Nonsuicidal Self-Injury E-Book

E. David Klonsky

• Herausgeber: Hogrefe Publishing
• Kategorie: Fachliteratur
• Serie: Advances in Psychotherapy - Evidence-Based Practice
• Sprache: Englisch

Seitenzahl: 226

Veröffentlichungsjahr: 2011

Beschreibung

Nonsuicidal self-injury (NSSI) is a baffling, troubling, and hard to treat phenomenon that has increased markedly in recent years. Key issues in diagnosing and treating NSSI adequately include differentiating it from attempted suicide and other mental disorders, as well as understanding the motivations for self-injury and the context in which it occurs. This accessible and practical book provides therapists and students with a clear understanding of these key issues, as well as of suitable assessment techniques. It then goes on to delineate research-informed treatment approaches for NSSI, with an emphasis on functional assessment, emotion regulation, and problem solving, including motivational interviewing, interpersonal skills, CBT, DBT, behavioral management strategies, delay behaviors, exercise, family therapy, risk management, and medication, as well as how to successfully combine methods.

Leseprobe

Nonsuicidal Self-Injury

About the Authors

E. David Klonsky, PhD, is Assistant Professor of Psychology at the University of British Columbia in Vancouver, Canada, and President of the International Society for the Study of Self-injury (ISSS; ISSSweb.org). His research examines nonsuicidal self-injury, suicide, and disorders of emotion, and he has published more than 40 articles and book chapters. His scientific and professional contributions have been recognized by awards from the American Psychological Foundation and the Society of Clinical Psychology (Division 12, American Psychological Association).

Jennifer J. Muehlenkamp, PhD, is Assistant Professor of Psychology at the University of Wisconsin-Eau Claire and licensed clinician specializing in treating suicidal and NSSI behavior. She has published over 40 research articles and book chapters on Nonsuicidal Self-Injury, Suicide, and other related disorders. Her contributions to the field have been recognized by awards from the American Association of Suicidology, and she is a founding member of the International Society for the Study of Self-Injury.

Stephen P. Lewis, PhD, is Assistant Professor in Clinical Psychology at the University of Guelph in Ontario, Canada. His research examines the role of the Internet and social media on nonsuicidal self-injury (NSSI), NSSI functions, and ways to promote help-seeking and mental health literacy. In addition to publishing in scholarly journals, Dr. Lewis’ research has been featured in national and international media outlets, including The New York Times, Time, CNN, USA Today, ABC, CBS, The Globe and Mail, and the BBC.

Barent Walsh, PhD, is Executive Director of The Bridge, a human service agency comprised of 40 programs headquartered in Worcester, MA. He has a faculty appointment at Harvard University and has previously taught at Boston College and Simmons College. He is the author of the book, Treating Self-Injury: A Practical Guide. For his contributions to the field of suicidology, he has received several awards, including a “Lifetime Achievement Award” from the Massachusetts Chapter of the National Association of Social Workers.

Advances in Psychotherapy – Evidence-Based Practice

Series Editor

Danny Wedding, PhD, MPH, Professor of Psychology, California School of Professional Psychology / Alliant International University, San Francisco, CA

Associate Editors

Larry Beutler, PhD, Professor, Palo Alto University / Pacific Graduate School of Psychology, Palo Alto, CA

Kenneth E. Freedland, PhD, Professor of Psychiatry and Clinical Health Psychology, Washington University School of Medicine, St. Louis, MO

Linda C. Sobell, PhD, ABPP, Professor, Center for Psychological Studies, Nova Southeastern University, Ft. Lauderdale, FL

David A. Wolfe, PhD, RBC Chair in Children’s Mental Health, Centre for Addiction and Mental Health, University of Toronto, ON

The basic objective of this series is to provide therapists with practical, evidence-based treatment guidance for the most common disorders seen in clinical practice – and to do so in a “reader-friendly” manner. Each book in the series is both a compact “how-to-do” reference on a particular disorder for use by professional clinicians in their daily work, as well as an ideal educational resource for students and for practice-oriented continuing education.

The most important feature of the books is that they are practical and “reader-friendly:” All are structured similarly and all provide a compact and easy-to-follow guide to all aspects that are relevant in real-life practice. Tables, boxed clinical “pearls”, marginal notes, and summary boxes assist orientation, while checklists provide tools for use in daily practice.

