Objective: Previous research has indicated that some forms of deliberate self-harm (DSH) are quite common in non-clinical samples and that these behaviours are associated with psychological variables such as anxiety and mindfulness. This study contributes information on the onset and the frequency of DSH in two samples of Swedish university students as well as its association with related constructs and gender. Method: Two samples of Swedish university students (n=500 and n=187 respectively) filled out questionnaires on DSH. Results: In the first sample 30.8 % of the respondents reported DSH at least once in their life and in the second 18.9 % reported ongoing or recent DSH. In the second sample DSH was shown to be positively correlated with anxiety and negatively correlated with mindfulness. Conclusion: In this non-clinical sample DSH is quite frequent and the identified relationships with anxiety and mindfulness are relevant for prevention and treatment of such behaviour

Bjärehed, Jonas

Johansson, Olof

Lund University Publications

LUND UNIVERSITYPO Box 117221 00 Lund+46 46-222 00 00Deliberate self-harm in Swedish university students – onset and relationships withanxiety and mindfulnessBjärehed, Jonas; Johansson, Olof2009Link to publicationCitation for published version (APA):Bjärehed, J., & Johansson, O. (2009). Deliberate self-harm in Swedish university students – onset andrelationships with anxiety and mindfulness. Paper presented at European Congress of Psychology, 2009, Oslo,Norway.Total number of authors:2General rightsUnless other specific re-use rights are stated the following general rights apply:Copyright and moral rights for the publications made accessible in the public portal are retained by the authorsand/or other copyright owners and it is a condition of accessing publications that users recognise and abide by thelegal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private studyor research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portalRead more about Creative commons licenses: https://creativecommons.org/licenses/Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will removeaccess to the work immediately and investigate your claim.As in several previous studies, DSH was found to be fairly common in the two separate non-clinical samples of university students studied here, and is similar to the prevalences found when similar methodology has been used to assess DSH in previous research. The number of behaviors asked for and also the time-period measured is important for the overall estimate of DSH prevalence in a particular sample and have to be considered when interpreting results over different studies.The results from Sample 1 suggests that some extreme forms of DSH, such as “rubbed sandpaper on your body”, “dripped acid onto your skin”, “used bleach, comet, or oven cleaner to scrub your skin”, “rubbed glass into your skin” and “broken your own bones” are only reported by a very small proportion of respondents in non-clinical samples.As it have been suggested that DSH could be relatively unstable over time (Bjärehed & Lundh, 2008), and that DSH often start during early adolescence and then generally  dissipate over time lower prevalence-rates would be expected when only recent DSH is asked for. DSH reported during the last 6 months, might therefore be more relevant as an estimate of the prevalences of commonly found forms of DSH in non-clinical populationsThe correlation between DSH and anxiety and the elevated level of anxiety in the group of self-harming participants is consistent with the view of DSH as a symptom of psychopathology. It would also be consistent with the view that DSH could be a dysfunctional strategy to regulate negative emotion (i.e. anxiety). The relationship with mindfulness also fits this model as high mindfulness related to more functional emotional regulation, and low mindfulness would be found correlating to both DSH and elevated anxiety in this model.This is the first Swedish study reporting onset of DSH. Mean age of onset in Sample 1 was 16.1 years while the mean age of Sample 2 was lower, 13.5 years. One possible interpretation of this difference that would warrant further investigation is that the group with recent DSH, as compared to life-time DSH, are younger when they first engage in DSH, e.i. persons with a history of DSH, but no recent such behavior increase the mean age of onset for the group. This hypothesis should be explored in future studies as early onset of DSH might be indicatory of pervasive DSH.  Deliberate self-harm in Swedish university studentsJonas Bjärehed and Olof JohanssonDepartment of psychology / Division of clinical psychologyOnset and relationships with anxiety and mindfulnessPrevious research Present study MethodResultsTo date no Swedish data on the prevalence of DSH in university students  exists. Therefore, this study was planned in two steps:➡ First a shortened Swedish adaptation of the Deliberate Self-Harm Inventory - short (DSHI-s; Lund, Karim, & Quilsich, 2007) was used in a sample of university students. This version of the instrument screened for the life-time prevalence of a broad range of different forms of DSH and was thus used to establish if these behaviors indeed were present in university students. ➡ Second, a further shortened version of the instrument called the Deliberate Self-Harm Inventory  9-item version-revised (DSHI9-r; Bjärehed & Lund, 2008), that had previously been used with Swedish adolescents was administered to a second sample of university students. The reason for using the DSHI-9r was that a shorter instrument would be easier and quicker for participants to answer.Data reported in this study was collected on two separate occasions with about one year interval in two separate samples of university students at one Swedish University. PARTICIPANTSIn Sample 1 a total of 512 university students were recruited to respond to the questionnaire. After excluding participants with extensive missing data 500 (247 men and 252 women, 1 had not stated sex) remained. Age of respondents was between 18-49 years (mean age: 24.0, SD = 4.9).In Sample 2, a total of 187 university students (91 men and 95 women, 1 had