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Deliberate self-harm and suicide attempt in custody: distinguishing features in male inmates' self-injurious behavior.
Int J Law Psychiatry 2006 Sep-Oct; 29(5):370-85IJ

Abstract

Self-injurious behavior involving deliberate self-harm and suicide attempts by inmates while under custodial authority is a major problem for prisons and jails (prevalence, legal obligation for suicide prevention, and stress for officers). The differentiation of "serious" vs. "non-serious" and often manipulative suicide attempts as distinct phenomena, each with its own clinical features, is controversially discussed in current literature and a challenge for every diagnostician. If distinct clinical presentations and histories can be observed, an estimation of the seriousness of each act of self-injurious behavior can be simplified, whereby appropriate treatment of the individual case becomes possible. The aim of the study was to find differences between self-injurious behavior of "low seriousness" (i.e. low lethality and low suicidal intent) and of "high seriousness". Therefore, inmates showing self-injurious behavior were divided into subgroups of deliberate self-harm and suicide attempters on the basis of the act's intent and lethality. This was followed by a comparison of the clinical presentations of the individual inmates constituting the subgroups. Hence, 49 inmates showing self-injurious behavior were interviewed and tested with a variety of instruments (SCID-I and II, PCL-R, BDI-II, BHS, BSS, SIS, etc.), and their prison and health files were examined. The results indicate significant correlations between seriousness and some demographic, prison-related variables as well as different measures of depression. Negative, but nonsignificant correlations could be observed with regard to cluster B personality disorders. The PCL-R total score as well as PCL-R factor 1 showed a statistical trend for negative correlations with measures of seriousness. Inmates showing deliberate self-harm and suicide attempters seem to differ in a number of ways. Implications on how the individual prisoner should be treated are discussed.

Authors+Show Affiliations

Institute of Forensic Psychiatry -- Charité Universitätsmedizin Berlin, Limonenstrasse 27, 12203 Berlin, Germany. johannes.lohner@charite.deNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16782200

Citation

Lohner, Johannes, and Norbert Konrad. "Deliberate Self-harm and Suicide Attempt in Custody: Distinguishing Features in Male Inmates' Self-injurious Behavior." International Journal of Law and Psychiatry, vol. 29, no. 5, 2006, pp. 370-85.
Lohner J, Konrad N. Deliberate self-harm and suicide attempt in custody: distinguishing features in male inmates' self-injurious behavior. Int J Law Psychiatry. 2006;29(5):370-85.
Lohner, J., & Konrad, N. (2006). Deliberate self-harm and suicide attempt in custody: distinguishing features in male inmates' self-injurious behavior. International Journal of Law and Psychiatry, 29(5), pp. 370-85.
Lohner J, Konrad N. Deliberate Self-harm and Suicide Attempt in Custody: Distinguishing Features in Male Inmates' Self-injurious Behavior. Int J Law Psychiatry. 2006;29(5):370-85. PubMed PMID: 16782200.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deliberate self-harm and suicide attempt in custody: distinguishing features in male inmates' self-injurious behavior. AU - Lohner,Johannes, AU - Konrad,Norbert, Y1 - 2006/06/19/ PY - 2005/12/01/received PY - 2006/03/03/revised PY - 2006/03/21/accepted PY - 2006/6/20/pubmed PY - 2007/1/24/medline PY - 2006/6/20/entrez SP - 370 EP - 85 JF - International journal of law and psychiatry JO - Int J Law Psychiatry VL - 29 IS - 5 N2 - Self-injurious behavior involving deliberate self-harm and suicide attempts by inmates while under custodial authority is a major problem for prisons and jails (prevalence, legal obligation for suicide prevention, and stress for officers). The differentiation of "serious" vs. "non-serious" and often manipulative suicide attempts as distinct phenomena, each with its own clinical features, is controversially discussed in current literature and a challenge for every diagnostician. If distinct clinical presentations and histories can be observed, an estimation of the seriousness of each act of self-injurious behavior can be simplified, whereby appropriate treatment of the individual case becomes possible. The aim of the study was to find differences between self-injurious behavior of "low seriousness" (i.e. low lethality and low suicidal intent) and of "high seriousness". Therefore, inmates showing self-injurious behavior were divided into subgroups of deliberate self-harm and suicide attempters on the basis of the act's intent and lethality. This was followed by a comparison of the clinical presentations of the individual inmates constituting the subgroups. Hence, 49 inmates showing self-injurious behavior were interviewed and tested with a variety of instruments (SCID-I and II, PCL-R, BDI-II, BHS, BSS, SIS, etc.), and their prison and health files were examined. The results indicate significant correlations between seriousness and some demographic, prison-related variables as well as different measures of depression. Negative, but nonsignificant correlations could be observed with regard to cluster B personality disorders. The PCL-R total score as well as PCL-R factor 1 showed a statistical trend for negative correlations with measures of seriousness. Inmates showing deliberate self-harm and suicide attempters seem to differ in a number of ways. Implications on how the individual prisoner should be treated are discussed. SN - 0160-2527 UR - https://www.unboundmedicine.com/medline/citation/16782200/Deliberate_self_harm_and_suicide_attempt_in_custody:_distinguishing_features_in_male_inmates'_self_injurious_behavior_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0160-2527(06)00047-1 DB - PRIME DP - Unbound Medicine ER -