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Citation |
McAuliffe C, Corcoran P, Keeley HS, Arensman E, Bille-Brahe U, De Leo D, Fekete S, Hawton KE, Hjelmeland H, Kelleher M, Kerkhof AJ, Lonnqvist JK, Michel K, Renberg EL, Schmidtke A, van Heeringen CK, Wasserman D. Psychol. Med. 2005; 36(1): 45-55. |
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Affiliation |
National Suicide Research Foundation, Cork, Ireland. |
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Copyright |
(Copyright © 2005, Cambridge University Press) |
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DOI |
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PMID |
16194285 |
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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. |