not stated sex) between 19-45 years (mean age: 23.6, SD = 3.7) were recruited to answer the questionnaire.PROCEDUREIn both cases of data collection participants were approached on the University campus by research assistants. They were given general information about the study and asked to fill out the questionnaire. ConclusionsCutting wrists, arms, or body areasMinor cuttingBurning with cigarette, lighter or matchCarving words, pictures, etc. into skinSevere scratching, causing bleedingBiting yourself, so that the skin is brokenSticking sharp objects into the skinBanged head/Punching self, causing a bruisePreventing wounds from healingRubbed sandpaper on your body Dripped acid onto your skinScrubbed skin with bleach, comet, or oven cleanerRubbed glass into your skinBroken your own bones85 90 95 100NeverOccasional Self-HarmRepeated Self-HarmR e l a t i o n s h i p s between self-harm and Mindfulness and Anxiety respectively in 187 univers i ty studentsCutting wrists, arms, or body areasMinor cuttingBurning with cigarette, lighter or matchCarving words, pictures, etc. into skinSevere scratching, causing bleedingBiting yourself, so that the skin is brokenSticking sharp objects into the skinBanged head/Punching self, causing a bruisePreventing wounds from healing85 90 95 100No Self-Harm56,1 %Occasional Self-Harm30,1 %Repeated Self-Harm13,9 %No Self-Harm76,5 %Occasional Self-Harm18,7 %Repeated Self-Harm4,8 %02040600 54Deliberete Self-harmr = .26, p < .001r = -.21, p = .05MindfulnessAnxietyINSTRUMENTSThe Deliberate Self-Harm Inventory. The DSHI (Gratz, 2001) asks respondents to report how many times they have engaged in a number of self-harming behaviors. In Sample 1 a version of the DSHI that asks for the life-time occurrences of 16 different forms of DSH was used (Lundh et al. 2007). In Sample 2 a shortened version of the DSHI that asks for occurrences of 9 forms of DSH during the last 6 months  was used (Bjärehed & Lundh, 2008).The Mindful Attention Awareness Scale. The MAAS (Brown & Ryan, 2003) measures dispositional mindfulness, i.e. awareness of and attention to events and experience in the present moment. The MAAS is composed of 15 self-report items that asks how often participants experience different day-to-day experiences like “I could be experiencing some emotion and not be conscious of it until some time later.” on a 1 (almost always) to 6 (almost never) scale where high scores represent high degree of mindfulness.The Hospital Anxiety and Depression Scale. The HADS (Zigmond & Snaith, 1983) is a commonly used measure to detect states of depression and anxiety. The scale consists of 7 items that measur anxiety, like “I feel tense or wound up” and 7 items that measur depression, like “I still enjoy the things I used to enjoy”. Occurrence of life-time, occasional, and repeated self-harm in 5 0 0 u n i v e r s i t y studentsFrequencies of different forms of lifetime DSH in 512 university studentsO c c u r r e n c e o f o c c a s i o n a l a n d repeated self-harm during last 6 months in 187 univers i ty studentsFrequencies of different forms of DSH during last 6 months in 187 university studentsMean age, and range of reported first occurrence of DSH, as reported by participants in Sample 1 and 2 respectivelyDeliberate self-harm (DSH) can be defined as intentional self-induced harming of one´s own body resulting in relevant tissue damage (Flige et al., 2009).Such behaviors have received much interest in research and in literature-reviews during recent years (Nock, 2009).DSH typically has its onset in early adolescence and is strongly correlated with psychiatric symptoms, but occurs over many different disorders, as well as in non-clinical samples (Heath, et al. 2008; Nock, et al., 2006).DSH is generally viewed as a dysfunctional coping mechanism or as a non-adaptive strategy to regulate tension and other negative emotions used by some people (Klonsky, 2007).Regrettably, the research in this field has been obstructed by methodological shortcomings, such as the lack of a unison definition of DSH and reliable instruments to measure such behaviors. One attempt to amend these methodological problems has been the development of the Deliberate Self-Harm Inventory (DSHI; Gratz, 2001). Sample 1Sample 2%%REFERENCES Bjärehed, J., & Lundh, L. (2008). Deliberate Self-Harm in 14-Year-Old Adolescents: How Frequent Is It, and How Is It Associated with Psychopathology, Relationship Variables, and Styles of Emotional Regulation? Cognitive Behaviour Therapy, 37(1), 26-37.Brown, K.W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.Fliege, H., Lee, J., Grimm, A., & Klapp, B. F. (2009). Risk factors and correlates of deliberate self-harm behavior: A systematic review. Journal of Psychosomatic Research, 66(6), 477-493.Gratz, K. (2001). Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23(4), 253-263.Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008). An examination of nonsuicidal self-injury among college students. Journal of Mental Health Counseling, 30(2), 137-156.Klonsky, E. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(2), 226-239.Lundh, L., Karim, J., & Quilisch, E. (2007). Deliberate self-harm in 15-year-old adolescents: A pilot study with a modified version of the Deliberate Self-Harm Inventory. Scandinavian Journal of Psychology, 48(1), 33-42.Nock, M. (2009). Why do People Hurt Themselves? New Insights Into the nature and Functions of Self-Injury. Current Directions in Psychologival Science. In press. Nock, M., Joiner, T., Gordon, K., Lloyd-Richardson, E., & Prinstein, M. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144(1), 65-72.Zigmond AS, Snaith RP; The hospital anxiety and depression scale. Acta Psychiatric Scandinavica. 1983 67(6), 361-70.5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32M=16.1 (SD=4.1)Sample 1M=13.5 (SD=5.5)Sample 2YearsACKNOWLEDGMENTWe thank the following for their support with the preparations and data collection for this work:  Patrik Kapeller, Tommy Bank, Micaela García andSara Makboul.

Deliberate self-harm in Swedish university students – onset and relationships with anxiety and mindfulness

Abstract

Similar works

Full text

Available Versions

Lund University Publications