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Problem-solving ability and repetition of deliberate self-harm: a multicentre study.
Carmel McAuliffe1, Paul Corcoran, Helen S Keeley
1National Suicide Research Foundation, Cork, Ireland. carmel.nsrf@iol.ie
Psychological Medicine
|October 1, 2005
Summary
Individuals with repeated deliberate self-harm (DSH) often use passive-avoidance problem-solving strategies. Interventions should target these coping mechanisms and low self-esteem in repeat DSH patients.
Area of Science:
- Psychiatry
- Psychology
- Public Health
Background:
- Deliberate self-harm (DSH) is a significant public health concern.
- Previous research indicates problem-solving deficits in individuals who self-harm.
- Few studies differentiate between first-time and repeat DSH episodes regarding problem-solving.
Purpose of the Study:
- To investigate the association between specific problem-solving dimensions and repeated deliberate self-harm (DSH).
Main Methods:
- Utilized data from the WHO/EURO Multicentre Study on Suicidal Behaviour.
- Interviewed 836 medically treated DSH patients (59% repeaters) using the European Parasuicide Study Interview Schedule (EPSIS II).
- Assessed habitual problem-solving responses using the Utrecht Coping List (UCL).
Main Results:
- Factor analysis identified five problem-solving dimensions: Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions, and Negative Expression.
- Passive-Avoidance, characterized by inaction, worry, and resignation, was most strongly linked to DSH repetition.
- The association between Passive-Avoidance and repetition was weakened by higher self-esteem.
Conclusions:
- Problem-solving interventions are crucial for DSH patients experiencing repeat episodes.
- Passivity, avoidance, and low self-esteem are key factors in DSH repetition, necessitating intensive therapeutic support and follow-up.