Alcoholics Anonymous AA
Alcoholics Anonymous, often referred to simply as AA, is an international fellowship of people working together to overcome their addictions to alcohol.
Alcoholics Anonymous AA
Alcoholics Anonymous, often referred to simply as AA, is an international fellowship of people working together to overcome their addictions to alcohol.
Suicide Risk Assessment and Interventions - no videosKevin J. Drab
An in depth presentation of the current information known about suicide and the most effective interventions we currently have. If you are unclear about how to handle suicidal behavior or what are the more research-based approaches this PPT will be an excellent review for you. I have been training clinicians in Suicidology for over 20 years and have always stayed on top of the latest research and literature.
-Definition of mental health
-Definition of mental illness
-When do you need to see a psychiatrist?
-Causes of mental illness
-Consequences of mental illness
-Treatment team
-Medications used in mental illness
-Myths and facts about mental illness (misconceptions)
Growing old in a society that has been obsessed with youth may have a critical impact on the mental health of many people. This situation has serious implications for psychiatric nursing.
This chapter focuses on physical and psychological changes associated with the aging process, as well as special concerns of the elderly population, such as retirement, long-term care, elder abuse, and rising suicide rates. The nursing process is presented as the vehicle for delivery of nursing care to elderly individuals.
Suicide, it’s importance, global burden, burden of suicide in India, theories of suicide, it’s prevention, psychiatric co-morbidities associated with suicide, its treatment
Suicide Risk Assessment and Interventions - no videosKevin J. Drab
An in depth presentation of the current information known about suicide and the most effective interventions we currently have. If you are unclear about how to handle suicidal behavior or what are the more research-based approaches this PPT will be an excellent review for you. I have been training clinicians in Suicidology for over 20 years and have always stayed on top of the latest research and literature.
-Definition of mental health
-Definition of mental illness
-When do you need to see a psychiatrist?
-Causes of mental illness
-Consequences of mental illness
-Treatment team
-Medications used in mental illness
-Myths and facts about mental illness (misconceptions)
Growing old in a society that has been obsessed with youth may have a critical impact on the mental health of many people. This situation has serious implications for psychiatric nursing.
This chapter focuses on physical and psychological changes associated with the aging process, as well as special concerns of the elderly population, such as retirement, long-term care, elder abuse, and rising suicide rates. The nursing process is presented as the vehicle for delivery of nursing care to elderly individuals.
Suicide, it’s importance, global burden, burden of suicide in India, theories of suicide, it’s prevention, psychiatric co-morbidities associated with suicide, its treatment
This a brief presentation introducing self-harm. It looks at what self-harm is, symptoms of self-harm, possible causes of self-harm and how to respond to self-harm.
This is a short presentation which gives a definition of self-harm, then looks at why people self-harm including the self-harm cycle. It looks at who can be affected and what might trigger them then tells you some signs to look out for, how to respond if someone tells you about their self-harm and gives some ideas which are useful during recovery.
This presentation can be used just for information or as part of a brief training session.
Young People & Self Harm Presentation Deck (Contact-Nathan M To)Nathan M. To, PhD
(Updated) In our deck for an IDEO/Acumen course on Human-Centred Design and Design-Thinking, our team developed a graphic novel prototype regarding Young People and Self-Harm. For our audience, it was important to articulate an engaging story and visual. We clearly articulated how research processes could produce actionable insights, tangible prototypes, and practical next steps. My role: developing structure, editing, visual “feel”, pacing, content & narrative for wider audiences.
Prevention of Substance Abuse and Suicide in the Elderly PopulationSande George
Bill Fitzpatrick, Senior Services Coordinator, Lines For Life, presents at the OSRAA Fall Conference 2018.
Incidences of substance abuse and suicide are rising in the older adult population. Learn to identify the warning signs. Discover how you can help. Know where to get help.
Suicide -HOW TO START A SURVIVORS GROUP-PREVENTING SUICIDE selvaraj227
HOW TO START A SURVIVORS GROUP-PREVENTING SUICIDE Etiology Risk factor for suicide Common misconceptions about suicide Suicide Prevention Nursing interventions
A suicidal person is one who is experiencing a personal suicide crisis; that is the person is attempting suicide, is seeking a means to die by suicide, or is contemplating suicide.
Impact of Suicide on People Exposed to a FatalityFranklin Cook
"Impact of Suicide on People Exposed to a Fatality" is excerpted and adapted from Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines (2015), by the Survivors of Suicide Loss Task Force (bit.ly/sosl-taskforce) of the National Action Alliance for Suicide Prevention. The original document is available free for download at bit.ly/respondingsuicide.
