Deliberate Self Harm vs Suicidal Ideation

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Questions and Answers

What is deliberate self-harm (DSH)?

Intentional harm to one’s body tissue without suicidal intent (correct)

Accidental injury resulting from reckless behavior

A mental health condition characterized by suicidal thoughts

A method of seeking attention from others

Which of the following is NOT classified as a form of deliberate self-harm?

Cutting

Planning a suicide (correct)

Burning or scalding

Hitting

What distinguishes suicidal ideation (SI) from deliberate self-harm (DSH)?

DSH is always accompanied by a suicide attempt.

SI involves actual physical injury, while DSH does not.

SI refers to thoughts of death, whereas DSH is a behavior without suicidal intent. (correct)

There is no difference; they are the same concept.

Which statement accurately describes suicide?

It occurs when a person successfully acts on their suicidal ideation. Signup and view all the answers

Which statement reflects the attitudes towards the content of suicide and self-harm that should be encouraged?

Students should openly discuss their feelings about these topics. Signup and view all the answers

What is a common reason that individuals engage in self-harm?

To manage their anxiety Signup and view all the answers

Which of the following statements about suicide statistics is accurate?

More than 8 people a day died by suicide in Australia in 2018 Signup and view all the answers

What is categorized as a predisposing factor in relation to self-harm and suicide?

Previous self-harm incidents Signup and view all the answers

What percentage of self-harm admissions in 2018 was due to intentional self-poisoning?

83% Signup and view all the answers

Which statement best describes deliberate self-harm (DSH)?

A maladaptive coping strategy for emotional relief Signup and view all the answers

Which factor is categorized as predisposing for self-harm and suicide?

Poor impulse control Signup and view all the answers

Which of the following is a precipitating factor related to suicide?

Bereavement Signup and view all the answers

What is considered a perpetuating factor for self-harm and suicide?

Unresolved housing problems Signup and view all the answers

Which condition is NOT a psychological predisposing factor for self-harm and suicide?

Conflict between parents Signup and view all the answers

Which of the following accurately exemplifies a precipitating risk factor?

Entering care Signup and view all the answers

Which option describes a perpetuating factor linked to suicidal behavior?

Continuing negative experiences of care Signup and view all the answers

Which statement is true regarding factors related to self-harm?

Poor interpersonal problem solving is a predisposing factor. Signup and view all the answers

Which factor is primarily associated with the management or control of risk related to self-harm?

Believing that distress is not taken seriously Signup and view all the answers

What does the mental status examination (MSE) primarily aim to uncover?

The subjective experience of the consumer Signup and view all the answers

Which of the following components is NOT typically assessed during an MSE?

Medical history Signup and view all the answers

In what setting is the MSE most commonly integrated into routine nursing interactions?

Inpatient settings Signup and view all the answers

What is a primary benefit of using standardized instruments in mental health assessments?

They ensure assessments are thorough and accurate Signup and view all the answers

How does conducting ongoing MSEs assist healthcare professionals?

It establishes a baseline of mental state expectations Signup and view all the answers

Which aspect of a mental health consumer's state is LEAST likely to be assessed through their MSE?

Dietary habits Signup and view all the answers

What is a key role of collaboration in mental health assessments?

To ensure different perspectives are considered Signup and view all the answers

Which of the following statements describes the importance of observing behavior and mood during MSE?

They provide insight into the consumer's current state Signup and view all the answers

Which component of cognitive assessment involves understanding the current environment and oneself?

Orientation Signup and view all the answers

What does the Mini-Mental State Examination primarily screen for?

Cognitive function Signup and view all the answers

In assessing insight, what indicates a complete understanding of one’s mental health issues?

Acknowledging the problem and possible treatments Signup and view all the answers

What is an essential factor when considering a person's judgment in a mental state examination?

The extent to which symptoms affect behavior and decisions Signup and view all the answers

Which type of cognitive assessment may be necessary if dysfunction is suspected during an initial screening?

Extended cognitive assessment Signup and view all the answers

What aspect is typically assessed under abstract thinking during a cognitive function evaluation?

Understanding complex concepts and ideas Signup and view all the answers

How does memory assessment differentiate between types of memory?

Through immediate, recent, and remote recall Signup and view all the answers

What indicates that a consumer is vulnerable to risks in a mental health context?

Lack of insight into their behavioral patterns Signup and view all the answers

What is a key characteristic of affect in observing a person's emotional state?

It is the outward expression of emotion. Signup and view all the answers

Which observation indicates psychomotor hyperactivity?

The person appears restless and paces around. Signup and view all the answers

When conducting a mental status examination, what should be noted about speech?

Quality, quantity, rate, and tone should all be assessed. Signup and view all the answers

What is the significance of body language when observing a person's behavior?

It can provide insights into the person's emotional state. Signup and view all the answers

How can mood be best described in a mental status examination?

As a subjective emotional state experienced by the individual. Signup and view all the answers

Which of the following behaviors could indicate a flattened affect?

Minimal facial expressions and monotone speech. Signup and view all the answers

What role does collaboration play in mental health assessments?

It enhances understanding and comprehensive evaluation. Signup and view all the answers

Why are standardized assessments important in mental health evaluations?

They streamline observations into a predefined framework. Signup and view all the answers

Study Notes

Deliberate Self Harm (DSH) vs Suicidal Ideation (SI)

Deliberate self harm (DSH) is the intentional injuring of body tissue without suicidal intent
DSH covers a range of behaviours including cutting, scratching, hitting, head banging, burning, scalding, hair pulling, and excessive use of substances.
Although individuals engaging in DSH may not have suicidal thoughts, there is a possibility of death through misadventure.
Suicidal ideation (SI) involves thoughts, ideas or plans about causing one's own death.
Suicide attempt is when someone acts on their suicidal ideation.
Suicide is when a suicide attempt is successful.

