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Open Access Self-Harm Intentions: Can They Be Distinguished Based Upon a History of Childhood Physical and Sexual Abuse? L'intention de s'automutiler : les antécédents de sévices corporels et sexuels constituent–ils un facteur distinctif?

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Abstract:

A non-experimental, comparative design is used to measures self-harm intention in clients with and without a history of childhood physical and sexual abuse (CP/SA) presenting to an emergency department with an episode of self-harm behaviour. The traditional suicide literature identifies the key intention concepts of wish-to-die, lethality, hopelessness, and depression. However, the trauma literature understands self-harm behaviour to be an adaptive response to CP/SA and as such possibly helpful for managing intense affect and dissociation. The findings of this study demonstrate that a CP/SA history is not a distinguishing factor in self-harm intention. Almost all participants, regardless of abuse history, gave multiple reasons for their self-harm behaviour, in addition to or other than the wish-to-die. The striking similarity between the non-abused and abused groups with regard to self-harm intention challenges clinicians to assess for the full range of intentions of people who engage in self-harm and suicidal behaviour.

French
Nous avons suivi une méthodologie non expérimentale et comparative afin d'examiner l'intention de s'automutiler chez des clients avec et sans antécédents de sévices corporels et sexuels pendant l'enfance, qui se sont présentés à l'urgence après un épisode d'automutilation. La documentation sur le suicide évoque habituellement certains thèmes prédominants comme le désir de mort, la létalité, le désespoir et la dépression. Dans les études sur les traumatismes, toute fois, l'automutilation est présentée comme une réaction adaptative aux sévices subis à un jeune âge, qui permettrait peut-être de maîtriser un affect intense et la dissociation. Selon nos observations, des antécédents de sévices pendant l'enfance ne constituent pas un facteur distinctif relativement à l'intention de s'automutiler. Peu importe leurs antécédents, presque tous les participants ont donné des raisons multiples pour expliquer leur comportement outre le désir de mort. Les ressemblances frappantes relevées entre les deux groupes devraient amener les cliniciens à s'interroger sur l'éventail complet des raisons qui motivent le passage à l'acte en matière d'automutilation et de comportement suicidaire.

Keywords: CHILD ABUSE; MENTAL HEALTH/PYSCHOSOCIAL; PSYCHIATRIC NURSING; STRESS AND COPING; THEORY

Document Type: Research Article

Publication date: December 1, 2010

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