Peer-Reviewed Journal Details
Mandatory Fields
Larkin, C;Di Blasi, Z;Arensman, E
2013
August
Medical Hypotheses
Self-cutting versus intentional overdose: Psychological risk factors
Validated
Optional Fields
BARRATT IMPULSIVENESS SCALE EMERGENCY-DEPARTMENT FINNISH ADOLESCENTS HOPELESSNESS SCALE SUICIDE ATTEMPTERS HARM REPETITION MULTICENTER PARASUICIDE PEOPLE
81
347
354
Individuals who present to emergency departments with self-harm are at elevated risk of further self-harm and suicide, and these risks are yet higher among patients who self-cut. Repetitive self-injury has previously been explained using a behaviourist approach focussing on operant conditioning, but we propose that the increased risk of self-harm repetition among those who present with self-cutting is at least partly mediated by pre-existing psychological risk factors. Several studies show that those who present with self-cutting differ from intentional overdose patients on demographic, psychiatric and social factors, but, based on findings from community-based studies, we hypothesise that there may be additional psychological differences that may also be associated with increased repetition risk. We conducted a small-scale cohort study of 29 self-harm patients presenting to A&E and compared theoretically-derived psychological variables between 8 self-cutting and 21 overdose patients. Those presenting with self-cutting scored significantly higher on hopelessness and lower on non-reactivity to inner experience and generally had a more vulnerable profile than those presenting with overdose. These findings support our hypothesis that the association between self-cutting and prospective repetition is at least partly due to pre-existing psychological vulnerabilities that increase both the likelihood of engaging in self-cutting as a method of self-harm and the likelihood of subsequent repetition of self-harm. Existing evidence suggests that self-cutting is a risk factor for repetition of self-harm, and it is possible that reducing and preventing repetition among these patients can be achieved by implementing psychological interventions to reduce hopelessness and increase tolerance of emotional distress. (C) 2013 Elsevier Ltd. All rights reserved.
EDINBURGH
0306-9877
10.1016/j.mehy.2013.04.001
Grant Details