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What Prevents Self-Harm?

What Prevents Self-Harm?

World-first University of Otago study to also examine causes of gambling problems

Suicide, the leading cause of injury-related death in young adults in their early 20’s, is now claiming the lives of similar numbers in the 25 to 34 year old age group in New Zealand.

Newly-funded research, set to begin at the University of Otago’s Injury Prevention Unit, promises to yield important new data towards developing a national strategy of self-harm prevention, says principal investigator Dr Shyamala Nada-Raja.

“We know a great deal about what puts people more at risk, but this study aims to shed light on the positive elements that make it less likely that people will deliberately harm themselves,” she said.

There was growing evidence that both aspects worked together, she said, and the study would offer a more “comprehensive and meaningful picture” of how they interacted. “It will be easier to promote positive development when we know what the protective factors are and how they impact over time.”

The three year community-based longitudinal study, a world first, will work with information from a cohort of nearly 1,000 participants in their early 30’s in the well-known Dunedin Multidisciplinary Health and Development Study.

Using data from earlier research when participants were 26, the new results will reveal whether participants have continued or reduced any patterns of self-harm, and will identify factors that may help lessen the risk, such as spirituality, coping skills, having a sense of purpose in life and feeling connected to one's community.

The study will use a number of new approaches, including asking about self-harm irrespective of mental health status and inquiring about a wide range of self-harmful behaviours - even those without reported suicidal intent - as a way of dealing with emotional pain. These include self-hitting or bruising, self-biting and wounding, excessive exercise and denying a necessity, such as food, as forms of self-punishment.

Also new, is the move away from the traditional questioning of asking about suicidal intent first. “Often these actions are impulsive, and people don’t have a conscious suicidal intent. By asking participants about behaviour first, we believe it will help them to remember incidents and will also reduce the stigma of talking about them”, she said.

Separate project funding from the Problem Gambling Purchasing Agency will enable the research group to work with the same cohort to examine protective factors for gambling problems, also a world-first longitudinal study into the incidence and causes of gambling problems. “This group is now of an age where access to disposable income and exposure to gambling opportunities are both relatively high.”

Dr Nada-Raja will be assisted by University of Otago colleagues Professor John Langley (Director of the Injury Prevention Research Unit), Dr Keren Skegg (Psychological Medicine), Associate Professor Rob McGee (Preventive and Social Medicine), and international research and clinical experts, including Professor Alex Blaszczynski (Australia) and Professor Michael King (U.K.). Interviews with study participants are expected to begin in November and continue over about 16 months.

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