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A sequence analysis of patterns in self-harm in young people with and without experience of being looked after in care
Armstrong, Marie Majumder, Pallab
Armstrong, Marie
Majumder, Pallab
Abstract
Objectives:Young people in the public care system (‘looked-after’ young people) have high levels of self-harm.
Design:This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (CaTS).
Methods:Young people in care (looked-after group: n = 24; 14–21 years) and young people who had never been in care (contrast group: n = 21; 13–21 years) completed the CaTS, describing sequences of factors leading to their first and most recent episodes of self-harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self-harm across 6 months.
Results:Young people in care reported feeling better immediately following their first episode of self-harm. However, fearlessness of death, impulsivity, and access to means were reported most proximal to recent self-harm. Although difficult negative emotions were salient to self-harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self-harm sequence 6 months prior to most recent self-harm.
Conclusions:Sequences of factors leading to self-harm can change and evolve over time, so regular monitoring and assessment of each self-harm episode are needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self-harm attempts, particularly for the young persons with experience of being in care, is recommended.
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Date
2017
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Article
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Self-injurious behaviour, Emotions, Depression
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Wadman, R., Clarke, D., Sayal, K., Armstrong, M., Harroe, C., Majumder, P., Vostanis, P. & Townsend, E. (2017). A sequence analysis of patterns in self-harm in young people with and without experience of being looked after in care. British Journal of Clinical Psychology, 56 (4), pp.388-407.
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This is the peer reviewed version of the following article: Wadman, R., Clarke, D., Sayal, K., Armstrong, M., Harroe, C., Majumder, P., Vostanis, P. & Townsend, E. (2017). A sequence analysis of patterns in self-harm in young people with and without experience of being looked after in care. British Journal of Clinical Psychology, 56 (4), pp.388-407, which has been published in final form at http://dx.doi.org/10.1111/bjc.12145. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving