Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Autism and self harm, by caroline hattersley


Published on

Autism and self harm, by Caroline Hattersley.

Published in: Health & Medicine
  • Be the first to comment

Autism and self harm, by caroline hattersley

  1. 1. Self-harm in women and girls with autism Caroline Hattersley MEd MIoD Head of Information, Advice and Advocacy
  2. 2. Content <ul><li>Defining self-harm </li></ul><ul><li>Classification of self-harm and self-injury </li></ul><ul><li>Forms of self-harm </li></ul><ul><li>Prevalence and theories </li></ul><ul><li>Reasons people self-harm </li></ul><ul><li>Personal characteristics and risk of self-harming </li></ul><ul><li>Self harm and autism </li></ul><ul><li>Anya’s story </li></ul><ul><li>A nurse’s perspective </li></ul><ul><li>Conclusions </li></ul><ul><li>Comments and questions </li></ul>
  3. 3. Defining self-harm <ul><li>Self-harm is a broad term. “People may injure or poison themselves by scratching, cutting or burning their skin, by hitting themselves against objects, taking a drug overdose, or swallowing or putting other things inside themselves”. (Mind 2010) </li></ul>
  4. 4. Classifying self-harm and self-injury <ul><li>Four categories of self-harm/self-injury </li></ul><ul><li>Stereotypic </li></ul><ul><li>Major </li></ul><ul><li>Compulsive </li></ul><ul><li>Impulsive </li></ul><ul><li>(Simeon and Favazza 2001) </li></ul>
  5. 5. Forms of self-harm <ul><li>Cutting </li></ul><ul><li>Stabbing </li></ul><ul><li>Scratching the skin </li></ul><ul><li>Placement of sharp objects under the skin </li></ul><ul><li>Biting the inside of the mouth </li></ul><ul><li>Picking at sores and reopening wounds </li></ul><ul><li>Burning the skin with heat or chemicals </li></ul><ul><li>Pulling hair out </li></ul><ul><li>Bruising or breaking bones by hitting </li></ul><ul><li>Using ligatures to restrict blood flow </li></ul><ul><li>Ingesting toxins or objects </li></ul>
  6. 6. Forms of self-harm <ul><li>Arms and wrists - 74% </li></ul><ul><li>Legs – 44% </li></ul><ul><li>Abdomen - 25% </li></ul><ul><li>Head - 23% </li></ul><ul><li>Chest and breasts - 18% </li></ul><ul><li>Genitals - 8% </li></ul><ul><li>(Favazza and Conterio 1989) </li></ul>
  7. 7. Prevalence <ul><li>10% of 15-16 year olds have self-harmed (normally by cutting) (Mind 2010). </li></ul><ul><li>As many incidences of self-harm are kept secret and do not come to the attention of health professionals- figures are likely to be an under estimate (Hawton et al 2002a - cited NICE 2004 ); Meltzer et al 2002b - Cited NICE 2004 ). </li></ul><ul><li>National survey suggested between 4.6 - 6.6% have self-harmed. </li></ul><ul><li>(Meltzer et al 200b - Cited NICE 2004 ). </li></ul><ul><li>In a school survey 13% of 15-16 year olds stated that they had self-harmed. (Hawton et al 2002b - Cited NICE 2004 ). </li></ul><ul><li>Girls are more likely to self-harm than boys (Mind 2010) </li></ul>
  8. 8. Theories <ul><li>“ There is an unhelpful circularity in that self-harm is considered to be one of the defining features of both borderline and histrionic personality disorder”. (NICE 2004). </li></ul><ul><li>Self-harm is not usually an attempt at committing suicide, but a way of expressing deep emotional feelings, such as low self-esteem. It is also a way to cope with traumatic events or situations, such as the death of a loved one, or an abusive relationship. Self-harm is not an illness, it is an expression of personal distress. (Department of Health 2009). </li></ul><ul><li>The pain theory - when self injurious behaviour occurs the body produces chemical substances called opioids which act as an analgesia. (Ghaziuddin 2005). </li></ul><ul><li>The addiction theory – when the brain becomes addicted the endorphins that the body releases during episodes of self harm (Ghaziuddin 2005). </li></ul>
  9. 9. Possible reasons <ul><li>To demonstrate self hatred or self-loathing </li></ul><ul><li>To punish oneself. This can be specific or non-specific </li></ul><ul><li>To release emotions that can not be expressed in any other way </li></ul><ul><li>To prevent/stop/control intrusive thoughts or distressing flashbacks </li></ul><ul><li>To prevent suicide attempts </li></ul><ul><li>To see blood </li></ul><ul><li>To feel pain </li></ul><ul><li>To stop or calm ones thoughts </li></ul><ul><li>Reasons and methods for self-harming may differ (NICE 2004). </li></ul>
  10. 10. Personal characteristics that increase risk of self-harm <ul><li>Impairment in the ability to problem solve (Sadowski and Kelly 1993) </li></ul><ul><li>Reduced focus on the future (Orbach, Bar-Joseph and Dror (1990) </li></ul><ul><li>Effectiveness of problem solving (Hawthorn et al. 1999) </li></ul><ul><li>Lack of concern for danger (Shaffer et al 1988) </li></ul><ul><li>Presence of depressive symptoms and disorders (Kovacs, Goldston and Gatsonis 1993) </li></ul>
  11. 11. Self-harm and autism <ul><li>“Children with ‘higher-functioning’ ASD may deliberately self-harm, </li></ul><ul><li>for example by cutting, as a way of coping with anxiety and feelings </li></ul><ul><li>of being ‘different’”. </li></ul><ul><li>(NAS 2011) </li></ul>
  12. 13. A nurse's experience
  13. 14. Conclusions <ul><li>More research on autism and self-harm </li></ul><ul><li>Advice on self-harming to be accessible to people with autism </li></ul><ul><li>Better training and support for professionals </li></ul><ul><li>Joint working across services </li></ul>
  14. 15. <ul><li>“The myth that self mutilation is an attention-seeking device is purely that - a myth. In fact it is a very personal and private affair.”  </li></ul><ul><li>Jackson (2002) </li></ul>