self harm

自我伤害
  • 文章类型: Journal Article
    背景:自杀是全球死亡的主要原因。新闻报道准则旨在遏制不安全报道的影响;然而,在新闻报道中自杀的框架可能因情况和死者的性别等重要特征而有所不同。
    目的:本研究旨在研究新闻媒体对自杀报道使用污名化或荣耀化的语言进行陷害的程度,以及性别和自杀情况在这种陷害方面的差异。
    方法:我们分析了200篇有关自杀的新闻文章,并应用经过验证的自杀污名量表来识别污名化和荣耀化的语言。我们用2个广泛使用的指标来评估语言相似性,余弦相似性和互信息得分,使用基于机器学习的大型语言模型。
    结果:男性自杀的新闻报道比女性自杀的报道更类似于污名化(P<.001)和美化(P=.005)语言。考虑到自杀的情况,互信息得分表明,在使用污名化或美化语言的性别差异最明显的文章归因于法律(0.155),关系(0.268),或心理健康问题(0.251)为原因。
    结论:语言差异,按性别,在报告自杀时使用污名化或美化语言可能会加剧自杀差异。
    BACKGROUND: Suicide is a leading cause of death worldwide. Journalistic reporting guidelines were created to curb the impact of unsafe reporting; however, how suicide is framed in news reports may differ by important characteristics such as the circumstances and the decedent\'s gender.
    OBJECTIVE: This study aimed to examine the degree to which news media reports of suicides are framed using stigmatized or glorified language and differences in such framing by gender and circumstance of suicide.
    METHODS: We analyzed 200 news articles regarding suicides and applied the validated Stigma of Suicide Scale to identify stigmatized and glorified language. We assessed linguistic similarity with 2 widely used metrics, cosine similarity and mutual information scores, using a machine learning-based large language model.
    RESULTS: News reports of male suicides were framed more similarly to stigmatizing (P<.001) and glorifying (P=.005) language than reports of female suicides. Considering the circumstances of suicide, mutual information scores indicated that differences in the use of stigmatizing or glorifying language by gender were most pronounced for articles attributing legal (0.155), relationship (0.268), or mental health problems (0.251) as the cause.
    CONCLUSIONS: Linguistic differences, by gender, in stigmatizing or glorifying language when reporting suicide may exacerbate suicide disparities.
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  • 文章类型: Journal Article
    目的:本文旨在研究监狱中女性在四个领域(注意力和注意力;社交和沟通;协调和组织;识字和算术)的功能模式之间的关系。此外,考虑功能和以前的神经发育障碍(NDD)诊断之间的潜在关联,以前的精神健康诊断和头部受伤史,自残和自杀企图。
    方法:邀请苏格兰一所监狱的妇女参加;87同意。对妇女进行功能障碍筛查,并询问其相关的教育和病史。
    结果:一半的参与者报告了一个或多个领域的困难。发现了功能困难的所有可能组合。只有8名妇女报告了以前的NDD诊断。功能困难与自我伤害史显著相关,自杀未遂史和精神健康诊断。总的来说,32%的女性报告至少有一次头部受伤,但这与功能困难并无显著相关.
    结论:样本相对较小,问题是自我报告。由于缺乏适当的一般人群数据,分析基于队列内比较。
    结论:显然需要及时,在司法系统中对女性进行实用和全面的分析。目前的系统似乎没有充分确定有功能困难或其他逆境的妇女。指出更多地使用跨学科工作和共享培训,从分类诊断系统向维度方法的转变也是如此。
    结论:这项研究是首次调查与NDD相关的困难之间的关联。监狱中女性的心理健康困难和头部受伤。
    OBJECTIVE: This paper aims to examine the relationship between patterns of functioning in four domains (attention and concentration; social and communication; coordination and organisation; and literacy and numeracy) in women in prison. Also, to consider potential associations between functioning and previous Neurodevelopmental Disorder (NDD) diagnoses, previous mental health diagnoses and history of head injury, self-harm and attempted suicide.
    METHODS: Women in one Scottish prison were invited to participate; 87 consented. Women were screened for functional difficulties and asked about their relevant educational and medical history.
    RESULTS: Half of participants reported difficulties in one or more domains. All possible combinations of functional difficulties were found. Only eight women reported previous NDD diagnoses. Functional difficulties were significantly associated with history of self-harm, history of attempted suicide and mental health diagnoses. In total, 32% of women reported at least one head injury, but this was not significantly associated with functional difficulties.