This summary report concludes that:
The research delineated above represents the solid and growing body of evidence that, for a significant number of people exposed to the suicide fatality or attempt of another person, there are long-term, harmful mental health consequences. Shneidman’s declaration (1972) that postvention is prevention for the next generation is unquestionably supported by clear and overwhelming evidence that exposure to the suicide of another person, particularly of a close intimate, elevates the risk of suicidal behavior and of death by suicide in the population of people exposed.
The Grief After Suicide blog post related to this essay is http://bit.ly/impactessay.
Powerpoint accompanying workshop session from the Homeless and Housing Coalition of Kentucky's 2013 conference. Presented by Tim Welsh
Trauma is a common occurrence in the lives of homeless individuals and can have a significant impact on one’s
ability to function. This training will help participants identify signs of trauma and ways in which they can engage
in trauma-informed practice with clients
Comment 1Suicide in recent years has increased by 300 in adoles.docxdivinapavey
Comment 1
Suicide in recent years has increased by 300% in adolescent males aged 15 to 19 years old. Male adolescents were 6 times more likely to commit suicide then a female (Adolescence, C. O.,2000). Suicide between the ages of 15 to 19 is the third leading cause of death for adolescents (Edelman, C., Kudzma, E., Mandle, C., 2010). Adolescent suicide is preventable as problematic adolescents tend to give clues that can be verbal and nonverbal. It is important for people around the adolescent to recognize important warning signs.
There are many factors that contribute to suicide such as family history of mental illness, substance abuse, history of child abuse, and any type of abuse the adolescent has faced are leading factors of suicide. Depression leading from social problems, family problems, or environmental issues can also lead to suicide. There are three levels of suicide prevention first being the primary prevention which is reducing the risk factors and promoting the factors to end suicide by educating and giving the awareness of suicide. The second prevention is secondary prevention where a person has tendency of suicide and has been assessed as suicidal. It is then that the person is offered crisis counseling to help address any underlying problems and gets screening for suicide. The third prevention is the tertiary prevention where long term services and program are used to help the suicidal person because of the consequences of attempted suicide (Georgia Institute of Technology, 2018).
For a nurse it is hard to assess if an adolescent child is suicidal or not. There are warning signs & symptoms that a nurse can look for to make an assessment. Behavioral changes such as substance use and abuse, writing notes or letters, poems and essays with suicidal material written in them, the adolescent becomes more of a risk taker, and increased physical violence to themselves or others.(Edelman, C., Kudzma, E., Mandle, C., 2010). Other symptoms include mood change like increased anger, sleep problems, hearing voices or talking to people not there, taking interest in death related things, and an expression of hopelessness (Edelman, C., Kudzma, E., Mandle, C., 2010). Other symptoms that are physically noticeable are posture, body movements, unusual dressing, and grooming and hygiene (Jarvis, C., 2012).
New Jersey state has a peer support & suicide prevention hotline where people can call 1-855-NJ-HOPELINE 24 hours a day to talk to someone confidentially. They can help provide support to people who just needs someone to talk to when life becomes stressful. The NJ hopeline can provide further counseling, support and referrals to local resources in your difficult times. Another resource the state offers is nj211 which also can help not only for suicide, financial assistance, food, utilities, and housing. The local community resource that that helps suicidal people is the National Alliance on Mental Illness organization. The organization offe ...
This program is part of a comprehensive School Mental Health and High School Curriculum Guide.
Find out more about the guide by visiting:
teenmentalhealth.org
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Self harm in adolescents,adults and elderly (Chatzistavraki, Giannikakis, Gkioka, 2013)
1. CP 510: Professional Ethics and Law
Chatzistavraki Vania
Giannikakis Dimitris
Gkioka Maria
14/10/2013
2. What is Deliberate Self Harm (DSH)?
DSH an intentional act of self poisoning or self
injury regardless of the type of motivation or
degree of suicidal attempt (Whitlock et al., 2006).
It is considered to be an indication that something
is wrong and a primary disorder.
Whatever the type of DSH is used, it is an
unhealthy and dangerous act, and can leave
deep scars. Both physically and emotionally.
3. Types-Expression of DSH
Cutting the skin
o Sharp objects:
Razors
Knives
Needles/pins
Sharp stones
Broken glass
Deep Scratching
Burning
Hitting or brushing
Biting
Head banging
Pulling hair
Overdose/neglect of
medication-drugs
Alcohol abuse
Self mutilation
Hanging
Asphyxiation
Royal College of Psychiatrists (2010)
4. Adolescents
Ross & Heath (2002) the 13 % of the general
adolescent population
13%-25% of adolescents and young adults
(Rodham & Hawton, 2009)
Often is repetitive
Age 14-16 onset
Begin in childhood continue adulthood
All marks are hidden even in the summer periods
(e.g. long sleeves)
5. Adolescents (Demographics)
Prevalent among adolescent girls.