Reasons For DSH

People engaging in DSH may not want to die; the act may be used to:
- Manage anxiety
- Ground themselves
- Feel physical pain (easier than emotional pain)
- Punish themselves
- Gain relief
- Feel in control
Deliberate self-harm is described as a ‘maladaptive coping strategy’

Suicide and Self Harm Statistics

In 2018, 3046 people completed suicide in Australia
- More than 8 people a day
- Accounts for 1.9% of all deaths in Australia
- Males are 3 times more likely than females to end their life
- Average age of death is 44 years
In 2018, Self-Harm accounted for 10% of all ICU admissions
- 10% of injury-related admissions for 15-19 year olds
- Females are admitted at double the rate of males
- Intentional self-poisoning makes up 83% of all DSH admissions

Predisposing factors:
- Social: family history of self-harm and suicide, childhood abuse, homelessness, physical illness,
- Psychological: family history of mental illness, reduced ability to regulate emotions, poor impulse control, low self-esteem
- Interpersonal: conflict between parents, lack of supportive relationships, poor interpersonal problem solving
Precipitating Factors:
- Social: entering care, parents divorcing, bereavement, unplanned pregnancy, significant financial stress, sexual assault
- Psychological: mental illness, excessive alcohol, illicit drug use
- Interpersonal: perceived stressful situations involving others, relationship breakdown, argument/conflict with significant other
Perpetuating Factors:
- Social: being bullied, unresolved housing, employment and financial problems, ready availability of potentially lethal means of self-harm
- Psychological: Intoxication with alcohol/illicit substances, cognitive problems, believing that distress or problems are not being taken seriously
- Interpersonal: unresolved conflict with parents, continuing negative experiences of care, ongoing difficulty communicating feelings

Mental Status Examination (MSE)

The MSE is a standardized format for documenting observations of mental health consumers.
It aims to uncover the subjective experience of the consumer and determine the current mental state.
It helps professionals work collaboratively with consumers effectively and efficiently.
It is crucial for gathering comprehensive information about a person's emotional, behavioral, cognitive, and functional well-being.
MSEs establish a baseline of expectations around an individual's mental state.

Components of the MSE

Appearance: Assess the individual's physical appearance, clothing, hygiene, and overall presentation.
Behaviour: Observe the individual's demeanor, body language, gestures, eye contact, posture, and psychomotor activity.
Mood/Affect: Assess the individual's reported mood and observable emotional expression.
Speech: Analyze the individual's speech patterns, including quantity, quality, rate, volume, and tone.
Thought Form: Evaluate the organization and coherence of the individual's thoughts.
Thought Content: Examine the specific content of the individual's thoughts, including any unusual or disturbing themes.
Perception: Assess the reliability of the individual's perception of reality.
Cognition & Intellectual Functioning: Evaluate the individual's cognitive abilities, including orientation, memory, concentration, attention, and abstraction.
Insight & Judgement: Evaluate the individual's awareness and understanding of their situation, the origins of their mental health issues, and the ability to make safe and sound judgements.
Risks: Identify potential risks associated with the individual's mental state and behaviors.

Appearance

Ascertains basic brain processes and cognitive functioning.
Assessments include consciousness, orientation, memory, concentration, attention, capacity to read and write, visuo-spatial ability, and abstraction.

Cognition and Intellectual Functioning

Orientation: Assess the individual's understanding of time, place, and person.
Levels of Consciousness/Alertness: Observe the individual's level of alertness and responsiveness, including alert, clouding, fluctuating, delirium, stupor, drowsy, etc.
Abstract Thinking: Evaluate the individual's ability to understand concepts and juggle multiple ideas simultaneously.
Memory: Assess different types of memory including immediate, recent, and remote recall.

Insight and Judgement

Insight: Assess the individual's awareness and understanding of their mental health problem, its origins, and its implications.
Judgement: Evaluate the individual's ability to make safe and sound judgments in various situations, considering the potential consequences of their actions.

Risks

Observe and document potential risks associated with the individual's mental state and behavior.
Examples include distinctiveness features, clothing, hygiene, build, and any concerning behaviors.

Behavior

Assess the individual's cooperation, rapport, engagement, response, and interaction with the health professional.
Analyze body language, gestures, eye contact, posture, and psychomotor activity (hyperactivity, hypoactivity, compulsive behaviors, etc).
Document any bizarre or unusual behaviors.

Affect & Mood

Affect: Observe the outward expression of emotion, including facial expression, voice tone, body language, and posture.
Mood: Determine the individual's subjective experience of their pervasive and sustained emotional state. Assess the overall emotional tone and describe it using terms like dysphoric, flat, elevated, depressed, anxious, labile, restricted, euthymic, etc.

Speech

Assess the quantity, quality, rate, volume, and tone of the individual's speech.
Observe factors like talkativeness, poverty of speech, slurred speech, stuttering, whispering, pressured speech, rapid speech, slow speech, loudness, quietness, and monotone speech.

Thought Form

Assess the organization and coherence of the individual's thoughts through observation of behavior, speech, and expression of ideas.
Evaluate and document aspects like circumstantiality, tangentiality, flight of ideas, loose associations, thought blocking, perseveration, and neologisms.

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Description

Explore the critical differences between Deliberate Self Harm (DSH) and Suicidal Ideation (SI). This quiz delves into the behaviors associated with DSH, the reasons behind such actions, and the statistics surrounding these issues. Understand the psychological impacts and coping strategies related to these complex topics.