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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)45-55
Number of pages11
JournalPsychological Medicine
Volume36
Issue number1
DOIs
Publication statusPublished - Jan 2006

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