Uncovering key patterns in self-harm in adolescents: Sequence analysis using the Card Sort Task for Self-harm (CaTS).
Uncovering key patterns in self-harm in adolescents: Sequence analysis using the Card Sort Task for Self-harm (CaTS).
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DOI：
10.1016/j.jad.2016.07.004
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发表时间：
2016-12
影响因子：
6.6
通讯作者：
Clarke D
中科院分区：
文献类型：
--
作者：
Townsend E;Wadman R;Sayal K;Armstrong M;Harroe C;Majumder P;Vostanis P;Clarke D
自我伤害是青春期的一个重要临床问题。几乎没有研究在几个月，几周，几天和几小时内导致自我伤害的关键因素的相互作用。我们开发了自我伤害卡片分类任务（CaTS），以调查导致自我伤害的思想，情感，事件和行为的模式。45名最近反复自残的年轻人（年龄13-21岁）完成了CaTS，以描述他们的第一次/最近一次自残事件。滞后序贯分析确定了导致自我伤害的因素的显著转变（在状态转变图中呈现）。一个显着的顺序结构，以卡序列产生的观察，表现出相似性和重要的差异，在前因第一次和最近的自我伤害。生活事件在自我伤害路径中处于远端，并且更加异质。临床上值得关注的是，在最近的一次发作中，死亡的愿望和绝望成为重要的前因。第一次自残与事后感觉更好有关，但这种情况在最近的一集中消失了。更大的样本量是必要的，以检查更长的序列链和性别，年龄和自我伤害类型的差异。样本是自我选择的，53%的人有过护理生活的经验。CaTs提供了一种系统的方法来理解导致年轻人自我伤害的因素之间的动态相互作用。它提供了一种针对自我伤害途径中的关键点进行干预的方法。至关重要的是，最接近自我伤害的因素（负面情绪，冲动和获得手段）可以通过现有的临床干预措施进行修改。我们开发了自残卡片分类任务（CaTS）。序列分析揭示了自我伤害途径中的重要转变。最接近自我伤害的因素是可以干预的。在最近的事件中，绝望和自杀成为重要因素。第一次自我伤害（但不是最近的）与事后感觉更好有关。
Self-harm is a significant clinical issue in adolescence. There is little research on the interplay of key factors in the months, weeks, days and hours leading to self-harm. We developed the Card Sort Task for Self-harm (CaTS) to investigate the pattern of thoughts, feelings, events and behaviours leading to self-harm. Forty-five young people (aged 13–21 years) with recent repeated self-harm completed the CaTS to describe their first ever/most recent self-harm episode. Lag sequential analysis determined significant transitions in factors leading to self-harm (presented in state transition diagrams). A significant sequential structure to the card sequences produced was observed demonstrating similarities and important differences in antecedents to first and most recent self-harm. Life-events were distal in the self-harm pathway and more heterogeneous. Of significant clinical concern was that the wish to die and hopelessness emerged as important antecedents in the most recent episode. First ever self-harm was associated with feeling better afterward, but this disappeared for the most recent episode. Larger sample sizes are necessary to examine longer chains of sequences and differences in genders, age and type of self-harm. The sample was self-selected with 53% having experience of living in care. The CaTs offers a systematic approach to understanding the dynamic interplay of factors that lead to self-harm in young people. It offers a method to target key points for intervention in the self-harm pathway. Crucially the factors most proximal to self-harm (negative emotions, impulsivity and access to means) are modifiable with existing clinical interventions. We have developed the Card Sort Task for Self-harm (CaTS). Sequence analysis revealed important transitions in the pathway to self-harm. Factors most proximal to self-harm are amenable to intervention. For recent episodes, hopelessness and suicidality emerged as significant factors. First ever self-harm (but not most recent) was associated with feeling better afterward.
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DOI：
10.1023/a:1012779403943
发表时间：
2001-12-01
影响因子：
1.6
作者：
Gratz, KL
通讯作者：
Gratz, KL
DOI：
10.1111/j.1467-8721.2009.01613.x
发表时间：
2009-04-01
影响因子：
7.2
作者：
Nock MK
通讯作者：
Nock MK
影响因子：
22.4
作者：
FARAONE, SV;DORFMAN, DD
通讯作者：
DORFMAN, DD
影响因子：
4.6
作者：
Joiner, Thomas E., Jr.;Van Orden, Kimberly A.;Witte, Tracy K.;Selby, Edward A.;Ribeiro, Jessica D.;Lewis, Robyn;Rudd, M. David
通讯作者：
Rudd, M. David
影响因子：
168.9
作者：
Hawton, Keith;Saunders, Kate E. A.;O'Connor, Rory C.
通讯作者：
O'Connor, Rory C.