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Self-injurious behavior among Greek male prisoners: Prevalence and risk factors

Published online by Cambridge University Press:  16 April 2020

E.I. Sakelliadis
Affiliation:
Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, M. Asias 75, Goudi, 115 2, Athens, Greece
S.A. Papadodima*
Affiliation:
Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, M. Asias 75, Goudi, 115 2, Athens, Greece
T.N. Sergentanis
Affiliation:
Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, M. Asias 75, Goudi, 115 2, Athens, Greece
O. Giotakos
Affiliation:
Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, M. Asias 75, Goudi, 115 2, Athens, Greece
C.A. Spiliopoulou
Affiliation:
Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, M. Asias 75, Goudi, 115 2, Athens, Greece
*
*Corresponding author. E-mail addresses:[email protected], [email protected] (S.A. Papadodima).
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Abstract

Background

Self-harm among prisoners is a common phenomenon. This study aims to estimate the prevalence of self-injurious behavior (SIB) among Greek male prisoners, record their motives and determine independent risk factors.

Methods

A self-administered, anonymous questionnaire was administered to 173 male prisoners in the Chalkida prison, Greece. The questionnaire included items on self-harm/SIB, demographic parameters, childhood history, family history, physical and mental disease, lifestyle and smoking habits, alcohol dependence (CAGE questionnaire), illicit substance use, aggression (Buss–Perry Aggression Questionnaire [BPAQ] and Lifetime History of Aggression [LTHA]), impulsivity (Barrat Impulsivity Scale-11) and suicidal ideation (Spectrum of Suicidal Behavior Scale). Univariate nonparametric statistics and multivariate ordinal logistic regression were performed.

Results

Of all the participants, 49.4% (95% CI: 41.5–57.3%) disclosed self-harm (direct or indirect). The prevalence of SIB was equal to 34.8% (95% CI: 27.5–42.6%). Most frequently, SIB coexisted with indirect self-harm (80.7%). The most common underlying motives were to obtain emotional release (31.6%) and to release anger (21.1%). At the univariate analysis, SIB was positively associated with a host of closely related factors: low education, physical/sexual abuse in childhood, parental neglect, parental divorce, alcoholism in family, psychiatric condition in family, recidivism, age, sentence already served, impulsivity, aggression, alcohol dependence, self-reported diagnosed psychiatric condition and illicit substance use. Childhood variables were particularly associated with the presence of diagnosed psychiatric condition. At the multivariate analysis, however, only three parameters were proven independent risk factors: self-reported diagnosed psychiatric condition, illicit substance use and aggression (BPAQ scale).

Conclusion

The prevalence of SIB is particularly high. Psychiatric condition, illicit substance use and aggression seem to be the most meaningful risk factors; childhood events seem only to act indirectly.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2009