    CONCLUSIONS: The sample was comparatively small and questions were self-report. Analyses were based on within-cohort comparisons due to a lack of appropriate general population data.
    CONCLUSIONS: There is a clear need for timely, practical and comprehensive profiling of females in the Justice System. Current systems do not appear to adequately identify women with functional difficulties or other adversity. Greater use of interdisciplinary working and shared training is indicated, as is a move from categorical diagnostic systems towards dimensional approaches.
    CONCLUSIONS: This study is the first to investigate associations between difficulties associated with NDDs, mental health difficulties and head injury in women in prison.
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  • 文章类型: Journal Article
    人们越来越关注使用亚硝酸钠(SN)作为一种新兴的自杀手段,尤其是年轻人。鉴于传统公共卫生监测来源关于该主题的信息有限,我们研究了一个网上自杀论坛的帖子,\"被制裁的自杀,“这是有关SN使用和采购的主要信息来源。
    本研究旨在确定SN购买和使用的趋势,通过数据挖掘从论坛上的订阅者帖子获得。我们还旨在确定与SN共同出现的物质和主题,以及SN的用户和来源的地理分布。
    我们收集了该网站于2018年3月成立至2022年10月的所有公开可用信息。使用数据驱动方法,包括自然语言处理和机器学习,我们分析了SN提及随着时间的推移,包括SN消费者的位置和采购SN的来源。我们开发了基于变压器的源和位置分类器,以确定SN源的地理分布。
    与SN有关的帖子显示受欢迎程度上升,与疾病控制和预防中心(CDC)广泛的流行病学研究在线数据(=0.727;P<.001)和国家毒物数据系统(=0.866;P=.001)的数据相比,SN的实际使用与自杀意图之间存在统计学上的显着相关性。我们观察到止吐药的频繁出现,苯二氮卓类药物,和具有SN的酸调节剂。我们提出的基于机器学习的源和位置分类器可以检测到潜在的SN源,准确率为72.92%,并显示在美国和其他地方的消费。
    可以从在线论坛获得有关SN和其他新兴自杀机制的重要信息。
    UNASSIGNED: There is growing concern around the use of sodium nitrite (SN) as an emerging means of suicide, particularly among younger people. Given the limited information on the topic from traditional public health surveillance sources, we studied posts made to an online suicide discussion forum, \"Sanctioned Suicide,\" which is a primary source of information on the use and procurement of SN.
    UNASSIGNED: This study aims to determine the trends in SN purchase and use, as obtained via data mining from subscriber posts on the forum. We also aim to determine the substances and topics commonly co-occurring with SN, as well as the geographical distribution of users and sources of SN.
    UNASSIGNED: We collected all publicly available from the site\'s inception in March 2018 to October 2022. Using data-driven methods, including natural language processing and machine learning, we analyzed the trends in SN mentions over time, including the locations of SN consumers and the sources from which SN is procured. We developed a transformer-based source and location classifier to determine the geographical distribution of the sources of SN.
    UNASSIGNED: Posts pertaining to SN show a rise in popularity, and there were statistically significant correlations between real-life use of SN and suicidal intent when compared to data from the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (⍴=0.727; P<.001) and the National Poison Data System (⍴=0.866; P=.001). We observed frequent co-mentions of antiemetics, benzodiazepines, and acid regulators with SN. Our proposed machine learning-based source and location classifier can detect potential sources of SN with an accuracy of 72.92% and showed consumption in the United States and elsewhere.
    UNASSIGNED: Vital information about SN and other emerging mechanisms of suicide can be obtained from online forums.
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  • 文章类型: Systematic Review
    背景:所有伤害类型分类的关键组成部分是区分伤害是否是故意造成的以及由谁造成的,在监测文献中通常被称为“意图”。这些数据指导患者护理并告知监测策略。南亚被认为是故意烧伤人数最多的国家,但是国家监测数据没有按伤害意图分类。科学文献可用于不存在国家数据收集的伤害监测。为了综合研究成果,评估错误分类偏差的潜在影响至关重要。因此,我们进行了系统的范围审查,以了解用于区分南亚医院烧伤患者伤害意图的术语和方法。
    方法:我们遵循已注册协议(https://doi.org/10.17605/OSF)中的方法。IO/DCYNQ)。研究符合定义的人口,概念,context,并研究设计标准。数据库Embase,MEDLINE,CINAHL,PsycInfo,和PakMediNet进行了搜索。两名审阅者独立筛选结果。以标准化方式提取数据并进行验证。评估了用于区分伤害意图的方法的严格性。
    结果:筛选了1435篇文章。其中,89符合我们的纳入标准。大多数文章来自印度和巴基斯坦,并使用观察性研究设计。文章中使用了14个词干术语。最常见的是“原因”。有40个分类器术语。最常见的是“事故”,\"自杀\",和“凶杀”。很少有文章定义这些术语。仅在17%的文章中明确描述了用于区分伤害意图的方法,并且使用的方法的严谨性很低。在描述区分方法的地方,它们似乎是基于患者或家庭报告,而不是多学科评估.
