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👶 | Parents can do "self-harm", a little daughter who suddenly started beating herself saying "I'm all bad"


I had to think about it ... I started hitting my head.

What parents can do in front of a young daughter "self-harm" who suddenly started beating herself saying "I'm all bad"

 
If you write the contents roughly
Of course, if self-harm escalate or persist for a long time, we recommend that you consult a specialist once.
 

Mr. C (living in Tokyo, in his 30s) is a single mother raising two children. Mr. C is 2 years old who started a while ago ... → Continue reading

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Self-harm

Of the worldDisease burden(WHO, 2019)[1]
Rankingcause of deathDALYs (XNUMX)DALYs (%)DALYs
(Per 10 people)
1Neonatal disease20,182.18.02,618
2Ischemic heart disease18,084.77.12,346
3stroke13,942.95.51,809
4Lower respiratory tract infection10,565.24.21,371
5diarrheaSexual illness7,931.13.11,029
6Traffic accident7,911.63.11,026
7COPD7,398.12.9960
8Diabetes mellitus7,041.12.8913
9tuberculosis6,602.42.6857
10Birth defects5,179.72.0672
11Back and neck pain4,653.21.8604
12depressionSexual dysfunction4,635.91.8601
13Cirrhosis4,279.81.7555
14Trachea, bronchi, lung cancer4,137.81.6537
15Kidney disease4,057.11.6526
16HIV / AIDS4,014.71.6521
17OtherDeafness3,947.71.6512
18Death3,821.61.5496
19malaria3,339.81.3433
20Refractive error of the naked eye3,198.11.3415

Self-harm(JishoKoi,British: Self-harm, self-injury) Is intentionally own身体TheOr put it onpoisonTo ingest[2]..In terms of low lethalitysuicideIs different from.Wrist cut, With a lighter or cigaretteskinBake (Gut grill), Pull out the hair,injuryThere are acts such as hitting the wall until you do.Abuse Oftrauma,Psychological abuseas well as the Eating disorder,LowSelf-esteem,perfectionismIt is believed that there is a positive correlation with.またAlsoAntidepressantAnd other drugs are known to cause self-harm.

Overview

Self-harm was described in 1994 as "Mental disorder diagnosis and statistics manual』It is not independent as a diagnostic name of the 4th edition (DSM-IV),Mental disorderWas treated as one of the symptoms of.For background obstaclesBorderline personality disorder,Bipolar disorder,Post-traumatic stress disorder,Dissociative disorder,schizophrenia,Intellectual disabilityIn recent years, there has been some transmission in the general population where no problems have been seen.Since the treatment policy is completely different, it is very important to evaluate it, such as having the patient and his / her family resolve the misunderstanding about self-harm.脳の器質的障害が原因とされる自閉症にも自傷と呼ばれるAutism caused by organic brain damage is also called self-harmBehavioral disordersYou may see behaviors such as biting your hand, hitting your head against a wall or floor, or hitting your face.However, the self-harm and stressful ones seen in bipolar disorder, schizophrenia, borderline personality disorder, dissociative disorder, etc., which are statistically related between relatives, are different.Although the relationship with addiction has been pointed out, in Japan, where the power of traditional psychiatry is strong, there was a situation where a psychiatrist prescribed a drug even though there was a risk of drug addiction.もっとも、アメリカ合衆国でもHowever, even in the United StatesSteven LevenkronThere is also an argument that self-harm itself should be treated as a disease, and in the 2013th edition of 5, "non-suicide self-harm" was treated as an independent disease.

Self-harm was treated as an independent illness in WHO's ICD-10.自傷行為による疾病は、世界のDiseases caused by self-harm are the world'sDisability adjustment life yearIt accounts for 1.3% of (DALY) and is ranked 20th (WHO, 2003).特に青年においては一般的であるEspecially common in adolescents[3]..さらに自傷行為はFurthermore, self-harmsuicideIt is associated with risk that those who self-harm have a 12-50 times higher risk of suicide after 100 months.UK National Institute of Medical Technology(NICE) reports[3].. WHO estimates that 88 people worldwide have died from self-harm (2010)[4]..また、2019年5月にはICDは第11版(ICD-11)への改定が行われたが、この中に盛りこまれたIn May XNUMX, ICD was revised to the XNUMXth edition (ICD-XNUMX), which was included in this.Complexity PTSDIt has been pointed out that self-harm is one of the symptoms of emotional difficulty in controlling emotions.

