In this broad representative sample of adolescents aged 15-17 years approximately one in ten reported a previous episode of DSH of whom 45.9% had done so more than once. The lifetime prevalence of DSH of 9.1% is higher compared to the prevalence of deliberate self harm reported in previous Irish school-based studies [5-7], which can be explained by the use of a broader definition of self harming behaviour in the present study. Only 11.3% of teenagers who harmed themselves attended hospital and fewer sought help from other medical services following their episode of DSH, findings which are consistent with other Irish studies [9, 10]. Given this tendency for adolescents not to seek help and that most studies investigating deliberate self harm are based on hospital treated cases of deliberate self harm [11], previous estimates of the extent of deliberate self harm may have been underestimated.. The one-year prevalence rate based on the study definition criteria was 5.7%. Considering their lifetime ...
The aim of this cross-sectional 1-year study was to estimate the prevalence and to identify the risk factors for suicidal and self-injurious behaviours among patients with depression. A convenience sample of 557 out- and inpatients diagnosed with mood disorders was selected from 3 treatment settings in Riyadh, Saudi Arabia. Eligible patients completed data on sociodemographic variables and the Columbia suicide severity rating scale risk assessment version. The reported prevalence of attempted suicide in the previous week was 36.6%, interrupted suicide attempt 29.8%, aborted suicide attempt 34.6% and self-injurious behaviour without suicide intent 7.7%. Concerning suicide ideation, 47.2% reported suicidal thoughts, 36.6% suicidal thoughts with methods but without a specific plan and 35.4% suicidal intent without a specific plan. Male sex, joint family type, literate education, being in employment, smoking and physical co-morbidities were significantly associated with all types of suicide ...
A non-suicidal self-injury can be scary for parents to discover. Before reacting emotionally, learn why it occurs, who is at risk, and what you can do.
The limitations people with profound intellectual disabilities experience in functioning contribute to a vulnerability to self-injurious behavior. Since this problem behavior has important negative consequences for people concerned, examining the effectiveness of treatments is important. In the current meta-analysis, single-case studies investigating non-aversive, non-intrusive forms of reinforcement were combined using hierarchical linear models. This analysis revealed that the average effect of treatment was relatively large and statistically significant. Further, significant variance was observed between both studies and participants. In addition, some evidence was found for a moderator effect of sensory impairment. Finally, no statistically significant moderator effects of medication, motor impairment, setting, age, gender, matching of treatment with behavioral function and contingency were found ...
Oliver, Chris and Richards, Caroline (2010) Self-injurious behaviour in people with intellectual disability. Current Opinion in Psychiatry. ISSN 0951-7367 ...
Find all books from Cram101 Textbook Reviews - Outlines & Highlights for Self-Injurious Behavior in Intellectual Disabilities, Vol. 2 by Johannes Rojahn, ISBN: 9780080448893. At euro-book.co.uk you can find used, antique and new books, COMPARE results and immediately PURCHASE your selection at the best price. 9781614610793
I have often heard that about 20 to 30% of individuals with an autism spectrum disorder (ASD) will exhibit significant symptoms of irritability and/or aggression including quickly changing moods, severe tantrums, and self-injurious behaviors (SIB). These behaviors are more prevalent in low functioning individuals and/or those that are non-verbal. Medications like antipsychotics (also known as…
I have often heard that about 20 to 30% of individuals with an autism spectrum disorder (ASD) will exhibit significant symptoms of irritability and/or aggression including quickly changing moods, severe tantrums, and self-injurious behaviors (SIB). These behaviors are more prevalent in low functioning individuals and/or those that are non-verbal. Medications like antipsychotics (also known as…
PubMed journal article Self-injurious behavior in adolescent girls. Association with psychopathology and neuropsychological function were found in PRIME PubMed. Download Prime PubMed App to iPhone or iPad.
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Background. Self-harm is a major and growing public health issue among young people worldwide. Self-harm is an important risk factor for suicide, which is one of the leading causes of death for young people. Although suicide rates are declining overall, this trend is not seen in young people. Young people with mental distress and/or suicidal thoughts are reluctant to seek help, and often drop out of treatment initiated after a self-harm episode. Many young people who self-harm have had contact with healthcare before their first self-harm episode, but often for reasons other than suicidal thoughts or psychiatric problems. In this context, physical illness is associated with increased risk for self-harm and suicide among young people. The present thesis investigated how young people perceived the help and support they received before and after an episode of self-harm. A further aim was to map the inpatient somatic healthcare contacts young patients had before an episode of self-harm, and determine ...
