A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care

Objectives: Young people in the public care system (‘looked-after’ young people) have high levels of self-harm. Design: This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Sel...

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Main Authors: Wadman, Ruth, Clarke, David, Sayal, Kapil, Armstrong, Miriam, Harroe, C., Majumder, P., Vostanis, Panos, Townsend, Ellen
Format: Article
Published: Wiley 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/42900/
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author Wadman, Ruth
Clarke, David
Sayal, Kapil
Armstrong, Miriam
Harroe, C.
Majumder, P.
Vostanis, Panos
Townsend, Ellen
author_facet Wadman, Ruth
Clarke, David
Sayal, Kapil
Armstrong, Miriam
Harroe, C.
Majumder, P.
Vostanis, Panos
Townsend, Ellen
author_sort Wadman, Ruth
building Nottingham Research Data Repository
collection Online Access
description Objectives: Young people in the public care system (‘looked-after’ young people) have high levels of self-harm. Design: This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (CaTS). Methods: Young people in care (looked-after group: n = 24; 14-21 years) and young people who had never been in care (contrast group: n = 21; 13-21 years) completed the CaTS, describing sequences of factors leading to their first and most recent episodes of self-harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self-harm across six months. Results: Young people in care reported feeling better immediately following their first episode of self-harm. However, fearlessness of death, impulsivity and access to means were reported most proximal to recent self-harm. Although difficult negative emotions were salient to self-harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self-harm sequence six months prior to most recent self-harm. Conclusions: Sequences of factors leading to self-harm can change and evolve over time, so regular monitoring and assessment of each self-harm episode is needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self-harm attempts, particularly for the young persons with experience of being in care, is recommended.
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spelling nottingham-429002020-05-04T19:54:56Z https://eprints.nottingham.ac.uk/42900/ A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care Wadman, Ruth Clarke, David Sayal, Kapil Armstrong, Miriam Harroe, C. Majumder, P. Vostanis, Panos Townsend, Ellen Objectives: Young people in the public care system (‘looked-after’ young people) have high levels of self-harm. Design: This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (CaTS). Methods: Young people in care (looked-after group: n = 24; 14-21 years) and young people who had never been in care (contrast group: n = 21; 13-21 years) completed the CaTS, describing sequences of factors leading to their first and most recent episodes of self-harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self-harm across six months. Results: Young people in care reported feeling better immediately following their first episode of self-harm. However, fearlessness of death, impulsivity and access to means were reported most proximal to recent self-harm. Although difficult negative emotions were salient to self-harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self-harm sequence six months prior to most recent self-harm. Conclusions: Sequences of factors leading to self-harm can change and evolve over time, so regular monitoring and assessment of each self-harm episode is needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self-harm attempts, particularly for the young persons with experience of being in care, is recommended. Wiley 2017-11 Article PeerReviewed Wadman, Ruth, Clarke, David, Sayal, Kapil, Armstrong, Miriam, Harroe, C., Majumder, P., Vostanis, Panos and Townsend, Ellen (2017) A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care. British Journal of Clinical Psychology, 56 (4). pp. 388-407. ISSN 2044-8260 self-harm; adolescence; sequence analysis; children in care; looked-after children http://onlinelibrary.wiley.com/doi/10.1111/bjc.12145/full doi:10.1111/bjc.12145 doi:10.1111/bjc.12145
spellingShingle self-harm; adolescence; sequence analysis; children in care; looked-after children
Wadman, Ruth
Clarke, David
Sayal, Kapil
Armstrong, Miriam
Harroe, C.
Majumder, P.
Vostanis, Panos
Townsend, Ellen
A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title_full A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title_fullStr A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title_full_unstemmed A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title_short A sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
title_sort sequence analysis of patterns in self-harm in young people with and without experience of being looked-after in care
topic self-harm; adolescence; sequence analysis; children in care; looked-after children
url https://eprints.nottingham.ac.uk/42900/
https://eprints.nottingham.ac.uk/42900/
https://eprints.nottingham.ac.uk/42900/