Treatment is in Europe and AmericaCognitive behavioral therapyIs the main subject.It is achieved by learning less dangerous behaviors instead of self-harm.For specific treatment methods and support methods, see "Self-harm #treatmentSee.

Term history

In the United StatesWrist cutSelf-harm like this has been popular since the 1960s[5].. 1990年代以前には、自傷行為を表す英単語としてself-mutilationという語が使われていたが、mutilationとは機能不全にするように切断するというような意味であり、1990年代半ばからself-injuryという語に置き換わっていったBefore the XNUMXs, the word self-mutilation was used as an English word for self-harm, but mutilation means cutting to make it dysfunctional, and since the mid-XNUMXs self-mutilation. It was replaced by the word injury[6]..偶発的に起こることではないIt's not something that happens accidentally[7]..In 1999 in JapanSteven LevenkronThe translator who translated "Self-harm Girl" into Japanese introduced in the postscript that the word "self-harm" is unfamiliar, and it will be a problem in Japan after that.[5].

In 1983, Pattison and Kahan proposed the concept of "Deliberate self-harm syndrome", the three signs of which are "substance abuse or addiction," "self-harm," and "eating behavior." "Abnormal" was mentioned[8]..女性ではFor womenEating disorderIt is said that 60 to 70% of men are accompanied by self-harm, and more than 50% of substance abuse is accompanied by self-harm, which may be related as a common pathology or a common acting out factor.

Body modificationタ ト ゥ ー,EarringsThese are culturally endorsed, symbolic or aesthetically pleasing in most cultures, and although it is inappropriate to consider them as self-harm, they take such an aesthetic point of view. Can be self-harm if given by oneself in the absence, especially if it is done impulsively motivated to escape psychological distress[9]..アメリカでタトゥー、ピアスを自傷行為と考える専門家は80〜90%であったが、2000年半ばには5〜10%であり、ゆえに社会的に容認されていれば、身体改造を自傷と考えることは不適切であるIn the United States, XNUMX-XNUMX% of experts consider tattoos and piercings to be self-harm, but in mid-XNUMX it was XNUMX-XNUMX%, so if socially acceptable, body modification would be self-harm. Is inappropriate to think[9].

Distinguishing between self-harm and suicide

Self-harm and suicide are strictly different.Misunderstanding self-harm as suicide hinders treatment (Lineham, 1993a)[Detailed information for identifying documents]).

suicideHowever, it is motivated by the desire to end consciousness and to stay away from pain forever.[10]..自傷に多い、切るという方法は、自殺では1.4%の者しかとらないOnly XNUMX% of people commit suicide by cutting, which is common in self-harm.[10].

Self-harm is to relieve and change psychological distress, as many self-harms self-report, while a few say that robotic emotional emptiness is distressing and escapes from it. Report[10]..自傷では、切る、火傷、殴る、頭をぶつける、タトゥー、ピアス、抜毛など、極端な事例を除けば死に至る可能性は低く、自殺とは異なり反復的に行われ、その部位も選択されているSelf-harm is unlikely to result in death except in extreme cases, such as cutting, burns, hitting, hitting the head, tattoos, piercings, and plucking. Are[11]..そうではなく、より強く傷をつける場合には、行動のコントロールができなくなっていることを示唆し、自傷というよりは上述したself-mutilationであるInstead, if you hurt more strongly, it suggests that you are out of control of your behavior, and it is the self-mutilation mentioned above rather than self-harm.[11].

Cause

Sadness and anger,孤独When feelings such as feelings and inferiority complex make the urge uncontrollable, orDifficulty breathing,headache, Nausea, etc.stressIt is generally said that when the symptoms caused by the above occur at the same time, they hurt themselves in order to suppress them.However, it is usually unclear to the individual what exactly triggers the self-harm.自傷を行う者は「ただ強い衝動があった」などといったはっきりとしない妙な説明をしてしまうことが多く、中には自傷をしている時点でThose who do self-harm often give unclear and strange explanations such as "I just had a strong urge", and some of them at the time of self-harmMemory,ConsciousnessThere may be no.これはいわゆるThis is so-calledDissociative disorderSeems to be.

The purpose is to reach deathsuicideRather, it is an act in which the desire to live appears in a refracted form, such as "reconfirmation of oneself" and "stress relief" to dispel the feeling of loneliness and emptiness.However, although self-harm is an act of wanting to live, the person often has suicidal ideation.Self-harm helps prevent suicide, but suicidal ideation can eventually lead to suicide.However, it is difficult to distinguish between accidental death and suicide due to self-harm, and the actual situation is not clear.Self-harm is often regarded as mysterious and difficult to understand in society.However, it is necessary to understand it as a danger signal for the person's condition.