Mental disorders were diagnosed in only approximately one half of emergency department visits by young people, following an episode of deliberate self-harm
C-SSRS assessed whether participant experienced following: completed suicide (1), suicide attempt (2) (response of Yes on actual attempt), preparatory acts toward imminent suicidal behavior (3)(Yes on preparatory acts or behavior), suicidal ideation (4) (Yes on wish to be dead, non-specific active suicidal thoughts, active suicidal ideation with methods without intent to act or some intent to act, without specific plan or with specific plan and intent), any suicidal behavior or ideation, self-injurious behavior (7)(Yes on Has subject engaged in non-suicidal self-injurious behavior ...
PubMed journal article Factors associated with deliberate self-harm among Irish adolescent were found in PRIME PubMed. Download Prime PubMed App to iPhone or iPad.
The details of practice resource - Australian and New Zealand clinical practice guidelines for the management of adult deliberate self-harm
Suicide is the second leading cause of death among young people ages 10-19 in the U.S., and rates of youth suicide and self-injury hospitalization are on the rise, especially among younger adolescents (1, 2). A 2017 survey estimated that more than 1 in 6 high school students nationwide seriously considered suicide in the previous year, a figure nearly 20% higher than findings from a decade earlier (3). Between 2007 and 2015, suicide rates rose 130% for U.S. children ages 10-14 and 46% for youth ages 15-19 (2). Similar to suicide trends, from 2001 to 2015 self-injury hospitalization rates increased by more than 130% for ages 10-14 and by 47% for ages 15-19 (2). While self-inflicted injuries typically are not the result of suicide attempts and do not involve intent to die, non-suicidal self-injury (NSSI) is a risk factor for suicide (4). Data from a 2015 national survey show that in the previous year 18% of high school students had engaged in NSSI at least once, and 6% had engaged in NSSI six or ...
Suicide is the second leading cause of death among young people ages 10-19 in the U.S., and rates of youth suicide and self-injury hospitalization are on the rise, especially among younger adolescents (1, 2). A 2017 survey estimated that more than 1 in 6 high school students nationwide seriously considered suicide in the previous year, a figure nearly 20% higher than findings from a decade earlier (3). Between 2007 and 2015, suicide rates rose 130% for U.S. children ages 10-14 and 46% for youth ages 15-19 (2). Similar to suicide trends, from 2001 to 2015 self-injury hospitalization rates increased by more than 130% for ages 10-14 and by 47% for ages 15-19 (2). While self-inflicted injuries typically are not the result of suicide attempts and do not involve intent to die, non-suicidal self-injury (NSSI) is a risk factor for suicide (4). Data from a 2015 national survey show that in the previous year 18% of high school students had engaged in NSSI at least once, and 6% had engaged in NSSI six or ...
Abnormal behavior commonly occurs in captive nonhuman primates. It differs from normal behavior in either kind or degree and consists of behaviors such as pacing, self-grasping, and self-inju
EDITOR-We agree with Foster that greater attention must be paid to alcohol use disorders if national and international targets for suicide reduction are to be met.1 Accident and emergency departments have a central part to play in tackling the link between alcohol misuse and suicidal behaviour as most patients with deliberate self harm present there.. Research has indicated that over half of men who present to hospital after deliberate self harm have consumed alcohol in the few hours preceding the attempt, half regularly drink excessive amounts of alcohol, and 23% are alcohol dependent.2 Despite this strong association many patients who present to hospital after deliberate self harm do not have their alcohol use assessed.3. At the accident and emergency department at St Marys Hospital, in inner London, the proportion of patients whose alcohol consumption is assessed has been greatly increased by the introduction of the Paddington alcohol test.4 This test takes less than a minute to complete and ...
Arron, K and Oliver, C and Berg, K and Moss, J and Burbidge, C (2011) Prevalence and phenomenology of self-injurious and aggressive behaviour in genetic syndromes. Journal Of Intellectual Disability Research, 55. pp. 109-120. ...
This study presents unique descriptions of how adolescents living in urban England view self-harm. Adolescents depicted self-harm as a complex behaviour involving a range of methods, functions and taboos. Those who self-harmed described it as a private, inwardly focused expression of distress, often with a reluctance to disclose and seek help. This was reinforced by the comments about self-harm as attention seeking from participants who had not self-harmed. Such views may contribute to fears about responses from others, particularly where social support may be variable or lacking. Self-harm being discovered by others was often viewed as a negative experience. Although most participants were unclear about what would constitute "help", some reflected on the benefits of help they had received following disclosure of self-harm. The ethnic diversity within this sample illustrated that self-harm was concern across a range of ethnic groups. Mixed reflections and experiences described in this study ...
