team and an A&E observation ward is appropriate for the management of many deliberate self harm patients.

Adolescent↗
PubMedDate not supplied

Self-enucleation in drug-related psychosis.

OBJECTIVE: To report on a patient who committed self-enucleation with his own fingers. METHODS: Case report of a 28-year-old man who self-enucleated his right eye. After ophthalmological treatment, he was referred to the psychiatric department for further evaluation and treatment. RESULTS: Reconstruction of the orbit was performed, and neither ophthalmological nor neurological complications were noted. The psychiatric history revealed continuous drug abuse (cannabis and amphetamines). The diagnosis of a drug-induced psychosis was established. CONCLUSIONS: Self-enucleation or 'oedipism' is a rare entity which requires, besides an operative reconstruction of the orbit, neurological monitoring to prevent possible intracranial complications. Long-term psychiatric therapy should be attempted to prevent further self-injurious behaviour.

Adult↗
PubMed2002

Situational determinants of inpatient self-harm.

Auto-aggressive individuals have a higher likelihood of engaging in interpersonal violence, and vice versa. It is unclear, however, whether ward circumstances are involved in determining whether aggression-prone patients will engage in auto-aggressive or outwardly directed aggressive behavior. The current study focuses on the situational antecedents of self-harming behavior and outwardly directed aggression of psychiatric inpatients. Inwardly and outwardly aggressive behavior were monitored on a locked 20-bed psychiatric admissions ward for 3.5 years with the Staff Observation Aggression Scale-Revised (SOAS-R). A map of the ward was attached to each SOAS-R form, enabling staff members to specify locations of aggressive incidents. Time of onset, location, and provoking factors of auto-aggressive incidents were compared to those connected to aggression against others or objects. Of a total of 774 aggressive incidents, 154 (20%) concerned auto-aggressive behavior. Auto-aggression was significantly more prevalent during the evening (i.e., 50% compared to 32%), and reached its highest level between 8 and 9 P.M. (17% compared to 7%). The majority of self-harming acts (66%) were performed on patients' bedrooms. Outwardly directed aggression was particularly common in the day-rooms (24%), the staff office (19%), the hallways of the ward (14%), and the dining rooms (10%). Provoking factors of auto-aggressive behavior are less often of an interactional nature compared to outwardly directed aggression. The results suggest that a lack of stimulation and interaction with others increases the risk of self-injurious behavior. Practical and testable measures to prevent self-harm are proposed.

Adult↗
PubMedDate not supplied

A support group for self-harm patients.

Health care professionals often try to convince people who self-harm to stop, becoming caught up in a pattern of arguing with them against self-injury. Patients at the Northgate Clinic (Senior) asked for a self-harm support group to be set up so that they could talk about their behaviour and the reasons for it. Its aims were to ensure that their negative beliefs about themselves were not reinforced, that they could articulate their experiences in an empowering way and that they could take some responsibility for their behaviour.

Adolescent↗