Population in middle school is in higher risk
because this is the rate they initiate in self-injury
(Gollust, et al., 2008).
No socioeconomic status give significant
differences (Jacobson & Gould, 2007).
High risk appear to be in bisexual individuals
compared to heterosexual or homosexual
teenagers.
6. Adolescents Intentionally …
Harm themselves and usually are documented to
have the following characteristics-disorders:
•
•
•
•
•
•
•
•
•
Depression
Schizophrenic
Abused
Childhood trauma
Poor family communication
Low family warmth
Cope with painful emotions
Feel good of chemical release
Influence by peers
(Ross & Heath, 2002)
7. Adolescents Intentionally …
Adolescents are not able to handle their emotions
(negative or sensitive) and experience an intense
shame or they cannot control their selves
(Chapman et al., 2006)
During the self-injury the brain releases
chemicals, the endorphins. They produce a “high”
feeling that causes an addiction to the teenagers
(Sher & Stanley, 2009).
8. Adults
There is a stereotype that only teenagers and
young girls commit self-harm. However, it is also
common during the adulthood for both genders.
The rate of self-harm is higher in females, but
fatal self-harm which concluded into suicide is
more prevalent among men (Royal College of
Psychiatrics, 1994).
Adults are more prevalent into suicide in
comparison to adolescents (Hepple &
Quinton, 1997).
9. Adults
Adults from all social and cultural backgrounds
commit self-harm, but some individuals are more
vulnerable because of:
Life experiences
Personal or social circumstances
Socioeconomic deprivation (Mitchell &
Dennis, 2006)
Physical factors or a combination of the above
10. Reasons for self-harm in adults
Bipolar disorder
Mood disorders
Alcohol abuse
Drugs abuse
Traumatic events
Coping mechanism (for some individuals self-
harm can be a coping mechanism)
Illness
(Royal College of Psychiatrist, 1994)
11. Further Research in self-harm in
adults
Self harm is one of the commonest reasons for
emergency hospital attendance in England and
Wales with an estimated 140-150,000 hospital
presentations every year (Gunnell et al., 2004).
4026 (99.8%) episodes
o 3198 (79,4%) Overdose
o 457 (11,4%) Self-laceration
o 193(4,8%) combination of laceration and overdose
o 178(4,4%) Other methods
o Bleach/ weed killer (n=30),
o Self strangulation/Hanging (n=27)
o Jumping (n=22)
o Carbon monoxide poisoning (n=19)
12. Mitchell & Dennis (2006) review table
This figure illustrates the difference between the above age groups concerning
the two genders in Deliberate self harm attendances (DSH).
13. Older people who self harm are in
high risk for committing suicide.
It is more likely to be
MEN over 75 years old.
Evidence suggest that
fatal and non-fatal self
harm are more closely
related in elderly than in
younger adults.
Elderly who self harm
are more likely to live
alone or to be single
(Murphy, 2011)
Elderly
who self-harm
present
67
times
greater
risk
to
committee suicide than
elderly who don’t.
There is 3 times greater
risk of suicide than
younger adults who self
harm (Murphy, 2011).
Approximately 90% of
older people who are
both depressed and
self-harmed, committee
suicide
(Merrill
&
Owens, 1990).
14. How they self harm
34% are Paracetamol
overdose
30% Benzodiazepine
overdose
12%
Antidepressant
overdose
11%
Psychotropic
overdose
9% Aspirin overdose
From those who self harm:
40% were sorry they self
harmed.
40% were ambivalent
and
20% regretted the fact
they were alive.
(Dennis, Wakefield, Molloy
, Andrews, &
15. What are their motives
1.
2.
3.
4.
5.
6.
61% to gain relief from an intolerable state of
mind.
53% to escape from an intolerable situation.
22% to make other people understand how
desperate the person was feeling.
18% to influence others.
18% to seek help.
12% to make other people feel sorry
(Hawton, Cole, O’Grady, & Osborn, 1982). percentages
1,3,5 higher
were noticed in depressed
elderly.
2,4,6 higher percentages
were noticed in non-
16. Diseases elderly suffer when selfharm:
Most common:
(43%) Depression, (24%)Recurrent
Depression, (1%)Bipolar affective disorder
(currently depressed)
Less Common: Alcohol abusers, Alzheimer
sufferers.
19% has no psychiatric disorder (Dennis, et.
al, 2006).
17. Why they self harm?
79% face difficulties with their own health.
19% face relationship difficulties.
17% are affected by other’s health problem.
6% face financial difficulties.
(Dennis, et. al, 2006)
18. Possible treatments of DSH
Antidepressants
Problem solving therapy
Individual therapy
Group therapy
Family therapy
In-patient hospitalization
Stress reduction and management skills
Attention to possible indicators after the therapy for
repeated episodes of DSH
(Mitchell & Dennis, 2005)
19. Ethical Codes for DSH
AMHCA (2010), in Confidentiality section, the
counselor has to break off the confidentiality in cases
of self harm, suicidality or other extreme occasion
(abuse, murder, neglect) that threat the client or
others.
