Motivational Aspects of Deliberate Self-Poisoning in Adolescents

Abstract

A systematic study of 50 adolescent self-poisoners aged from 13 to 18 demonstrated considerable discrepancies between the reasons chosen by the subjects to explain the overdoses and those chosen by clinical assessors. Most adolescents indicated that they had been feeling lonely or unwanted, or angry with someone, and had taken the overdose to alleviate or demonstrate this distress. A third said they had wanted to die. In contrast, clinical assessors tended to attribute the overdose to punitive or manipulative reasons and suggested that only seven out of the 50 had wished to die. The adolescents rarely indicated that they had taken the overdose to get help; this may explain the resistance that may be shown to psychiatric intervention, that casts doubt on the possible effectiveness of preventive agencies. Modification of attitudes to both self-poisoning and early help-seeking may be a more effective means of prevention.

Why Do Adolescents Self-Harm?

“…This finding mirrors what has been reported elsewhere (Rodham, Hawton & Evans, 2004;Boergers, Spririto & Donaldson, 1998;Hawton, Cole, O'Grady & Osborn, 1982). What is more, those young people who reported self-harming as a result of psychological pain were 16 17 times more likely to repeat self-harm over the 6 month follow up period.…”

“…In addition, research has highlighted a number of risk (e.g., depression, hopelessness, bullying, sexual/physical abuse, exposure to the self-harm by others) and protective factors (e.g., good problem-solving skills, peer relationships), which gives some insight into why some adolescents are more vulnerable to self-harm than others (e.g., Fliege, Lee, Grimm, & Klapp, 2009;Gutierrez, 2006;Hawton, Saunders, & O'Connor, 2012;O'Connor, Rasmussen & Hawton, 2012); however, our understanding of the motives behind these behaviours remains limited. A more detailed appreciation is imperative for the development of interventions in this population (Hawton, Cole, O'Grady, & Osborn, 1982). 4 Motives for adolescent self-harm There is growing evidence that adolescents report multiple reasons for self-harm, and that the behaviour is primarily an expression of intolerable psychological pain.…”

How adolescents who cut themselves differ from those who take overdoses

“…This list of motives was an adapted version of that developed by Bancroft and colleagues [1] and used in several other studies, e.g. [18,27]. We have previously reported motives for self-harm acts as reported by adolescents who cut themselves and those taking overdoses [38] but included them in the present study for completeness.…”

Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury

“…According to community-based studies, self-injury (SI, SIB) including suicidal and non-suicidal self-injury (SSI, NSSI) is increasingly prevalent in secondary school reports and in community-based surveys of adolescents ranging from 2.2 to 15% [12,32,43]. However, although researchers do not include cases of violent SI in the statistics of DSH in the majority of studies [19][20][21], frequency data of SI may vary depending on whether impulsive or non-impulsive self-poisoning is considered self-injurious practice by the authors. Hungarian data from the ''Child and adolescent self harm in Europe (CASE)'' project studying the risk factors of youth suicide in a sample of more than 4,000 adolescents failed to discriminate between suicidal and self-injurious behaviour.…”