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References

AAPOR. The American Association for Public Opinion Research. Standard definitions: final dispositions of case codes and outcome rates for surveys. 5th ed. Kansas: Lenexa; 2008.Google Scholar
Barratt, ESImpulsiveness and aggression. Monahan, J, Steadman, HJ, Violence and mental disorder. Chicago: University of Chicago Press; 1994. 6179.Google Scholar
Borrill, J, Burnett, R, Atkins, R, Miller, S, Briggs, D, Weaver, Tet al.Patterns of self-harm and attempted suicide among white and black/mixed race female prisoners. Crim Behav Ment Health 2003;13(4):229240.CrossRefGoogle ScholarPubMed
Briere, J, Gil, ESelf-mutilation in clinical and general population samples: prevalence, correlates and functions. Am J Orthopsychiatry 1998;68:609620.CrossRefGoogle ScholarPubMed
Brooke, D, Taylor, C, Gunn, J, Maden, ASubstance misuse as a marker of vulnerability among male prisoners on remand. Br J Psychiatry 2000;177:248251.CrossRefGoogle ScholarPubMed
Brown, GL, Goodwin, FK, Ballenger, JC, Goyer, PF, Major, LFAggression in humans correlates with cerebrospinal fluid amine metabolites. Psychiatry Res 1979;1(2):131139.CrossRefGoogle ScholarPubMed
Buss, AH, Perry, MThe aggression questionnaire. J Pers Soc Psychol 1992;63(3):452459.CrossRefGoogle ScholarPubMed
Claes, L, Vandereycken, WSelf-injurious behavior: differential diagnosis and functional differentiation. Compr Psychiatry 2007;48:137144.CrossRefGoogle ScholarPubMed
Dennis, M, Wakefield, P, Molloy, C, Andrews, H, Friedman, TSelf-harm in older people with depression: comparison of social factors, life events and symptoms. BMJ 2005;186:538539.Google ScholarPubMed
Dhalla, S, Kopec, JAThe CAGE questionnaire for alcohol misuse: a review of reliability and validity studies. Clin Invest Med 2007;30(1):3341.CrossRefGoogle ScholarPubMed
Dumais, A, Lesage, AD, Lalovic, A, Séguin, M, Tousignant, M, Chawky, NTurecki GIs violent method of suicide a behavioral marker of lifetime aggression?. Am J Psychiatry 2005;162(7):13751378.CrossRefGoogle Scholar
Ewing, JADetecting alcoholism, the CAGE questionnaire. JAMA 1984;252:19051907.CrossRefGoogle ScholarPubMed
Favazza, AR, Conterio, KFemale habitual self-mutilators. Acta Psychiatr Neurol Scand 1989;79:283289.CrossRefGoogle ScholarPubMed
Feldman, MDThe challenge of self-mutilation: a review. Compr Psychiatry 1988;29:252269.CrossRefGoogle ScholarPubMed
Fotiadou, M, Livaditis, M, Manou, I, Kaniotou, E, Xenitidis K, Prevalence of mental disorders and deliberate self-harm in Greek male prisoners. Int J Law Psychiatry 2006;29(1):6873.CrossRefGoogle ScholarPubMed
Gallo, LC, Smith, TWConstruct validation of health-relevant personality traits: interpersonal circumplex and five-factor model analyses of the Aggression Questionnaire. Int J Behav Med 1998;5:129147.CrossRefGoogle ScholarPubMed
Gratz, KL, Conrad, SD, Roemer, LRisk factors for deliberate self-harm among college students. Am J Orthopsychiatry 2002;72(1):128140.CrossRefGoogle ScholarPubMed
Gray, NS, Hill, C, McGleish, A, Timmons, D, MacCulloch, MJ, Snowden, RJPrediction of violence and self-harm in mentally disordered offenders: a prospective study of the efficacy of HCR-20, PCL-R and psychiatric symptomatology. J Consult Clin Psychol 2003;71(3):443451.CrossRefGoogle ScholarPubMed
Guertin, T, Lloyd-Richardson, E, Spirito, A, Donaldson, D, Boergers, JSelf-mutilative behavior in adolescents who attempt suicide by overdose. J Am Acad Child Adolesc Psychiatry 2001;40(9):10621069.CrossRefGoogle ScholarPubMed
Harris, MB, Knight-Bohnhoff, KGender and aggression: II. Personal aggressiveness. Sex Roles 1996;35:2742.CrossRefGoogle Scholar
Hawton, K, Bergen, H, Casey, D, Simkin, S, Palmer, B, Cooper, Jet al.Self-harm in England: a tale of three cities. Multicentre study of self-harm. Soc Psychiatry Psychiatr Epidemiol 2007;42(7):513521.CrossRefGoogle ScholarPubMed
Hawton, K, Rodham, K, Evans, E, Weatherall, RDeliberate self-harm in adolescents: self-report survey in schools in England. BMJ 2002;325(7374):12071211.CrossRefGoogle ScholarPubMed
Herpertz, S, Sass, H, Favazza, AImpulsivity in self-mutilating behavior: psychometric and biological findings. J Psychiatr Res 1997;31:451465.CrossRefGoogle ScholarPubMed
