1. Deliberate Self Harm Prof Craig Jackson Head of Psychology health.bcu.ac.uk/craigjackson

3. Deliberate Self Harm Behavioural Markers Female:Male ratio. 2:1 15-21 largest age group At risk: Female Isolated Negative life events Pre-existing psychiatric conditions Familial history Intolerable stress Impulsive, immature, aggressive personality

4. Additional Conditions High levels of dissociation ("going numb") Borderline Personality Disorder Substance abuse disorders Post-Traumatic Stress Disorder Antisocial Personality Disorder (int. explosive) Eating Disorders Mood Disorders

5. Deliberate Self Harm

7. Art form

8. Follie a deux

9. Celebrity cache

11. Deliberate Self Harm

14. Mechanics Cutting Forearms Wrists Genitalia Burning Banging Pills / Toxins Sharps 4% of English hospital admissions (Carroll 2006) Fifth biggest cause of admissions

15. Use of an rubbers or friction to burn skin Burning with heat, chemicals or cigarettes Bruising Pulling fingernails and toenails Refusing to take needed medications Hitting self Banging one's head Ingesting sharp or toxic objects Picking scabs / keeping wounds from healing Deep scratching Inserting objects into body openings Inserting needles or sharp objects under the skin Some forms of hair-pulling Tooth-pulling Bone-breaking Carving symbols, names or images

16. Premeditation Prohibits sympathy Saving pills / blades Avoiding detection Long sleeves Bandage / dressing stockpiles Prepared excuses

18. Deliberate Self Harm

19. Motivation 1 Cry for help Attention seeking Coping strategy Destruction Escapism Control & Mastery Punish others Loved ones Family Failing relationships

20. Motivation 2 Negative self-esteem Hypersensitivity to rejection Supressed anger and sadness Chronic Anxiety Relationship problems Poor functioning in school, home or work More common in females than males Typical onset is at puberty History of physical and/or sexual abuse Average to high intelligence Middle to upper-class background

21. Motivation 3 Feels "empty" and isolated Drug or alcohol abuse Early history of medical illness or surgical procedures requiring hospitalization Imprisonment or institutionalization in drug treatment centres Inability to express or tolerate negative feelings Poor academic performance or truancy Has a background of emotional neglect Secondary Gain

22. Factitious Injury Feigned physical / psychological symptoms Aimed to receive medical / psychological care Mostly female, many working in healthcare Don't confront without good evidence Supportive confrontation Aware of role of behaviour in illness Offer psychological help Patients may stop but usually move on