Doctors may also suspect a brain organic disorder at first, but that is just a precaution.肉体を切るとWhen you cut your bodyEndorphinTo sayhormoneIs secreted and mental pain is relieved, so it is thought that some people unconsciously expect it and cut it.だが、大抵本人はこの事は分かっていないBut most of the time he doesn't know this[Source required].

Mental illness

The most suspected of self-harmBorderline personality disorder[3],Dissociative identity disorder.DSM-IV-TRThe fifth diagnostic criterion for borderline personality disorder includes "repeated suicide, pretense, intimidation, or self-harm."この他にはBesides thisdepression[3],Bipolar disorder[3]Histrionic personality disorder,Narcissistic personality disorder,Obsessive-compulsive disorderEtc. are also suspected.Also,schizophreniaMay be judged[3].

PsychiatryAbove is self-harmPersonality disorder,Dissociative disorderSuch asMental disorderIt is considered to be a secondary symptom of, and is not considered to occur alone.However, in reality, it has been found that the severity of symptoms does not always match the severity of self-harm.This seems to depend on whether or not the person has an "identity as a self-harm (wrist cutter)".これはかつて多くの精神病者と病院との間の関係でThis was once the relationship between many mentally ill people and hospitalsSociologyIt was pointed out by the people, and it is said that it is because the friendship at the hospital becomes steady and the consciousness that "I am a healthy person" is lost.

Drugs and alcohol

Alcohol abuse,Substance abuseRelated to[3].. At the age of 10-24SSRIThe results have shown that antidepressants of the system increase self-harm, with the frequency of self-harm doubling, especially when started at high doses.[12].

Genetic and biochemical factors

In the brain as a cause of self-harmSerotoninInactivity is also considered.しかし、そのBut thatBiochemistryAt this time, no conclusions have been reached as to whether the factor is identical to the genetic factor, as it is also said to be formed by trauma in early childhood.

AlcoholismSuch asHeredityTarget factors are thought to be factors that make self-harm worse.

Lack of self-ownership of the body

In some cases, the sense of ownership of one's body is weak, and the problem of the underlying pathology can be pointed out, but the direct causal relationship with self-harm is unknown.There is no view that a socio-cultural system such as the patriarchal system causes a vague perception that one's body is not one's own.There are no reliable reports that the patriarchal system is long like the Islamic society, and even now, self-harm in extremely strong countries is more common than in developed countries such as Japan.

Relevance to abuse

Abused people do not necessarily self-harm.

Kagoshima Universityが2006年1月に発表した、九州の5大学に通う1〜2年生1626人を対象にした調査がある。回答者1592人(男性831人、女性761人)のうち、自傷行為の経験者は120人(7.5%)であり、「家族からの放任や罵倒などを経験した」と答えた人が自傷行為をする危険性は、そうでない人の8.7倍、「第三者からの性的暴力を受けた」が5.8倍、「教師や友人からの無視を経験した」が5.5倍、「両親からかわいがられた経験がない」が4.2倍であった[Detailed information for identifying documents].

About direct motive

As a cause,FreudRelated toPsychoanalysisSometimes the interpretation of[13], Currently not so influential.精神分析学的PsychoanalyticEgo psychologyAccording to the interpretation related to, self-harm is caused by anxiety about separation from the mother when she was a child (around 1 to 3 years old), and it is claimed that it is used as a temporary means of confirming self-existence.この説はThis theoryPsychoanalysisThis happened because it was thought that the wrist was touching the breast and that it was trying to communicate with the mother.Based on this theory, self-harm is considered to be a type of communication with others such as mothers.However, first of all, if the wrist expresses communication with the mother, this theory is often inadequate at the time of leg cutting.Moreover, many patients continued to self-harm, although some were successful in actually improving their ability to communicate.For this reason, researchers have determined that self-harm has more complex causes, and the theory that there may be different causes is currently prevailing.In any case, we must be fully aware that the background differs from person to person.

It is known that in the case of self-harm, it may or may not dissociate.Many seem to use the two properly.The typical motives are described below, but it is not possible to clearly distinguish which one.However, the more dissociated it is, the more severe it is.