Nonsuicidal Self-Injury

E. David Klonsky

University of British Columbia, Vancouver, BC, Canada

Jennifer J. Muehlenkamp

University of Wisconsin – Eau Claire, WI, USA

Stephen P. Lewis

University of Guelph, ON, Canada

Barent Walsh

The Bridge of Central Massachusetts, Worcester, MA, USA

Library of Congress Cataloging information for the print version of this book is available via the Library of Congress Marc Database

Cataloging data available from Library and Archives Canada

© 2011 by Hogrefe Publishing

http://www.hogrefe.com

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Format: EPUB

ISBN 978-1-61334-337-1

Table of Contents

1         Description

1.1         Terminology

1.2         Definition

1.2.1      Conceptually Distinct Behaviors

1.2.2      A Behavior or a Diagnosis?

1.3         Epidemiology

1.3.1      Rates

1.3.2      Sex Differences

1.3.3      Ethnicity

1.3.4      Summary

1.4         Course and Prognosis

1.4.1      Longitudinal Studies

1.4.2      Cross-Sectional Studies

1.4.3      Summary

1.5         Differential Diagnosis

1.5.1      Suicidality

1.5.2      Borderline Personality Disorder

1.5.3      Other Behaviors and Diagnoses

1.6         Comorbidities

1.6.1      Borderline Personality Disorder

1.6.2      Psychiatric Illness

1.6.3      Concomitant Personality Factors

1.6.4      Nondiagnostic Comorbidities

1.6.5      Summary

1.7         Assessment

1.7.1      Assessor’s Demeanor

1.7.2      Domains of Interest

1.7.3      Assessment Instruments

1.7.4      Summary

2         Theories and Models of the Disorder

2.1         Psychological

2.1.1      Emotion Dysregulation

2.1.2      Self-Derogation

2.2         Social

2.2.1      Social Deficits

2.2.2      Social Influences

2.2.3      Social Functions

2.3         Biological

2.3.1      Endogenous Opioids

2.3.2      Serotonin

2.3.3      Other Biological Factors

2.4         Psychodynamic

3         Diagnosis and Treatment Implications

3.1         Differentiating Experimental NSSI from Clinically Severe NSSI

3.2         Level of Treatment

3.3         Target of Treatment

4         Treatment

4.1         Research Review

4.2         Methods of Treatment

4.2.1      Functional Assessment

4.2.2      Motivational Interviewing

4.2.3      Emotion Regulation

4.2.4      Problem Solving

4.2.5      Interpersonal Skills

4.2.6      Psychodynamic Therapies Addressing Attachment and Interpersonal Relationships

4.2.7      Self-Derogation and Cognitive Distortions

4.2.8      Behavioral Management Strategies

4.2.9      NSSI Delay Behaviors / Means Restriction

4.2.10    Exercise

4.2.11    Family Therapy

4.2.12    Risk Management

4.2.13    Medication

4.3         Mechanisms of Action

4.4         Efficacy and Prognosis

4.5         Variations and Combinations of Methods

4.5.1      Combining Methods

4.5.2      Group Treatment

4.6         Problems in Carrying Out Treatment

4.6.1      Managing Therapist Reactions to NSSI

4.6.2      Rapport and Trust Around a Sensitive Behavior

4.6.3      Requests for Immediate Cessation of NSSI

4.6.4      Confidentiality

4.6.5      Client Motivation

4.6.6      Peer Influences and Contagion

4.6.7      Viewing Wounds

4.6.8      Family Concerns

4.7         Multicultural Issues

5         Case Vignettes

5.1         Case Vignette 1: Amber

5.2         Case Vignette 2: James

6         Further Reading

7         References

8         Appendices: Tools and Resources

1

Description

Once thought to occur primarily in mental hospitals and group homes, NSSI frequently occurs in the general population, especially adolescents

Nonsuicidal self-injury (NSSI) is a baffling and troubling phenomenon because it involves people recurrently hurting their bodies for reasons that are complex and hard to treat. Rates of NSSI have markedly increased over the past decade, especially among adolescents and young adults (Muehlenkamp, Williams, Gutierrez, & Claes, 2009). Once thought to occur primarily in mental hospitals and group homes, NSSI is now frequently encountered in the general population such as among middle and high school and university students. Research has documented NSSI in secondary schools (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007), elite universities (Whitlock et al., 2006), and high-functioning military recruits (Klonsky, Oltmanns, & Turkheimer, 2003). In a 1995 study, almost 50% of therapists reported treating a client with NSSI, and in light of increasing rates of NSSI, this figure is likely to be considerably higher today (Suyemoto & MacDonald, 1995).