Parents’ Attitudes Toward and Experience of Non-Suicidal Self-Injury in Adolescents: A Qualitative Study

Fu, Xi; Yang, Jiaxin; Lin, Jingjing; Peng, Yao; Shen, Yidong; Ou, Jianjun; Li, Yamin; Chen, Runsen

doi:10.3389/fpsyt.2020.00651

Cited by 31 publications

(59 citation statements)

References 34 publications

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“…However, participants did not receive sufficient attention and appropriate support from their parents, teachers and friends. 26 Similar to a previous study in the UK, our participants felt patronised and ignored. 27 Some parents of our adolescents considered self-injury to be a shameful behaviour, and these adolescents felt humiliated by their parents.…”

Section: Discussionsupporting

confidence: 75%

A qualitative study of how self-harm starts and continues among Chinese adolescents

et al. 2020

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Background It is essential to investigate the experiences behind why adolescents start and continue to self-harm in order to develop targeted treatment and prevent future self-harming behaviours. Aims The aims of this study are to understand the motivations for initiating and repeating nonfatal self-harm, the different methods used between first-time and repeated self-harm and the reasons that adolescents do not seek help from health services. Methods Adolescents with repeated nonfatal self-harm experiences were recruited to participate in individual, semi-structured qualitative interviews. The interviews were analysed with interpretative phenomenological analysis. Results We found that nonfatal self-harm among adolescents occurred comparatively early and was often triggered by specific reasons. However, the subsequent nonfatal self-harm could be causeless, with repeated self-harm becoming a maladaptive coping strategy to handle daily pressure and negative emotions. The choice of tools used was related to the ease of accessibility, the life-threatening risk and the size of the scars. Adolescents often concealed their scars on purpose, which made early identification insufficient. Peer influence, such as online chat groups encouraging self-harm by discussing and sharing self-harm pictures, could also lead to increased self-harm. The results also included participants’ opinions on how to stop nonfatal self-harm and their dissatisfaction with the current healthcare services. Conclusions The current study provides important implications both for early identification and interventions for adolescents who engage in repeated nonfatal self-harm, and for individualising treatment planning that benefits them. It is also worthwhile to further investigate how peer influence and social media may affect self-harm in adolescents.

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Section: Discussionsupporting

confidence: 75%

A qualitative study of how self-harm starts and continues among Chinese adolescents

et al. 2020

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“…Self-injurious behavior among young people applies as an important risk factor for the prediction of a borderline personality disorder ( 14 ). Unfortunately, many parents have no knowledge of NSSI and its treatment and thus suffer from great emotional stress because of it ( 15 ). An additional risk factor is the strong association between NSSI and suicidal behavior ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Emotional Reactivity and Family-Related Factors Associated With Self-Injurious Behavior in Adolescents Presenting to a Child and Adolescent Psychiatric Emergency Service

et al. 2021

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Background: Adolescents presenting in a child and adolescent psychiatric emergency service show various psychiatric disturbances, most commonly suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI). It was postulated that especially disturbed emotion regulation contributes to self-injurious behavior of young people. This study aims to investigate the relevance of emotional reactivity (ER), as part of emotion regulation, during an acute crisis, how it relates to self-injurious behavior reinforcement and how a family as well as peers' history of self-injurious behavior are associated with self-injurious behavior of presenting adolescents. Additionally, crisis-triggering background factors were evaluated from the perspective of patients and their caregivers.Methods: A consecutive sample of 86 adolescents aged 11–18 years presenting to the emergency outpatient department due to self-injurious thoughts and behavior received a pretreatment psychiatric evaluation. Among other psychometric measures and structured clinical interviews, ER was measured via the Emotion Reactivity Scale (ERS). Family-related aspects were collected both through evaluation of history and through questionnaires filled in by custodians or parents.Results: Data analysis revealed that suicidal ideation was significantly related to family history with self-injurious behavior in comparison with a family background without such a history. A significant positive correlation was apparent between the ERS sensitivity score and occurrence of NSSI within the past year. A relationship between the ERS and distinct types of reinforcement as a motivation factor for NSSI was found. Post-hoc tests revealed a significant difference between boys and girls when no positive peers' history is present with boys having lower ERS scores than girls, but no difference when both groups had friends engaging in self-injurious behavior. There was only moderate agreement between parents and their children in naming reasons for the current crisis involving NSSI.Conclusion: Emotional regulation, especially ER, has an influence on patients' acute psychiatric symptomatology and when experiencing an acute crisis should be brought into focus early at psychiatric assessment. A history of self-injurious behavior taken from patient's family members and close circle of friends and agreement on reasons for the crisis should be routinely included in the exploration of a patient presenting with self-injurious behavior.

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“…Most parents lack related knowledge and awareness of mental health. Previous research found that when parents know their children engaged in self-harm, their first reaction is to ignore [ 29 ]. Thus, until their children have serious SRBs, professional institutions were the last resort for parents.…”

Section: Discussionmentioning

confidence: 99%

Parents’ and medical staff’s experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study

Yang

Shen

et al. 2021

BMC Psychiatry

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Background Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff’s perspective in China. The study aims to explore parents’ and the front-line medical staff’s experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China. Design Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system. Methods Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis. Results Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceive patients with SRBs as difficult to engage (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service). Conclusion This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.

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Parents’ Attitudes Toward and Experience of Non-Suicidal Self-Injury in Adolescents: A Qualitative Study

Cited by 31 publications

References 34 publications

A qualitative study of how self-harm starts and continues among Chinese adolescents

A qualitative study of how self-harm starts and continues among Chinese adolescents

Emotional Reactivity and Family-Related Factors Associated With Self-Injurious Behavior in Adolescents Presenting to a Child and Adolescent Psychiatric Emergency Service

Parents’ and medical staff’s experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study

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