Arch Suicide Res. 2020 Jul-Sep;24(3):384-401. doi: 10.1080/13811118.2019.1624669. Epub 2019 Jul 19.
Although UK clinical guidelines make tentative recommendations for "harm minimization" strategies for repeated self-harm, this is in the absence of empirical evidence supporting their acceptability or effectiveness. We explore young people's views of harm minimization strategies (e.g., snapping elastic bands on skin, drawing on skin with red ink), as a proxy for self-harm. In this mixed methods study we examine data (secondary analysis) from: (1) an online questionnaire (= 758) observing the frequency of these strategies being used as a form of self-harm, and as a form of alternative coping (viewed as distinct from self-harming), and (2) semi-structured interviews ( = 45), using thematic analysis to identify themes related to harm minimization. Predominant themes suggest that many young people viewed harm minimization strategies as a proxy for self-harm as ineffective. Where such strategies were reported as helpful, their utility was reported to be short-lived or situation-specific. Findings from both studies indicate that some young people described using harm minimization (e.g., elastic band snapping) as a form of self-harm (e.g., to break the skin). Harm minimization strategies should not be recommended in isolation and their use must be monitored. Further research is urgently needed to develop an evidence base that informs practice.
尽管英国临床指南对重复自伤的“伤害最小化”策略提出了试探性建议，但这是在缺乏支持其可接受性或有效性的经验证据的情况下进行的。我们探讨了年轻人对伤害最小化策略（例如，在皮肤上弹橡皮筋、用红墨水在皮肤上画画）的看法，这些策略是自伤的一种替代方式。在这项混合方法研究中，我们分析了以下数据（二次分析）：（1）一项在线问卷调查（=758 人），观察这些策略作为自伤形式以及作为替代应对方式（与自伤不同）的使用频率；（2）半结构化访谈（=45 人），使用主题分析来确定与伤害最小化相关的主题。主要主题表明，许多年轻人认为伤害最小化策略作为自伤的替代方式是无效的。在报告这些策略有用的情况下，它们的效用是短暂的或特定于情况的。两项研究的结果均表明，一些年轻人将伤害最小化（例如弹橡皮筋）描述为一种自伤形式（例如划破皮肤）。不应孤立地推荐伤害最小化策略，必须对其使用进行监测。迫切需要进一步研究，以建立一个为实践提供信息的证据基础。