    结论:异质性方面,缺乏定义,并且对伤害意图的有限调查意味着该变量很可能容易出现错误分类偏差。我们强烈建议全球燃烧社区联合起来开发一个通用的数据元素,包括定义和评估方法,用于烧伤意图的概念,以实现更可靠的数据收集实践和研究间比较。
    A key component in the classification of all injury types is to differentiate whether the injury was deliberately inflicted and by whom, commonly known as \"intent\" in the surveillance literature. These data guide patient care and inform surveillance strategies. South Asia is believed to have the greatest number of intentional burn injuries, but national surveillance data is not disaggregated by injury intent. Scientific literature can be used for injury surveillance where national data collection does not exist. In order to synthesise research findings, it is essential to assess the potential impact of misclassification bias. We therefore conducted a systematic scoping review to understand terminology and methods used to differentiate injury intent of hospital burn patients in South Asia.
    We followed the methods in our registered protocol (https://doi.org/10.17605/OSF.IO/DCYNQ). Studies met defined population, concept, context, and study design criteria. The databases Embase, MEDLINE, CINAHL, PsycInfo, and PakMediNet were searched. Two reviewers independently screened results. Data were extracted in a standardised manner and verified. The rigour of the method used to differentiate injury intent was appraised.
    1435 articles were screened. Of these, 89 met our inclusion criteria. Most articles were from India and Pakistan, and used an observational study design. There were 14 stem terms used in the articles. The most common was \"cause\". There were 40 classifier terms. The most common were \"accident\", \"suicide\", and \"homicide\". Few articles defined these terms. The method used to differentiate injury intent was only described explicitly in 17% of articles and the rigour of the methods used were low. Where methods of differentiation were described, they appear to be based on patient or family report rather than multidisciplinary assessment.
    The heterogeneity in terms, lack of definitions, and limited investigation of injury intent means this variable is likely to be prone to misclassification bias. We strongly recommend that the global burn community unites to develop a common data element, including definitions and methods of assessment, for the concept of burn injury intent to enable more reliable data collection practices and interstudy comparisons.
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  • 文章类型: Journal Article
    背景:保护公众是卫生从业者监管的首要目标,然而,全球越来越关注监管投诉流程与从业者心理健康和福祉之间的关联。目的是了解经验,尤其是痛苦,参与监管投诉过程的卫生从业人员,以确定潜在的策略,以最大程度地减少未来的痛苦风险。
    方法:对最近经历过监管投诉过程的澳大利亚卫生从业人员进行了半结构化定性访谈,以及对参与此类过程四年的所有已确定的卫生从业人员自残或自杀案件的相关文件进行回顾性分析。
    结果:来自访谈和严重事件分析的数据发现,监管投诉过程中存在导致从业者痛苦的因素。其中包括沟通不畅,延长了结束调查的时间,以及健康相关问题的管理。研究发现,外部个人情况和预先存在的条件可能会使从业者面临更大的痛苦风险。在这个过程中发现了关键时刻——触发因素——从业者特别有遭受严重痛苦的风险。强大的支持网络,个人和专业,被发现对痛苦有保护作用。
    结论:通过流程改进和,在适当的情况下,对从业者的额外支持,我们希望在参与监管投诉过程时,进一步尽量减少执业者痛苦和伤害的风险。调查结果还指出,监管机构和主要利益相关者之间需要改善伙伴关系,例如法律辩护组织,赔偿提供者,雇主,以及那些有投诉过程经验的人。他们一起可以改善对面临投诉的从业者的支持,并解决耻辱,与监管投诉过程相关的羞耻和恐惧。该项目提供了进一步的证据,表明更富有同情心的监管方法有可能对所有各方都更好,最终,更广泛的医疗保健系统。
    Protection of the public is the paramount aim for health practitioner regulation, yet there has been growing concern globally on the association between regulatory complaints processes and practitioner mental health and wellbeing. The objective was to understand the experience, particularly distress, of health practitioners involved in a regulatory complaints process to identify potential strategies to minimise future risk of distress. Semi-structured qualitative interviews were conducted with health practitioners in Australia who had recently been through a regulatory complaints process, together with a retrospective analysis of documentation relating to all identified cases of