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. 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.