More than 90 percent of the patients were female, three-quarters were white, and the average age was 15, the researchers noted. Nearly 41 percent were found to have engaged in intentional self-inflicted injury. More than 85 percent of the time this took the form of cutting themselves. Yet despite the high prevalence, only about half of the patients had been asked by hospital staff if they had hurt themselves on purpose. Those who were asked tended to fit a classic profile: they were female, older, white and had a diagnosis of bulimia and/or substance abuse of some kind. "The question is," said Peebles, "are we missing other kids who are not meeting this profile? This is part of why we wanted to look at this. If you see an innocent-looking 12-year-old boy, you dont even think of asking about self-injurious behavior. We need to get much better about universal screening ...
article{93c4e9a8-0b03-490c-899d-0e33bd080295, abstract = {Objective: A disturbed glucose metabolism has been observed in patients with aggressive behaviour. Interleukin (IL)-1β is a pro-inflammatory cytokine that can induce hypoglycaemia, but has also been suggested to be involved in the generation of hostility and aggression. Our group has previously shown an altered glucose metabolism in patients with self-inflicted aggressive behaviour. We investigated the hypothesis that the levels of IL-1 would be increased in these patients, because this might explain the aberrant glucose metabolism and add further knowledge to the aetiology of self-inflicted aggressive behaviour. Method: We investigated plasma cytokine changes in 13 patients with borderline personality disorder and 13 healthy controls during a 5-h glucose challenge. Plasma samples were analysed for cytokines IL-1β, TNF-α and IL-6 using high-sensitivity multiplex ELISA. Psychiatric symptoms were rated using the Aggression ...
1 Results of the first funding period To investigate the influence of tissue damage in the context of non-suicidal self-injury (NSSI), we first characterized nociceptive non-invasive stimuli and a mechanical stimulus associated with tissue injury (incision). Twenty healthy men and women each were investigated regarding pain intensity and affective/sensory characteristics of the stimuli. Affective scores were significantly lower than sensory scores for all modalities, including the incision. In women, affective scores were not different for blade, laser and incision stimuli. In a second step, a non-invasive mechanical "blade" stimulus was matched by means of pain intensity with the incision stimulus. Comparing time courses of blade and incision pain, the time course including the pain maximum was very similar (point-by-point comparison between p=0.8 and 1.0). In the ongoing second study, we were successful to induce stress in all groups (current BPD, remitted BPD, healthy controls), verified by ...
Background. Self-harm is a major and growing public health issue among young people worldwide. Self-harm is an important risk factor for suicide, which is one of the leading causes of death for young people. Although suicide rates are declining overall, this trend is not seen in young people. Young people with mental distress and/or suicidal thoughts are reluctant to seek help, and often drop out of treatment initiated after a self-harm episode. Many young people who self-harm have had contact with healthcare before their first self-harm episode, but often for reasons other than suicidal thoughts or psychiatric problems. In this context, physical illness is associated with increased risk for self-harm and suicide among young people. The present thesis investigated how young people perceived the help and support they received before and after an episode of self-harm. A further aim was to map the inpatient somatic healthcare contacts young patients had before an episode of self-harm, and determine ...
BACKGROUND: Studies of self-harm in Black and minority ethnic (BME) groups have been restricted to single geographical areas, with few studies of Black people. AIMS: To calculate age- and gender-specific rates of self-harm by ethnic group in three cities and compare characteristics and outcomes. METHOD: A population-based self-harm cohort presenting to five emergency departments in three English cities during 2001 to 2006. RESULTS: A total of 20 574 individuals (16-64 years) presented with self-harm; ethnicity data were available for 75%. Rates of self-harm were highest in young Black females (16-34 years) in all three cities. Risk of self-harm in young South Asian people varied between cities. Black and minority ethnic groups were less likely to receive a psychiatric assessment and to re-present with self-harm. CONCLUSIONS: Despite the increased risk of self-harm in young Black females fewer receive psychiatric care. Our findings have implications for assessment and appropriate management for some BME
Discussion. In the UK, rates of self-harm in immature people are among the highest in Europe ( Anderson et al. 2004 ) . Caring for immature people admitted to hospital after self- harming can be disputing for nurses and healthcare workers. One of the cardinal findings of the current research was that immature people on the ward compete for attending by self-harming, such that if one patient self-harms, other patients will so self-harm more badly in an effort to acquire more attending. A turning organic structure of research has shown that attending seeking is frequently non the chief intent of ego injury, but instead a method of get bying with jobs and emotional hurt ( Preece and Jowett 2007 ) . The consequences of this research challenge these old findings and suggest that the self-harm behavior exhibited by patients in this survey was chiefly driven by a demand for attending. A figure of possible causative factors for this behavior are discussed below.. The nature of the curative ...