BPS (2009), in Confidentiality section 4.3 the
psychologist disclosures when there is adequate
indication about the safety of the client. Has to
inform appropriate third parties without prior consent.
20. Ethical Codes for DSH
Counselors also have responsibilities to parents
and the school (ASCA, 2004).
In Standard D.1b, p. 2 ( ASCA) informs the
appropriate officials in accordance with school
policy and the parents..
ACA (2005) B.1.b, Respect for Confidentiality, the
therapist do not share confidential information only in
a few serious situations, harm to him/herself or
others.
All of the Codes of Ethics state that all of the above occur
especially in minority groups (children, teenagers and elder).
Especially, when the individuals are not able to decide for
themselves (e.g. mental illness).
21.
22. Additional guidance for self harm
According to National Institute for Health and Care
Excellence (2004):
Self harmed individuals deserve equal
treatment, respect and confidentiality, as any other
patient.
Health care professionals should also take under
consideration the possible distress and the emotional
damage these people have experienced, and they
should provide them emotional support and
supervision.
Furthermore, they should sympathize with the clients
and encourage them to express their feelings about
their self harm experience.
Psychologists should have a risk assessment for all
age groups in order to avoid suicidal attempts.
A psychiatric diagnosis is also recommended for
individuals with DSH.
23.
24. References
American Counseling Association (1995).Code of ethics
and standards of practice. Alexandria, VA: Author.
American Mental Health Counselors Association (2010).
Code of Ethics. Alexandria, VA: Author
American School Counselor Association (2004). ASCA
ethical standards. Alexandria, VA: Author
British Psychological Society (2009). Code of Ethics and
Conduct. Ethics Committee of the British Psychological
Society.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006).
Solving the puzzle of deliberate self-harm: The
experiential avoidance model. Behavior Research and
Therapy, 44(3), 371-394.
Dennis, M., S., Wakefield, P., Molloy, C., Andrews, H. &
Friedman, T. (2006). A study of self-harm in older people:
Mental disorder, social factors and motives. Aging &
Mental Health.
25. References
Gollust, S. E., Eisenberg, D., & Golberstein, E. (2008).
Prevalence and correlates of self-injury among university
students. Journal of American College Health, 56, 491498.
Gunnell, D., Bennewith, O., Peters, J., House, A., Hawton, K.
(2004). The epidemiology and management of self-harm
amongst adults in England. Journal of public health. Vol
27, no 1, 67-73.
Hawton, K., Cole, D., O’Grady, J., & Osborn, M. (1982).
Motivational aspects of Deliberate self- poisoning in
adolescents. British Journal of Psychiatry, 141, 286-291.
Hepple, J., & Quinton, C. (1997). One hundred cases of
attempted suicide in the elderly. British Journal of
Psychiatry, 171: 42-46
Jacobson, C. M., & Gould, M. (2007). The epidemiology and
phenomenology of non-suicidal self-injurious behavior
among adolescents: A critical review of the literature.
Archives of Suicide Research, 11(2), 129-147.
26. References
Mitchell, A., & Dennis, M. (2006). Self harm and attempted
suicide in adults: 10 practical questions and answers for
emergency department stuff. Emergency Medicine
Journal.
Murphy, E., (2011). Risk factors for repetition and suicide
following self-harm in older adults: multicentre cohort
study.
National Institute for Health and Care Excellence (2004).
Self-harm: The short-term physical and psychological
management and secondary prevention of self-harm in
primary and secondary care. Retrieved from
http://publications.nice.org.uk/self-harm-cg16/guidance
Rodham, K., & Hawton, K. (2009). Epidemiology and
phenomenology of nonsuicidal self-injury. In M. K. Nock
(Ed.), Understanding nonsuicidal self-injury:
27. References
Ross, S. and Heath, N. (2002). A study of the frequency
of self-mutilation in a community sample of
adolescents. Journal of Youth and Adolescents, 31
(1): 67-78
Royal College of Psychiatrists (2010). Selfharm, suicide and risk: helping people who self-harm.
College Report CR158, Royal College of
Psychiatrists.
Sher, L., & Stanley, B. (2009). Biological models of
nonsuicidal self-injury. In M. K. Nock
(Ed.), Understanding nonsuicidal self-injury:
Origins, assessment, and treatment (pp. 99-116).
Washington, DC: American Psychological Association.
Whitlock, J., Eckenrode, J., & Silverman, D. (2006).
Self-injurious behaviors in a college population.
Pediatrics, 117, 1939-1948.