Dual harm: the importance of recognising the duality of self-harm and violence in forensic populations

Slade, Karen

doi:10.1177/0025802419845161

Cited by 17 publications

(40 citation statements)

References 16 publications

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“…Aggression is often seen as an unreasonable act in which an individual offends against others, consequently leading to a reactive response, typically in the form of containment and punishment orientated strategies (Slade, 2019). In contrast, self-harm is perceived as a sign of distress and an act against the self, which is more likely to elicit a care-giving response (Slade, 2019). Despite their historic separation, there is increasing evidence that self-harm and aggression are linked and co-occur.…”

Section: Dual-harmmentioning

confidence: 99%

“…There is a need to investigate whether dual-harm should be considered and treated separately from sole-harm behaviours. Furthermore, previous literature has not offered a definition of dual-harm that specifies how close in time self-harm and aggression must co-occur (Slade, 2018(Slade, , 2019Slade et al, 2020). According to working definitions, an individual may self-harm and be aggressive at different points during their lifetime, and this would be considered dual-harm.…”

Section: A Unique Clinical Construct?mentioning

confidence: 99%

“…While self-harm and aggression may initially seem distinct, research has consistently shown that these behaviours co-occur across various populations. The co-occurrence of self-harm and aggression during the course of an individual's lifetime has been termed "dual-harm" (Slade, 2019). There is emerging evidence to suggest that, compared to those who engage in selfharm alone or aggression alone ("sole-harm"), individuals who dual-harm may have distinct characteristics.…”

Section: Introductionmentioning

confidence: 99%

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The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

et al. 2021

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There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.

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Section: Dual-harmmentioning

confidence: 99%

Section: A Unique Clinical Construct?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

et al. 2021

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“…Suicide and violence represent a major concern in prisons with 87 suicides, 55,598 incidents of self-injurious behaviours and 34,223 assault incidents in England and Wales in 2018 (Ministry of Justice, 2019). Previous research on harm in prison has tended to focus on either harm to self (self-harm and suicide) or harm to others (violence and aggression), though more recently it has been recognised that it is important to focus on the duality of these risks (Slade, 2018(Slade, , 2019(Slade, , 2017. Slade (2018) has therefore advocated for further research to be conducted into the exploration of 'dual harm' in prisonerswhere an individual engages in both harm to self and harm to others.…”

Section: Introductionmentioning

confidence: 99%

Prison staff’s views and understanding of the role of emotions in prisoner suicide and violence

Hemming

Pratt

Shaw

et al. 2020

The Journal of Forensic Psychiatry & Psychology

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Suicide and violence are a major concern in prisons, and it has been suggested that alexithymia may be associated with these behaviours. Alexithymia can be defined as the inability to identify and describe emotions. This study aimed to explore staff's understanding and attitudes about identifying and discussing emotions in prisoner suicide and violence. Twenty prison staff across departments were interviewed about their understanding of how emotional difficulties contribute towards prisoner suicide and violence. Interviews were transcribed verbatim and analysed using thematic analysis. Analysis revealed five main themes and nine subthemes. Staff felt that prisoners struggled to identify, understand and communicate their emotions which led to intense and sudden outbursts of emotion. In turn, prisoners responded to these outbursts using two main maladaptive coping strategies; drug and alcohol use and harming self or others. This process was placed in a broader context of both upbringing and the prison environment. These findings therefore suggest that a change to prison regime and culture is crucial to encouraging prisoners to overcome difficulties with identifying, understanding and communicating emotions which, in turn, could help to reduce rates of suicide and violence in prison.

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“…11,13,14 Along with these figures come the complexities surrounding prisoners’ health and social care: 7 out of every 10 prisoners are said to present with two or more mental disorders, 15 with those displaying both self-harm and violent behaviour – termed as ‘dual harm’ – existing as a subset of this population. 16 In addition, one in six of the incarcerated population is ageing; this group typically exhibits complex medical needs and higher social-care dependencies compared to younger prisoners. 17,18 Overall, a combination of overcrowding and health complexities among this population has served to intensify the institutional instability further during the time of austerity.…”

Section: Imprisonment As a Political Choicementioning

confidence: 99%

The politics of austerity, imprisonment and ignorance: A case study of English prisons

Ismail

2020

Med Sci Law

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Dual harm: the importance of recognising the duality of self-harm and violence in forensic populations

Cited by 17 publications

References 16 publications

The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm

Prison staff’s views and understanding of the role of emotions in prisoner suicide and violence

The politics of austerity, imprisonment and ignorance: A case study of English prisons

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