Doyle L, Sheridan A, Treacy M P
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
J Psychiatr Ment Health Nurs. 2017 Mar;24(2-3):134-142. doi: 10.1111/jpm.12360. Epub 2017 Jan 25.
WHAT IS KNOWN ON THE SUBJECT?: Self-harm is a relatively common occurrence in adolescents; however, there remains a lack of understanding about the motivations behind adolescent self-harm, and this poor understanding can have a negative impact on how mental health professionals respond to young people who self-harm. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper identifies the reasons for self-harm in a community sample of young people and finds that the functions of self-harm differ for different people and that there may be multiple reasons for self-harm. Findings provide support for the affect-regulation model of self-harm which states that young people self-harm to regulate how they are feeling, but provides little support for the interpersonal influence model which proposes that self-harm is an attempt to influence how other people respond to them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Self-harm for most young people serves at least one specific function and is an indication of distress. There is a requirement for a non-pathologizing response towards young people who self-harm; self-harm should be understood as a meaningful behaviour rather than a symptom of an illness. Mental health nurses need to understand the multiple functions of self-harm. A better understanding of the individualized meaning behind self-harm can positively impact on attitudes towards young people who self-harm and provide for improved mental health service provision.
Introduction Although self-harm is a relatively common occurrence in adolescents, there is a lack of understanding about the motivations behind it. A poor understanding of self-harm contributes to negative perceptions about those who self-harm and a poor healthcare experience. Aim & Methods This study identifies motivations behind self-harm in school-based adolescents using a cross-sectional survey. Motivations behind self-harm were elicited using a scale and open-ended responses. Results Of the 856 adolescents who completed the survey across 11 postprimary schools, 103 reported a history of self-harm. The most commonly endorsed reason for self-harm was to 'get relief from a terrible state of mind' (79%). Open-ended responses were consistent with scale responses with most reporting that they self-harmed to relieve distressing emotions. Discussion Findings provide support for the affect-regulation model of self-harm with support also demonstrated for the self-punishment and antidissociation models. There was little support for the interpersonal influence model suggesting that the commonly held belief that self-harm is attention-seeking is one attributed by others to young people, and not widely reported by young people themselves. Implications for practice Mental health services need to be responsive to the needs of young people who self-harm which requires eliciting and understanding the individual and multiple meanings behind self-harm to best inform treatment options.
关于该主题已知的信息有哪些？：青少年自我伤害是一种相对常见的现象；然而，对于青少年自我伤害背后的动机仍缺乏了解，而这种了解不足会对心理健康专业人员应对自我伤害的年轻人的方式产生负面影响。本文对现有知识有何补充？：本文确定了社区中青少年自我伤害的原因，发现自我伤害的功能因人而异，且自我伤害可能有多种原因。研究结果为自我伤害的情绪调节模型提供了支持，该模型认为年轻人通过自我伤害来调节自己的情绪，但对人际影响模型的支持很少，该模型认为自我伤害是试图影响他人对自己的反应。对实践有何启示？：对大多数年轻人来说，自我伤害至少有一个特定功能，是痛苦的一种表现。需要对自我伤害的年轻人采取非病理化的应对方式；自我伤害应被理解为一种有意义的行为，而非疾病的症状。心理健康护士需要了解自我伤害的多种功能。更好地理解自我伤害背后的个性化意义，可对对待自我伤害年轻人的态度产生积极影响，并改善心理健康服务的提供。
引言 尽管青少年自我伤害较为常见，但对其背后的动机缺乏了解 。对自我伤害的理解不足导致对自我伤害者的负面看法以及不良的医疗体验。目的与方法 本研究通过横断面调查确定在校青少年自我伤害的动机。使用量表和开放式回答来引出自我伤害的动机。结果 在11所中学完成调查 的856名青少年中，103人报告有自我伤害史。自我伤害最常被认可的原因是“从糟糕的心理状态中解脱”（79%）。开放式回答与量表回答一致，大多数人报告他们自我伤害是为了缓解痛苦情绪。讨论 研究结果为自我伤害的情绪调节模型提供了支持，同时也为自我惩罚和抗解离模型提供了支持。对人际影响模型的支持很少，这表明人们普遍认为自我伤害是为了寻求关注，这是他人归因于年轻人的，而年轻人自己并未广泛报告这一点。对实践的启示 心理健康服务需要响应自我伤害年轻人的需求，这需要引出并理解自我伤害背后的个体和多种意义，以便为最佳治疗方案提供依据。