self-harm or suicide of health practitioners who were involved in such a process over 4 years. Data from interviews and the serious incident analysis found there were elements of the regulatory complaints process contributing to practitioner distress. These included poor communication, extended time to close the investigation, and the management of health-related concerns. The study found external personal circumstances and pre-existing conditions could put the practitioner at greater risk of distress. There were found to be key moments in the process-triggers-where the practitioner was at particular risk of severe distress. Strong support networks, both personal and professional, were found to be protective against distress. Through process improvements and, where appropriate, additional support for practitioners, we hope to further minimise the risk of practitioner distress and harm when involved in a regulatory complaints process. The findings also point to the need for improved partnerships between regulators and key stakeholders, such as legal defence organisations, indemnity providers, employers, and those with lived experience of complaints processes. Together they can improve the support for practitioners facing a complaint and address the stigma, shame, and fear associated with regulatory complaints processes. This project provides further evidence that a more compassionate approach to regulation has the potential to be better for all parties and, ultimately, the wider healthcare system.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    在COVID-19大流行期间,随着Tourette综合征样病例的出现增加,评估行为模仿对医疗保健提供者的日常功能很重要,由于社交媒体上流行的视频创作者而看到(例如,TikTok)展示这些行为。自闭症谱系障碍(ASD)患者在联系和同化方面面临困难,他们通过伪装自己的行为来适应神经典型的大多数人。我们的团队评估了一个患有ASD的人的行为,以确定伪装是否在我们住院的精神病院中对她的精神稳定起作用。我们提供了一个30岁女性自闭症患者的案例,承认我们的长期住院精神病院显著的情绪失调,尽管有许多治疗方法(调解,groups,等。).虽然她最初的行为包括头部撞击和自我诱发的跌倒,她的行为似乎根据同龄人的行为而改变,显然是试图伪装到单位内的社会环境中。她似乎也学会了新的自残行为,比如剥皮,她周围的同龄人。该团队能够在一些表现出特定行为的同龄人和我们的患者参与类似行为之间建立时间联系。虽然住院单位有效地管理其他精神疾病的长期稳定,这些环境不是为患有ASD的个人设计的。治疗团队应认识到ASD患者行为的延展性,并且必须在住院精神病治疗期间及早识别和管理行为模仿;否则,它可能会导致重大伤害。
    Evaluating behavioral mimicking is important in healthcare providers\' everyday functioning with an increased presentation of Tourette syndrome-like cases during the COVID-19 pandemic, seen due to the popular video creators on social media (e.g., TikTok) exhibiting these behaviors. Individuals with autism spectrum disorder (ASD) face difficulties with connection and assimilation, and they adapt by camouflaging their behaviors to fit with those of the neurotypical majority. Our team evaluated the behaviors of one individual with ASD to establish whether camouflaging was playing a role in her psychiatric stabilization in our inpatient psychiatric unit. We present a case of a 30-year-old female with ASD, admitted to our long-term inpatient psychiatric facility for significant mood dysregulation that persisted despite numerous treatment approaches (mediations, groups, etc.). While her initial behaviors included head banging and self-induced falls, her behaviors seemed to change based on those of her peers, in an apparent attempt to camouflage into the social environment within the unit. She also appeared to learn new self-harm behaviors, such as skin picking, from peers around her. The team was able to establish a temporal link between some instances of peers exhibiting specific behaviors and our patient engaging in similar behavior. Although inpatient units effectively manage long-term stabilization in other psychiatric disorders, these environments are not designed for individuals with ASD. Treatment teams should recognize the malleability of behaviors in patients with ASD and must identify and manage behavioral mimicking early during inpatient psychiatric treatment; otherwise, it may lead to significant harm.
