Joubert David
Department of Criminology, University of Ottawa, Ottawa, Canada.
Stress Health. 2025 Jun;41(3):e70057. doi: 10.1002/smi.70057.
Para-suicidal behaviours and self-harm are commonly observed in mental health institutions, with women inpatients being particularly at risk. Little research has looked at characteristics of women engaging in self-harmful conduct beyond diagnostic and socio-demographic information. The current study investigated occurrences of self-harm over time in a large sample of women housed in forensic mental health units in the province of Ontario, Canada. Background and clinical information was obtained from staff ratings on the Resident Assessment Instrument-Mental Health at admission and every 3 months afterwards for an approximately 2-year time period. Latent class mixed models identified two distinct profiles, the first one (77.4% of sample) characterised by a low or intermittent use of self-harm, the second (22.6% of sample) showing a stable elevated risk profile. Women in the at-risk group tended to be younger, showed increased signs of subjective distress and greater occurrence of adverse life events in their history. Psychiatric diagnosis in itself was not a valid predictor of the stability of self-harm for this sample. These findings highlight the importance of addressing both clinical and stress-related distal vulnerability factors in the background of institutionalised women who engage in self-harm on a stable basis.
准自杀行为和自我伤害在精神卫生机构中很常见，女性住院患者尤其面临风险。除了诊断和社会人口统计学信息外，很少有研究关注实施自我伤害行为的女性的特征。本研究调查了加拿大安大略省法医精神卫生单位中大量女性样本随时间推移的自我伤害发生率。背景和临床信息来自入院时以及之后每3个月对《住院患者评估工具-精神卫生》的工作人员评分，为期约2年。潜在类别混合模型识别出两种不同的类型，第一种（占样本的77.4%）的特征是自我伤害的使用频率较低或断断续续，第二种（占样本的22.6%）显示出风险持续升高的特征。处于风险组的女性往往更年轻，表现出更多主观痛苦的迹象，并且在其病史中出现不良生活事件的频率更高。对于该样本而言，精神科诊断本身并不是自我伤害稳定性的有效预测指标。这些发现凸显了在长期实施自我伤害行为的住院女性背景下，解决临床和与压力相关的远端脆弱因素的重要性。