Try to attract the eyes and attention of the surroundings
This is done to satisfy the desire to intentionally make eye-catching scratches and be worried because we want to overcome the feeling of being abandoned, such as not being worried or seen by others.わざととはいっても、この動機はOn purpose, this motive is無意識It is a typical thing, and the person himself does not clearly understand it.Dissociative self-harm is almost the opposite, and in most cases, the wound is shown off without trying to hide it from the beginning.
Perform as a ritual
This is done when you lose your lover or family in an accident.In this case, the act of self-harm is considered to be the way of the funeral of the person himself / herself.If the contact with the family or lover is weak, even if you try to visit the grave, you cannot go, and it is said that it is performed as a funeral ceremony for the death of the lover or family by cutting your wrist or arm and bleeding.In this case, it is often the case that they could not afford to be sad at first due to work or personal circumstances, and it is said that it often occurs a year later.
BibleSome of them describe self-harm as a religious ritual.[14][15].
Means for recognizing oneself
This is done to reconfirm the outline of your existence and suppress the feeling of self-disassembly.This is to deny the idea that "I may not be necessary in this world" when I feel abandoned by others.This is also the case when one's existence is projected onto the pain due to being abused.It is done because you can feel relieved by reconfirming your own life by seeing pain and flowing blood.
Means to seek help by pain
This is done when you seek help from the pain itself when you are in a very dangerous situation.It is said that this is to imitate suicide and suppress one's own desire to commit suicide.For example, this is the case when you hesitate to die even though you want to escape from this reality due to a work failure.
Direct the urge to attack yourself
This is done when a person (often women) who cannot direct his or her own aggression impulse outwards directs the impulse inward.For example, this is done when you realize that you cannot forgive your existence that is not loved by your parents or those around you.It can also be interpreted that when you get angry at the surroundings who do not understand you, you personalize and attack the wrists and the like as if they were around them.
Means of escapism
If you run into something very difficult, use it to temporarily deal with that reality by cutting yourself.For example, if you realize that you don't need to love your parents because of your parents' discord or abuse of yourself, or if your friendship is cracked because of you, you must be yourself. This is the case when you think "I'm glad".In this case, it is considered that they are begging for "forgiveness" by being punished.However, it does not really give forgiveness, and it is said that addiction will progress.
Means to make yourself another person
It is used as a means of separating oneself by seeing what one is doing with the eyes of others.By slashing yourself and making your normal struggling self unbelievable, by treating yourself like others, denying yourself, and recognizing another self who is not. , Deny oneself who is in conflict with each other, and gain mental stability.
Means to eliminate one's own existence
Use it as a means of losing your past experiences and memories.The conflict of "parent murder" may occur in the person.The situation is also described as "pure white."It transcends one's own mental pain with physical pain, thereby destroying thoughts and regressing oneself inward.In other words, I feel that there is no one who can protect me mentally other than my own physical pain.

Progress

Early symptoms

Self-harm, including wrist cuts, begins精神It is often several years behind the most unstable period, starting around the age of 10 at the youngest.It may be started with alcohol or medicine, but in many cases it develops spontaneously.The initial feeling was strong resentment,不安,パ ニ ッ クAnd so on.As a precursor, they may throw or destroy things in an attempt to suppress their emotions.

Initially, the wound is often hidden from shame on the surroundings.通常はNormally腕 時 計,WristbandHide the wound with long sleeves.<span>Grade 1-2</span>For example, if you are young, you often do self-harm with something other than a knife, probably because you do not have much knowledge about self-harm.

Addictive

Self-harm temporarily relieves the initial mental distress.However, since it is only immediately after injuring oneself, even if one wants to stop it, in most cases, it will be repeated many times due to new mental distress and become addictive.If you cut it many times, the feeling of that part will be paralyzed and you will become accustomed to seeing blood, so addiction will progress further.Also, when it comes to summer clothes, the wrists stand out, so arm cuts are more common than wrist cuts.

In generalrazor,cutter knifeI often use sharp blades.Not only do you cut self-harm, but you can also hit yourself.In addition, a hair dryer may be used for burning.また、激しい痛みを求める場合にはAlso, if you want severe painscissors,KnifeIn some cases, a blade with a jagged edge is used.切る時はただ切りたいという衝動に駆られるだけで切ることが多いが、後で傷跡やWhen cutting, it is often just driven by the urge to cut, but later scars andkeloidSometimes I feel ugly when I see it and despise myself.

Relationships often become unstable.Social withdrawalHowever, it is often temporary because we basically want to contact people.However, interpersonal relationships are often still unstable.If this condition continues, the ability to examine reality will be weakened overall.

Although it is extremely rare for self-harm to result in death,静脈Even a cut can cause a considerable amount of bleeding, which can be harmful to your health, such as weakening your heart due to extreme anemia.また、精神的に乖離している場合、予定外にAlso, if you are mentally divergent, unplannedarteryIn this case, it may result in death regardless of the person's will.

