Deliberate Self Harm
Deliberate self-harm included intentional self-poisoning or self-injury, irrespective of motivation. In females, the factors deliberate self-harm were identified as recent self-harm by friends, self-harm by family members, drug misuse, depression, anxiety, impulsivity, and low self-esteem. Pregnant women who are also HIV positive may be at higher risk of deliberate self-harm (DSH).
Deliberate self-harm is a troubling aspect of adolescence (and possibly even adulthood) that appears to be on the increase. Deliberate self-harm can help in the short-term management of problematic emotions (harming the self-seems to decrease the intensity of some emotions) and can, therefore, be experienced as stress-relieving.
Deliberate self-harm is one of the top five causes of acute medical admissions for both women and men. Deliberate self-harm involves acts such as poisoning, overdosing, cutting or head banging causing some tissue damage to the body. Deliberate self-harm was identified as a response to conflict or feeling distressed or angry. It can feel to other people that these things are done intentionally and deliberately – almost cynically.
Evidence regarding the prevalence of deliberate self-harm in adolescents usually comes from three main sources: 1) historical information from psychiatric samples; 2) hospital admissions, and 3) general population or epidemiological surveys. This is quite different from Munchausen’s syndrome, where people with the condition cause harm to themselves in order to achieve a specific physical symptom and often to get hospital admission to a medical ward. It is estimated that there are at least 170,000 cases of self-harm which come to hospital attention each year. The portrayal of self-poisoning in a popular TV drama in the UK was associated with a short-lived increase of self-poisoning cases in general hospitals.
There is some debate among therapists and people who self-harm about whether deliberate self-harm should form a primary focus of treatment. However, brief psychological therapies such as interpersonal therapy and problem-solving therapy are effective in the treatment of depression in similar clinical settings, and the latter has been shown to have benefits (if not reducing repetition) after self-harm. A study in the British Journal of Psychiatry in 1998 of teenagers presenting at Accident & Emergency departments for treatment for self-harm found that every hour three young people self-harm. However, visits to hospital A & E departments for treatment by self-harming teenagers represent only the tip of the iceberg