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  • 文章类型: Journal Article
    背景:研究表明,个人可能在尝试之前在互联网上搜索与自杀相关的术语。
    目标:因此,在两项研究中,我们调查了一项旨在吸引考虑自杀的个人的广告活动的参与情况。
    方法:首先,我们设计了这场运动来关注危机,开展为期16天的活动,其中与危机相关的关键词将触发广告和登陆页面,以帮助个人找到国家自杀热线号码。第二,我们扩大了这项运动,也帮助那些考虑自杀的人,通过一个共同设计的网站,提供更广泛的产品(例如,生活经验故事)。
    结果:在第一项研究中,该广告显示16505次,点击664次(点击率4.02%)。热线有101个电话。在第二项研究中,该广告显示120,881次,点击6227次(点击率5.15%);在这6227次点击中,与该网站有1419次(22.79%)签约,大大高于3%的行业平均水平。尽管可能存在自杀热线横幅,但广告的点击次数仍然很高。
    结论:搜索广告很快,影响深远,尽管存在自杀热线横幅,但仍需要以具有成本效益的方式接触那些正在考虑自杀的人。
    背景:澳大利亚新西兰临床试验注册(ANZCTR)ACTRN12623000084684;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385209。
    BACKGROUND: Studies have shown that individuals may search for suicide-related terms on the internet prior to an attempt.
    OBJECTIVE: Thus, across 2 studies, we investigated engagement with an advertisement campaign designed to reach individuals contemplating suicide.
    METHODS: First, we designed the campaign to focus on crisis, running a campaign for 16 days in which crisis-related keywords would trigger an ad and landing page to help individuals find the national suicide hotline number. Second, we expanded the campaign to also help individuals contemplating suicide, running the campaign for 19 days with a wider range of keywords through a co-designed website with a wider range of offerings (eg, lived experience stories).
    RESULTS: In the first study, the ad was shown 16,505 times and was clicked 664 times (4.02% click rate). There were 101 calls to the hotline. In the second study, the ad was shown 120,881 times and clicked 6227 times (5.15% click rate); of these 6227 clicks, there were 1419 (22.79%) engagements with the site, a substantially higher rate than the industry average of 3%. The number of clicks on the ad was high despite a suicide hotline banner likely being present.
    CONCLUSIONS: Search advertisements are a quick, far-reaching, and cost-efficient way of reaching those contemplating suicide and are needed despite suicide hotline banners being present.
    BACKGROUND: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000084684; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385209.
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  • 文章类型: Journal Article
    背景:非西方青少年自我伤害(SH)重复的数据有限;这项研究旨在调查预测因素。
    方法:招募了台湾北部的5879名青少年(平均年龄16.02岁)。参与者填写了关于他们的社会人口统计数据的在线问卷,自杀,抑郁症状,自尊,社会支持,家庭不和谐,冲动,在基线(T1)和1年随访(T2)时使用酒精和烟草。我们使用逻辑回归分析来检验SH延续的预测因素。然后估计广义结构方程模型(GSEM),以分析这两年的可处理变量,并研究它们的关系和中介效应。
    结果:共有125名学生被确定为SH延续组;而470名学生被确定为SH停止组。SH延续率为21%,无明显性别差异。Logistic回归分析显示,SH延续的预测因子为低学校排名,听亲戚的质量差,使用SH的切割方法,在过去的一年中,T1的自杀计划,以及更沮丧的情绪,使用SH的切割方法,在T2更多的自杀想法和计划。GSEM发现了类似的预测因子;发现T1时的自尊和T2时的抑郁情绪是途径的中介。
    结论:SH的延续率与西方国家报道的相似。这些预测因子应包括在治疗计划中以防止SH继续。
    BACKGROUND: Data on self-harm (SH) repetition in non-Western adolescents are limited; this study is to survey the predictors.
    METHODS: A total of 5879 adolescents (mean age 16.02 years) in Northern Taiwan were recruited. The participants filled in online questionnaires about their sociodemographic data, suicidality, depressive symptoms, self-esteem, social support, family discord, impulsivity, and alcohol and tobacco use at baseline (T1) and at the 1 year follow-up (T2). We used logistic regression analysis to examine the predictors of SH continuation. Generalized structural equation modeling (GSEM) was then estimated to analyze the treatable variables for both years and to investigate their relationships and mediating effects.
    RESULTS: A total of 125 students were identified as being in the SH continuation group; while 470 students were identified as being in the SH stop group. The SH continuation rate was 21%; no significant gender difference was found. Logistic regression analysis showed that the predictors of SH continuation were low school ranking, poor quality of listening from relatives, use of the cutting method for SH, and a suicide plan in the past year at T1, and more depressed mood, use of the cutting method for SH, more suicide ideation and plans at T2. Similar predictors were found by GSEM; self-esteem at T1 and depressed mood at T2 were found to be mediators in the pathways.
    CONCLUSIONS: The continuation rate of SH was similar to that reported in Western countries. These predictors should be included in the treatment plan to prevent SH continuation.
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