Reply

After a certain amount of time, self-injured people often express their mental stress in words.Since many people were unable to express their own suppressed stress, they often recover depending on the surrounding environment.In fact, if you calm down mentally, self-harm often subsides,ageAt the same time, the number of people who self-harm will decrease.This is thought to be because he gained a way to establish himself through age-appropriate experience.In addition, it may be cured by marriage.However, there are many people who cannot cope with love well and get divorced and self-harm again.

However, there are many cases where the impact is seen throughout the life.より深刻なMore seriousPost-traumatic stress disorder,Dissociative identity disorderThere may be some people.

治療

First of all, in a medical facility, protect it in a safe and privacy environment and do not leave it alone[16]..特に児童青年が自傷行為を行った場合、通常は児童青年病棟に一晩入院させるべきであり、それ以降にフォローアップを行うとNICEは勧告しているNICE recommends that child and adolescents should normally be hospitalized overnight in the child and adolescent ward, especially if they commit self-harm, and follow-up after that.[*1]..非精神科病棟への入院は好ましくなく、やむをえない場合は自傷が繰り返されないよう厳密な対策が求められるHospitalization in a non-psychiatric ward is not desirable, and strict measures are required to prevent repeated self-harm if unavoidable.[16].

Borderline personality disorder,Post-traumatic stress disorderIf you have symptoms of related diseases such as (PTSD), perform psychotherapy / drug therapy according to each guideline.[17].

Assistance policy

It is said that general punishment attitudes should be avoided[18][19]..また、接している者が感情的に混乱するとか、悲しくなるとか、軽蔑してしまうとか、身体の反応としてめまいや興奮、心拍の増加を感じることがあり、それは「正常な反応」であるが、自傷行為を抑制する点では役に立たないため、冷静さを取り戻す必要があるIn addition, the person in contact may feel emotionally confused, sad, despised, or feel dizziness, excitement, or increased heart rate as a physical reaction, which is a "normal reaction". , It is useless in suppressing self-harm, so it is necessary to regain calmness[16][20]..強い反応は、大人を騒がせたい思春期の子どもなど強い反応を期待している行為者にとっては、自傷行為を強化することになるA strong reaction will strengthen self-harm for adolescents who want to make a noise with adults and other actors who expect a strong reaction.[21]..あるいは、自分が他者に拒否されたという体験を追認させ、自傷行為の原因となりえる体験をまたひとつ作り出してしまうOr, let others confirm the experience of being rejected and create another experience that can cause self-injury.[22]..It is then necessary to avoid strong reactions from negative emotions.

You need to be empathetic, but a strong, emotionally positive reaction to help or help can also encourage a stronger self-harm to provoke a protective reaction. is there[23]..つまり、否定的であろうと肯定的であろうと、強い反応は有害であるということであるThat is, a strong reaction, whether negative or positive, is harmful.[24].

It is said that it is important to have good contact with people at that time, not trying to stop anything, but being undecided, compassionate, and not seeking rapid change.[25].

There is no evidence that a self-harm contract has a suppressive effect on self-harm, and the author of the Self-harm Treatment Guide does not recommend it because it is more dangerous.[26]..実際に自傷行為に替わる方法を身につける前の段階での契約では自傷行為を行わないことは難しく、それにもかかわらず「していないと言う」ようになる可能性があるIt's difficult not to do self-harm with a contract before you actually learn how to replace it, and you may nevertheless say you're not.[26].

The Self-harm Treatment Guide contains the Bill of Rights for Self-Injured People, especially for emergency medical professionals.[27][28]..つまり、治療が悪化につながることがあり、それを避けるために、叱責されず思いやりのある治療を受ける権利があり、他に傷がないか強制的に検査することは発見されにくい部位に傷を隠すようになるとか、決めつけをもった態度で接しないようにするための注意であるIn other words, treatment can be exacerbated, and to avoid it, you have the right to receive compassionate treatment without being reprimanded, and forcibly inspecting for other wounds will damage areas that are difficult to find. It is a precaution to avoid hiding or dealing with a prescriptive attitude.[27].

Psychological and social support

Cognitive behavioral therapyIs common.Family therapyEtc. may be used.UK National Institute of Medical Technology(NICE) guidelines suggest 3-12 sessions of psychotherapy[29].

