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Problem-solving ability and repetition of deliberate self-harm: a multicentre study.

Carmel McAuliffe·Paul Corcoran·Helen S Keeley·Ella Arensman·Unni Bille-Brahe·Diego De Leo·Sandor Fekete·Keith Hawton·Heidi Hjelmeland·Margaret Kelleher·Ad J F M Kerkhof·Jouko Lönnqvist·Konrad Michel·Ellinor Salander-Renberg·Armin Schmidtke·Kees Van Heeringen·Danuta Wasserman
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Abstract

BACKGROUND: While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH. METHOD: As part of the WHO/EURO Multicentre Study on Suicidal Behaviour, 836 medically treated DSH patients (59% repeaters) from 12 European regions were interviewed using the European Parasuicide Study Interview Schedule (EPSIS II) approximately 1 year after their index episode. The Utrecht Coping List (UCL) assessed habitual responses to problems. RESULTS: Factor analysis identified five dimensions--Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions and Negative Expression. Passive-Avoidance--characterized by a pre-occupation with problems, feeling unable to do anything, worrying about the past and taking a gloomy view of the situation, a greater likelihood of giving in so as to avoid difficult situations, the tendency to resign oneself to the situation, and to try to avoid problems--was the problem-solving dimension most strongly associated with repetition, although this association was attenuated by self-esteem. CONCLUSIONS: The outcomes of the study indicate that treatments for DSH patients with repeated episodes should include problem-solving interventions. The observed passivity and avoidance of problems (coupled with low self-esteem) associated with repetition suggests that intensive therapeutic input and follow-up are required for those with repeated DSH.

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Adaptation, PsychologicalAdultFactor Analysis, StatisticalFemaleFollow-Up StudiesHumansIntentionMalePeriodicityProblem SolvingRecurrenceSelf-Injurious BehaviorSurveys and QuestionnairesJournal ArticleMulticenter Study

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Carmel McAuliffe, Paul Corcoran, Helen S Keeley, Ella Arensman, Unni Bille-Brahe, Diego De Leo, Sandor Fekete, Keith Hawton, Heidi Hjelmeland, Margaret Kelleher, Ad J F M Kerkhof, Jouko Lönnqvist, Konrad Michel, Ellinor Salander-Renberg, Armin Schmidtke, Kees Van Heeringen, Danuta Wasserman. 2005-09-29. Problem-solving ability and repetition of deliberate self-harm: a multicentre study.. https://doi.org/10.1017/s0033291705005945

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