Herpertz, S, Steinmeyer, SM, Marx, D, Oidtmann, A, Sass, HThe significance of aggression and impulsivity for self-mutilative behavior. Pharmacopsychiatry 1995;28(Suppl. 2):6472.CrossRefGoogle ScholarPubMed
Holley, H, Arboleda-Florez, JEHypernomia and self-destructiveness in penal settings. Int J Law Psychiatry 1988;11(2):167178.CrossRefGoogle ScholarPubMed
Kisiel, CL, Lyons, JSDissociation as a mediator of psychopathology among sexually abused children and adolescents. Am J Psychiatry 2001;158(7):10341039.CrossRefGoogle ScholarPubMed
Klonsky, ED, Oltmanns, TF, Turkheimer, EDeliberate self-harm in a nonclinical population: prevalence and psychological correlates. Am J Psychiatry 2003;160:15011508.CrossRefGoogle Scholar
Matsumoto, T, Yamaguchi, A, Chiba, Y, Asami, T, Iseki, E, Hirayasu, YPatterns of self-cutting: a preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample. Psychiatry Clin Neurosci 58(4)2004 377382.CrossRefGoogle Scholar
Mohino Justes, S, Ortega-Monasterio, L, Planchat Teruel, LM, Cuquerella Fuentes, A, Talón Navarro, T, Macho Vives, LJDiscriminating deliberate self-harm (DSH) in young prison inmates through personality disorder. J Forensic Sci 2004;49:137140.Google ScholarPubMed
Patton, JH, Stanford, MS, Barratt, ESFactor structure of the Barratt impulsiveness scale. J Clin Psychol 1995;51(6):768774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Perry, AE, Gilbody, SDetecting and predicting self-harm behaviour in prisoners: a prospective psychometric analysis of three instruments. Soc Psychiatry Psychiatr Epidemiol 2009;12: [Epub ahead of print]Google Scholar
Pfeffer, CR, Newcorn, J, Kaplan, G, Mizruchi, MS, Plutchik, RSuicidal behavior in adolescent psychiatric inpatients. J Am Acad Child Adolesc Psychiatry 1988;27:357361.CrossRefGoogle ScholarPubMed
Rawlings, JO, Pantula, SG, Dickey, DAApplied Regression Analysis. A Research Tool. 2nd Ed. New York: Springer-Verlag; 1998.CrossRefGoogle Scholar
Rodriguez-Srednicki, OChildhood sexual abuse, dissociation and adult self-destructive behavior. J Child Sex Abus 2001;10(3):7590.CrossRefGoogle ScholarPubMed
Saxe, N, Chawla, N, Van der Kolk, BSelf-destructive behavior in patients with dissociative disorders. Suicide Life Threat Behav 2002;32(3):313–20.CrossRefGoogle ScholarPubMed
Schwartz, RH, Cohen, P, Hoffmann, NG, Meeks, JESelf-harm behaviors (carving) in female adolescent drug abusers. Suicide Life Threat Behav 1989;28(8):340346.Google Scholar
Simeon, D, Stanley, B, Frances, A, Mann, JJ, Winchel, R, Stanley, MSelf-mutilation in personality disorders: psychological and biological correlates. Am J Psychiatry 1992;149(2):221226.Google ScholarPubMed
Stanley, B, Gameroff, MJ, Michalsen, V, Mann, JJAre suicide attempters who self-mutilate a unique population?. Am J Psychiatry 2001;158(3):427432.CrossRefGoogle ScholarPubMed
Suyemoto, KL, MacDonald, MLSelf-cutting in female adolescents. Psychotherapy 1995;32:162171.CrossRefGoogle Scholar
Taiminen, TJ, Kallio-Soukainen, K, Nokso-Koivisto, H, Kaljonen, A, Helenius, HContagion of deliberate SM among adolescent inpatients. J Am Acad Child Adolesc Psychiatry 1998;37:211217.CrossRefGoogle Scholar
van der Kolk, BA, Perry, JC, Herman, JLChildhood origins of self-destructive behavior. Am J Psychiatry 1991;148:16651671.Google ScholarPubMed
Walsh, BW, Rosen, PMDistinguishing self-mutilation from suicide: a review and commentary. Self-Mutilation. New York: The Guilford Press; 1988. p. 1538.Google Scholar
Young, MH, Justice, JV, Erdberg, PRisk of harm: inmates who harm themselves while in prison psychiatric treatment. J Forensic Sci 2006;51:156162.CrossRefGoogle ScholarPubMed
Zanarini, MC, Frankenburg, FR, DeLuca, CJ, Hennen, J, Khera, GS, Gunderson, JGThe pain of being borderline: dysphoric states specific to borderline personality disorder. Harv Rev Psychiatry 6(4)1998 201207.CrossRefGoogle ScholarPubMed
Zlotnick, C, Mattia, JI, Zimmerman, MClinical correlates of self-mutilation in a sample of general psychiatric patients. J Nerv Ment Dis 1999;187:296301.CrossRefGoogle Scholar
Zweig-Frank, H, Paris, J, Guzder, JPsychological risk factors and self-mutilation in male patients with BPD. Can J Psychiatry 1994;39(5):266268.CrossRefGoogle ScholarPubMed
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