In "Self-injury Treatment Guide"Marsha LinehanDeveloped byDialectical behavior therapy(DBT)Borderline personality disorderIntroducing that it has been reported to be effective against, in the technique of LinehanMindfulnessIs considered to be a core element, and uses a calm yet focused mindfulness technique.John Kabat JinAnd Buddhist monksTik Nut HanIntroducing various meditation methods from deep breathing to meditation counting from 10[30]..毎日15〜20分の練習で、1〜2か月後には実用レベルにまで上達し、数か月では相当興奮していても効果を発揮するまでになるとしているWith XNUMX to XNUMX minutes of practice every day, it will improve to a practical level in XNUMX to XNUMX months, and in a few months it will be effective even if you are quite excited.[31]..他にもいくつか置換行動を紹介し、赤いペンで線を引いたり傷のつかない刺激を与えるといった自傷行為自体につながりかねないので、最小限に用いるべき置換行動や、運動や、芸術創作を行う、音楽を聴いたり演奏する、友人や家族など誰かとコミュニケーションする、あるいは何かで気を紛らわすといった行動を組み合わせることを提唱しているI will introduce some other replacement behaviors, which may lead to self-harm behavior such as drawing a line with a red pen or giving a stimulus that does not damage, so replacement behaviors that should be used to the minimum, exercise, art creation Advocates a combination of actions such as doing, listening to and playing music, communicating with someone such as friends and family, or distracting with something.[31].

If there is trauma such as PTSD, it refers to cognitive behavioral therapy to solve it.[32].

Drug use policy

For the purpose of reducing self-harm itselfDrug therapyNICE recommends not to go[33]..抗うつ薬や抗不安薬の服用が自傷行為の回数を増加させることもあるし、こうした薬物のTaking antidepressants and antidepressants may increase the frequency of self-injury, and of these drugsOverdoseMay also cause.併存疾患の治療のために薬物を処方する際には、過剰摂取の毒性を検討しConsider the toxicity of overdose when prescribing drugs for the treatment of comorbidities[16][34]For example, in antidepressants, the tricyclic system is highly toxic and should not be prescribed.SSRIIs preferred[34].

In 2009 NICE guidelines for borderline personality disorder, without using the medication when there is a strong tendency suicide attempt or suicidal ideation, also in prospect one week at a relatively safe drug as used if effective If not, it is recommended to stop[35].. 2008年の日本のガイドラインも、そうした患者に対し、抗うつ薬と抗精神病薬のような併用療法の有効性を支持する証拠もなく、同種類の薬を複数処方することにも注意し処方するとしても単剤とし、過量服薬の危険性にも注意し、特にThe XNUMX Japanese guidelines also note that there is no evidence to support the effectiveness of combination therapies such as antidepressants and antipsychotics for such patients, and they are also careful to prescribe multiple drugs of the same type. Even if it is a single agent, pay attention to the danger of overdose, especiallyBenzodiazepinesAnxiolyticIs recommended to avoid[36].

Epidemiology

Wrist cut1960 eraMainlyAmericaSeen by women in社会 問題It became.自傷行為経験者は若い未婚のThose who have experienced self-harm are young unmarriedFemaleMany,MaleThere are a certain number of them.It is highly addictive and often suffers for a long time because it is difficult to get the understanding of the surroundings.Canadian Broadcasting Corporation When (CBC) asked 500 school counselors about the number of self-injured people they had seen in the past year, they found that there were 1-2 in each school, which was an informal survey. The incidence was 3 in 250 girls.

Since the latter half of the 1990s, self-harm has emerged among the general population who are not diagnosed with mental illness, and there are often no traumatic experiences.[38]..リストカッターのおよそ半数がAbout half of the wrist cuttersSexual abuseFavazza's 1998 estimate of being a victim of is considered too high[39].

For the UK, the total population prevalence is estimated to be around 0.5%[3]..A large study of students aged 15-16 in the United Kingdom found that 11% of girls and 3% of boys reported self-harm the previous year (2000 and 2001). Year. For 41 students from 6000 schools in Oxford, Northern Stampton and Birmingham) [3]..Slash (65%) was the most common method of self-abuse, followed by excess (31%).

According to Western researchers, about 6% of the respondents are found to have been abused by their parents, but the remaining 4% are not.

The United KingdomTwo Olympic medalists (on land)Kelly Holmes, CyclingVictoria Pendleton) Admits that he was self-harming due to the pressure of the game[40].

Contagion

The transmission of self-harm has been reported since the first half of the 20th century, has a long history from the 1979 study by Ross and McKay, and in 1985 it was Rosen and Walsh who demonstrated and reported the transmission.[41].

