Prevalence of Deliberate Self Harm in School Going Children

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Prevalence of Deliberate Self Harm in school going children :

An epidemiological study

INTRODUCTION:

Deliberate self-harm is defined as the intentional injuringof ones own body without

apparent suicidal intent (Pattison&Kahan, 1983).Other names for this behavior include

superficial-moderate self-mutilation(Favazza&Rosenthal,1983), self-injurious

behaviour(Herpertz,1995),parasuicide(Ogundipe, 1999), and self-

wounding(Tantem&Whittaker, 1992). Deliberate self-harm is encountered frequently in

psychiatrichospitals (Favazza,1989) and also in outpatient settings

(Suyemoto&MacDonald,1995). Deliberateself-harm may be found in patients with a variety

of diagnoses,including substance abuse, eating disorders, posttraumatic stressdisorder,

major depression, anxiety disorders, and schizophrenia(How et al,2001), as well as each of

the personality disorders (Herpertz et al, 1997) andespecially borderline personality

disorder(Stanley et al, B2001) .

Deliberate self-harm occurs in nonclinical populations as well.Approximately 4% of the

general population (Briere,1998) and 14% of collegestudents (Favazza et al,1989) have

reported a history of deliberate self-harm.A recent study found that as many as 35% of

college studentsreport having performed at least one self-harm behavior in theirlifetime

(Gratz,2001). There is evidence that deliberate self-harm hasbecome more prevalent in

recent years. Several studies havefound higher rates of self -harm in individuals from

youngergenerations(Briere, 1998).

Skegg2005 proposes assessing selfharmbehavior descriptively and many authors have

adoptedthe approach of assessing deliberate self-harm as an act ofintentional self-injury or

self-poisoning irrespective of theapparent purpose of the act [Kapur et al, 2006].

However, if we want to

expand our knowledge on differences between suicidal andnonsuicidal self -harm, further

efforts to develop reliableassessments of intent are required. Some advances have

recently been made in this area [ Linehan et al,].

NEED FOR STUDY:

There is evidence that deliberate self-harm hasbecome more prevalent in recent years.

Several studies havefound higher rates of self-harm in individuals from youngergenerations

(Briere,1998) There have been no study so far in India to assess the prev alence of deliberate

self-harm in adolescent children. Thus, the need to conduct this study.

AIIMS:

To know the prevalence of deliberate self -harm in adolescents.



OBJECTIVES:

1. To know the prevalence of deliberate self -harm in adolescents.

2. To find out association of deliberate self -harm with psychiatric morbidity.

HYPOTHESIS:

1. School going children are prone to have deliberate self-harm.

2. Prevalence of psychiatric morbidity is higher in this group.

METHODOLOGY:

1. Study site-

2. Sample size-

3. Inclusion criteria-

y Teacher consent for study.

y Children studying in class 5th

to 12th

.y Children of both sexes.

y Age between 12yrs to 17 yrs.

4. Exclusion criteria-

y Teacher not giving consent for study.

y Children below class 5th

and above class 12th

.

y Children of both sexes.

y Age below 12yrs and above 17 yrs.

5. Tools to be used-

y socio-demographic data sheet.

y Deliberate Self-Harm Inventory (Gratz KL,2001)- The Deliberate Self-Harm Inventory (DSHI) is

a 17-item questionnaire, positive response to any of the item in the inventory indicate

presence of deliberate self harm.

Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) (Kaufman et al,1997)

The K-SADS-PL is a semi-structured diagnostic interview designed to assess current and past

episodes of psychopathology in children and adolescents according to DSM-III-R and DSM-IV

criteria. Administration of the K-SADS-PL requires the completion of Diagnostic Screening

Interview. The Screen Interview surveys the primary symptoms of the different diagnoses

assessed in the K-SADS-PL. Specific probes are then used to assess each symptom in detail.

6. Procedure-

Study would be conducted in secondary schools. They would be randomly chosen. Students

satisfying the inclusion criteria would be included in the study after obtaining consent from

their teachers. Socio-demographic data sheet would be administered to every student, study



would be completed in three stages. The first stage would be to screen the student using the

deliberate self- harm inventory those students who are found to have deliberate self -harm

would be interviewed personaly using the screening section of KSADS-PL responses would

be corroborated seperatly from the respective class teacher students who crossed the cut of

score for any of the domain in the screening interviewed would be selected for detailed

assessment in the 3

rd

stage. In the 3

rd

stage the domain specific supplement of KSADS-PLwould be applied.

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Prevalence of Deliberate Self Harm in School Going Children

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