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Nonsuicidal Self Injury

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by

Emily Pudlinski

on 22 May 2015

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Transcript of Nonsuicidal Self Injury

How do I assess for NSSI?
HIRE model
Clothing
Baggy, wearing long pants or long-sleeved shirts when it is warm out, making certain clothing does not move to reveal forearms
Build rapport
Psychosocial Functions of NSSI
Reasons for NSSI
Release of endorphins and other chemicals
Childhood abuse or trauma
Emotional dysregulation
To preserve life
What is NSSI?

No different than:
Exercising
Talking with a peer
Or any other manner of coping with life stresses
Nonsuicidal Self-Injury
True or False:
The age of onset for cutting behaviors is 11 years old and older.
False: The actual age of onset can be as young as 7 years old.
True or False:
Cutting is the only form of self-injury
False:
Self-injury includes, cutting, burning, interfering with the healing of wounds, and banging.
True or False:
One half of all adolescents will self-harm at least once.
True and False:
Depending on the source, estimates range from 5-66%.
True or False:
There is a relationship between NSSI and Suicide.
True: The relationship between NSSI and Suicide is complicated. While individuals using NSSI are at a higher risk for suicide, NSSI does not mean the individual is suicidal. NSSI can be used as a way to prevent suicidal ideation and intent.
True or False:
NSSI is addicting
True:
NSSI causes the release of chemicals in the brain such as dopamine and endorphins which can be addicting.
NSSI is defined as any behavior used to deliberately inflict damage to one's body without social sanction or intent to die.

NSSI can manifest as:
cutting
burning
scratching
interfering with wound healing
inserting objects in skin
bruising
bone breaking
hair-pulling
infecting onseself
Appropriate Terminology
self-harm
use reflective terminology to avoid appearing judgmental

Inappropriate terminology
self-mutilation
Adaptive coping mechanisms take longer to work and seem less effective than maladaptive coping mechanisms
Adaptive coping mechanisms should be use in place of maladaptive
ADAPTIVE VS. MALADAPTIVE COPING MECHANISMS
Examples of adaptive coping mechanisms:
Guided Imagery
Journaling
Using Ice Cubes
Talking
Exercise
Distraction
H
istory
I
nterest in change
R
easons for behavior
E
xposure to Risk
How are NSSI and Suicidal Behavior Related?
NSSI does not mean an individual is suicidal, but a suicide assessment should be given and the severity of the wounds should be evaluated to determine if medical attention is required.
One does not precipitate the other.
There is a higher risk for recurrent suicidal behavior when NSSI occurs after a suicide attempt.
Suicidal behavior includes some intent to die.
NSSI and suicidal behavior are on a spectrum of behavior that is self-destructive.
NSSI and suicidal behavior function differently on a neurobiological level, satisfy different motivations, and respond to different treatments.
NSSI and suicidal behavior are related, but separate phenomena.
NSSI tends to be more chronic than suicidal behavior.
NSSI can be used as a means to preserve an individual's life.
WHAT CAN I DO?
Form a connection and build rapport
Ask questions
Educate the student and parents
Strategies
Guided Imagery
Protective shield
Soothing Light
Narrative Therapy
Ice cubes
Write the name of a loved one on body part that is usually injured
Paper chain project
Butterfly Project
Online Resources
http://sioutreach.org/
References

True or False:
NSSI is typically an impulsive behavior
True: NSSI typically begins only one hour after having thoughts of self-injury
True or False:
Adolescents who self-injure will share instruments such as razor blades
True: it is important to educate students on the dangers of self-injuring as well as on caring for wounds and not sharing instruments
Brian Ackerman, MA, IMH11182 & Emily Pudlinski, UNF Intern
Brent, D. (2011). Nonsuicidal self-injury as a predictor of suicidal behavior in depressed adolescents [editorial]. American Journal of Psychiatry, 168, 452-454.
Buser, T., & Buser, J. (2013). The HIRE model: A tool for the informal assessment of nonsuicidal self-injury. Journal of Mental Health Counseling, 35(3), 262-281.
Catledge, C., Scharer, K., & Fuller, S. (2012). Assessment and identification of deliberate self-harm in adolescents and young adults. Journal for Nurse Practitioners, 8(4), 299-305.
Choate, L. H. (2012). Counseling adolescents who engage in nonsuicidal self-injury: A dialectical behavior therapy approach. Journal of Mental Health Counseling, 34, 56-70.
Darosh, A., & Lloyd-Richardson, E. (2013). Exploring why students self-injure: the functions of nonsuicidal self-injury. School Psychology Forum, 7(4), 111-120
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Taylor, J., Peterson, C., &Fischer, S. (2012). Motivations for self-injury, affect, and impulsivity: A comparison of individuals with current self-injury to individuals with a history of self-injury. Suicide & Life-Threatening Behavior, 42(6), 602-613.
Wells, A., & Axe, J. (2013). A three-tiered approach for addressing nonsuicidal self-injury in the classroom. 35-43.
Whitlock, J., Muehlenkamp, J., Eckenrode, J., Purington, A., Abrams, G., Barreira, P., & Kress, V. (2013). Nonsuicidal self-injury as a gateway to suicide in young adults. Journal of Adolescent Health, 52(4), 486-492.
Whitlock, J., & Rodham, K. (2013). Understanding nonsuicidal self-Injury in youth. School Psychology Forum, 7(4), 93-110.

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