Epidemiology in Japan

Research on self-harm is extremely late in Japan.本項目でも日本における調査を参考までに多く取り上げているが、これらの調査に対して自傷症患者を取材してきた記者からは「そもそも自傷行為の定義がはっきりしていない」とか「本当に注目しなければならないのは中毒症状になってしまった場合であるのにその辺りが曖昧である」といった疑問が投げかけられており、調査は大まかな指針にはなっても実際には実態を表していない可能性が強いとされているThis item also covers many surveys in Japan for reference, but reporters who have interviewed patients with self-harm for these surveys said, "The definition of self-harm is not clear in the first place." The question has been raised, "What you have to do is when you have a addiction symptom, but the area is ambiguous." It is said that there is a strong possibility that there is no[Source required].

Self-harm in Japan has been known since the 1970s, when cases from Europe and the United States were introduced.In Japan, the number of actual cases tends to increase with the spread of psychoanalysis and psychological terms.奈良教育大学の調査によるとAccording to a survey by Nara University of Education1999It is said that the number has increased sharply from around that time.[Source required].

The contagiousness of self-harm isインターネットThe impact on the above self-harm related sites was also pointed out. According to the evening edition of the Mainichi Shimbun on February 2, at a public junior high school in the Tokyo metropolitan area in 6, several third-year students began to make wrist cuts, but the number has increased sharply since then, and there are less than 2005 third-year students. It is said that the number of people exceeded 3 even if the school was aware of it.Doctors sometimes say that if they are not good at relationships, they may self-harm in order to feel a sense of companionship.

The National High School PTA Association, with the support of the (Germany) Welfare and Medical Organization (Child-rearing Support Fund), has been implementing a three-year plan since 2003 for the "enhancement of home education to foster the physical and mental health of high school students". According to the third year survey, responses from 3 second-year high school students,Masako KiharaAs a result of the aggregation and analysis by the assistant professor of Kyoto University Graduate School, 5.3% of boys and 10% of girls had experience of self-harm.また、同調査では「出会い系サイト」は男子3.9%、女子5.8%、「援助交際」は男子1.1%、女子1.5%が経験していると回答しているIn addition, in the same survey, "dating site" was experienced by XNUMX% of boys and XNUMX% of girls, and "enjo kosai" was experienced by XNUMX% of boys and XNUMX% of girls.[42].

Social dimension

Stigma

Self-harm used to besuicideIt was a symptom that was not understood enough to be regarded as an act.病院でもその行為が理解できない医者が大半であり、病院側も対処に困るケースが大半であったMost of the doctors did not understand the behavior even in hospitals, and in most cases the hospitals had trouble dealing with it.[43].

However, as self-harm became more widespread, it was a form of illness, and those who self-harm were considered to be mentally ill.It's a very negative note, but it's true that it's better understood than before.However, even after that, few people knew the actual situation in their hearts.Mental illnessAs a personSocial prejudiceOften receive.In general, self-harm is difficult to understand, just because it affects the act.ContemptBe seen.

Also, the Freudian interpretation of the act may be regarded as mere spoiled.From the surroundingsmasochistIt may be seen as an act based on a typical idea.これらの偏見は、本人が自分自身のThese prejudices are that you are your ownidentityIt may be recognized as, and the self-injured person may say so.

However, in reality, self-harm is a kind of self-defense against harsh reality, and such prejudice is caused by poor understanding of hospital staff and those around them who self-harm. Let's go.Those who actually self-harm often have some abnormalities in their family structure and surrounding environment, and are actually considered to be the most normal human beings among family members and surrounding human beings. There are also many.しかし、それらの人間には表面上はBut on the surface for those humansAnomalyMany people who actually self-harm often think that they are the most abnormal because there are few behaviors that are considered to be.However, self-harm is socially unacceptable, so it seems appropriate to take other measures as much as possible.

Animal self-harm

Animals that are cultivated or kept may go crazy due to stress and may self-harm.Animals kept in furry cages bite their bodies, and aquarium fish hit the walls themselves.Feather-plucking (pulling one's own feathers due to stress), which is often seen in domestic birds, is also a type of self-harm.

footnote

  1. ^ Original: All children or young people who have self-harmed should normally be admitted overnight to a paediatric ward and assessed fully the following day before discharge or further treatment and care is initiated (UK National Institute of Medical Technology 2004, Chapt.1.9.1.3)

