Nonsuicidal self-injury (NSSI) has a high prevalence among the general undergraduate population, but as yet, no study has investigated the rate of NSSI among medical students despite the high levels of depression and suicidal ideation found in this population. Our study aimed to estimate the prevalence of NSSI and suicide attempts in German medical students and explore the associations between these behaviors and the five major personality traits. Seven hundred fourteen medical students (67% women; age range, 18-35 years; mean age, 23.1 years) participated in an online survey. We report a lifetime prevalence of 14.3% for NSSI and 1.5% for suicide attempt. The students with NSSI showed higher levels of neuroticism and openness to experience but lower levels of conscientiousness and extraversion on the NEO Five-Factor Inventory. Our results are in line with previous research from other countries regarding the prevalence of NSSI among students and its association with personality.
BackgroundEvaluating youth welfare services is vital, both because of the considerable influence they have on the development of children and adolescents, as well as owing to the extensive financial costs involved, especially for child residential care. In this naturalistic study we have undertaken to evaluate changes in various behaviors of young people who are in youth welfare institutions, not only by using standardized questionnaires, but also specifically modified goal attainment scales (GAS). These scales were meant to represent the pedagogical objectives of youth welfare professionals as well as the individual goals of the young people in care.MethodsGoal attainment scales were used to ascertain behavioral changes in 433 children and adolescents (age 6 to 18 years) in 25 youth welfare institutions (day care and residential care) in Germany. Social and individual goals were rated by young people and caregivers together on at least two occasions. In addition, to examine potential problems of children and adolescents, quality of life as well as mental health and behavior problems were identified by the caregiver and also by the youth using a self-report inventory.ResultsMany of the children and adolescents had experienced critical life events, problems in school, impaired quality of life, along with mental health and behavior problems (range: 41-87%). During their stay in day care or residential care institutions, children and adolescents showed some improvement in social goals (Cohen’s d = 0.14-0.44), especially those young people with deficits at the beginning, and with regard to mental health and problem behavior (d = 0.10-0.31). For individual goals, progress was even more pronounced (d = 0.75). Improvements to social goals were more pronounced if mental health and behavior problems decreased. This link to changes in behavioral and emotional problems was only ascertained to a limited extent for individual goals.ConclusionsYoung people residing in youth welfare institutions achieved individual and social goals and improved with regard to behavior problems. The applied goal attainment scales are well suited for measuring individual change in children and adolescents and constitute a relevant addition to established instruments. Furthermore, their advantages include cooperative goal setting, the assessment of goals by caregivers and young people, and congruence with the pedagogical objectives of professionals.
ZusammenfassungIm stationären und ambulanten psychotherapeutischen Setting werden qualitätssichernde Maßnahmen zunehmend gefordert, um die erheblichen gesellschaftlichen Kosten rechtfertigen zu können; es ist ein Anliegen, Behandlungen zunehmend auf ihre Effektivität hin zu untersuchen. Dabei muss geklärt werden, welche Kriterien für die Wirksamkeit angelegt und mit welchen Methoden diese erfasst werden. Meist kommen standardisierte Selbst- und Fremdbeurteilungsinstrumente zum Einsatz, die ökonomisch angewendet werden können. Individuelle Ziele von Patienten, die während der Behandlung erreicht wurden, werden dadurch teilweise nur unzureichend erfasst. Das Goal Attainment Scaling (GAS) stellt eine Methode dar, mit deren Hilfe das Erreichen konkreter, individueller persönlicher Ziele im Verlauf einer Intervention gemessen werden können. Vorteil gegenüber der rein qualitativen Befragung ist, dass gleichzeitig mittels standardisierter Werte eine Vergleichbarkeit über verschiedene Personen und Treatments hinweg gemacht werden kann. In verschiedenen Therapiestudien konnte gezeigt werden, dass das GAS in Kombination mit standardisierten Fragebögen eine wertvolle, effektive und ökonomische Bereicherung der wissenschaftlichen Qualitätssicherung und Evaluationsforschung darstellt.
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