Source

  1. ^ (Excel) Global health estimates: Leading causes of DALYs (Report). who(2020-12). Download the data> GLOBAL AND BY REGION> DALY estimates, 2000–2019> WHO regions. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys 2021th of February 3Browse.. 
  2. ^ World Health Organization 2010, SUI.
  3. ^ a b c d e f g h i UK National Institute of Medical Technology 2014, Introduction.
  4. ^ Lozano, R (2012-12-15). “Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.”. Lancet 380 (9859): 2095–128. two:10.1016 / S0140-6736 (12) 61728-0. PMID 23245604. 
  5. ^ a b Bunshi Sueki"Suicide Thoughts: For Aya Nanjo(Pdf) Thanatology Research, Vol. 2, 2003, pp. 35-55, NOT 120000862981.
  6. ^ Bowers & Wilkin 2007, p. 21.
  7. ^ Bowers & Wilkin 2007, p. 22.
  8. ^ Pattison EM, Kahan J (July 1983). “The deliberate self-harm syndrome”. The American Journal of Psychiatry 140 (7): 867–72. PMID 6859301. 
  9. ^ a b Bowers & Wilkin 2007, pp. 22, 68-73.
  10. ^ a b c Bowers & Wilkin 2007, pp. 25-30.
  11. ^ a b Bowers & Wilkin 2007, pp. 25-30, 107.
  12. ^ Miller, Matthew; Swanson, Sonja A .; Azrael, Deborah; Pate, Virginia; Stürmer, Til (June 2014). “Antidepressant Dose, Age, and the Risk of Deliberate Self-harm”. JAMA Internal Medicine 174 (6): 899. two:10.1001 / jamainternmed.2014.1053. PMID 24782035. 
  13. ^ Yasuko Tanimoto, "Exploration of Human Aggression-Creation of Self-Other Aggression Scale-", Bulletin of Tokushima Bunri University, No. 80, Tokushima Bunri University, September 2010, p. 9.
  14. ^ 18 Kings (colloquial translation) # 28:XNUMX
  15. ^ Book of Jeremiah (colloquial translation) # 47: 5
  16. ^ a b c d World Health Organization 2010, SUI2.
  17. ^ UK National Institute of Medical Technology 2014, Chapt. 1.5.1.
  18. ^ UK National Institute of Medical Technology 2014, Chapt. 1.1.
  19. ^ Bowers & Wilkin 2007, pp. 94, 255.
  20. ^ Bowers & Wilkin 2007, pp. 249-252.
  21. ^ Bowers & Wilkin 2007, p. 96.
  22. ^ Bowers & Wilkin 2007, p. 97.
  23. ^ Bowers & Wilkin 2007, pp. 93, 95.
  24. ^ Bowers & Wilkin 2007, p. 98.
  25. ^ Bowers & Wilkin 2007, pp. 98-100.
  26. ^ a b Bowers & Wilkin 2007, pp. 145-147.
  27. ^ a b Bowers & Wilkin 2007, pp. 302-304.
  28. ^ Bill of Rights for People Who Self-Harm
  29. ^ UK National Institute of Medical Technology 2014, Chapt. 1.4.8.
  30. ^ Bowers & Wilkin 2007, pp. 149-160, 287-294, 320.
  31. ^ a b Bowers & Wilkin 2007, pp. 149-175, 287-294, 320.
  32. ^ Bowers & Wilkin 2007, pp. 213-215.
  33. ^ UK National Institute of Medical Technology 2014, Chapt. 1.4.9.
  34. ^ a b UK National Institute of Medical Technology 2014, Chapt. 1.5.2.
  35. ^ UK National Institute of Medical Technology (2009a-01). Borderline personality disorder --Clinical guidelines CG78 (Report). National Institute for Health and Clinical Excellence. Pp. Introduction, 1.3.5.1. http://guidance.nice.org.uk/CG78 2013th of February 3Browse.. 
  36. ^ Edited by Sadanobu Ushijima, "Chapter 8 Drug Therapy for Borderline Personality Disorder," "Borderline Personality Disorder-Japanese Treatment Guidelines," Kongo Publishing, September 2008, pp. 9-135.ISBN 9784772410410.
  37. ^ “Mortality and Burden of Disease Estimates for WHO Member States in 2002” (xls), World Health Organization(2002), http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls 2009th of February 12Browse. 
  38. ^ Bowers & Wilkin 2007, pp. 53-54.
  39. ^ Bowers & Wilkin 2007, p. 213.
  40. ^ Daily Mail
  41. ^ Bowers & Wilkin 2007, p. 259.
  42. ^ National High School PTA Association. “Promoting the risk of shoplifting and self-harm, such as weak relationships with family". 2008th of February 9Browse.
  43. ^ UK National Institute of Medical Technology 2004, Chapt. 1.1.

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