OBJECTIVES: To investigate the mental health, substance use, educational, and occupational outcomes of adolescents who self harm in a general population sample, and to examine whether these outcomes differ according to self reported suicidal intent. DESIGN: Population based birth cohort study. SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-92. PARTICIPANTS: Data on lifetime history of self harm with and without suicidal intent were available for 4799 respondents who completed a detailed self harm questionnaire at age 16 years. Multiple imputation was used to account for missing data. MAIN OUTCOME MEASURES: Mental health problems (depression and anxiety disorder), assessed using the clinical interview schedule-revised at age 18 years, self reported substance use (alcohol, cannabis, cigarette smoking, and illicit drugs) at age 18 years, educational attainment at age 16 and 19 years, occupational outcomes at age 19 years, and self harm at age
A national study of Medicaid data shows most young people who present to emergency departments with deliberate self-harm are discharged to the community, without receiving an emergency mental health assessment. Even more, ...
Sometimes health professionals can stand to be more sensitive to people with self-harm behavior. I came across the following that I thought I would share. Bill of Rights for People Who Self-Harm Preamble: An estimated one percent of Americans use physical self-harm as a way of coping with stress; the rate of self-injury in other…
Individuals with intellectual disability (ID) often engage in behaviours that are labelled as challenging (challenging behaviours; CB). CBs are actions that may place the individual at risk of harm or exclusion, or may place other people (e.g. carers) at risk of harm [1]. Thus, CBs are defined socially, in terms of their impact. Behaviours labelled as challenging typically include actions such as anger and aggression, self-injurious behaviours (e.g. self-biting, hitting body parts against objects, scratching and gouging), destruction of property, and inappropriate or risky social behaviour. CBs are, by definition, a significant challenge for services and impact negatively on the quality of life of people with ID. CBs are also related to risk of abusive practices (cf. Winterbourne View scandal exposed by BBC Panorama), increased carer stress [2, 3], and high cost of support services [4]. High quality epidemiological research suggests that 18-19% of adults with ID known to services engage in CB ...
Pharmacologic interventions may be considered for maladaptive behaviors such as aggression, self-injurious behavior, repetitive behaviors (eg, perseveration, obsessions, compulsions, and stereotypic movements), sleep disturbance, mood lability, irritability, anxiety, hyperactivity, inattention, destructive behavior, or other disruptive behaviors. After treatable medical causes and modifiable environmental factors have been ruled out, a therapeutic trial of medication may be considered if the behavioral symptoms cause significant impairment in functioning and are suboptimally responsive to behavioral interventions. In some cases, the diagnosis of a comorbid disorder, such as major depression, bipolar disorder, or an anxiety disorder, can be made reasonably and the patient can be treated with medications that are useful for treating these conditions in otherwise typically developing children and adolescents. Modifications of diagnostic criteria may be necessary to account for clinical ...
S-STS:8-item clinician/participant administered prospective rating scale to assess TE suicidal(Su) ideation(ID),behavior(BHV).Items 1a,2-6,7a,8 scored on 5-point Likert scale 0(not at all) to 4(extremely). Items 1,1b,7 require yes/no response. S-STS total score range 0-30. Lower score=reduced Su tendency. Responses on S-STS were mapped to Columbia Classification Algorithm of Suicide Assessment(C-CASA) as 1:Completed Su; 2: Su attempt; 3: Preparatory acts; 4: Su ID; 5: Self-injurious (SI) BHV, intent unknown; 6: Not enough information; 7: SI BHV, no Su intent; 8: Other, no deliberate self harm ...
Any family can find themselves struggling through the developmental stages of adolescence. Teens often struggle with depression, anxiety, self-injurious behavior or social and family pressures. Suicidal thoughts and behaviors are far too common among teens. The results can leave a family in crisis and weekly therapy simply is not enough structure for healing.. We help empower teens to find their strengths, accept their vulnerabilities and learn to care for their physical and mental health through increased self-esteem and purpose. We believe every family member has a role to play in the overall wellbeing of the family system.. Balance staff uses a family systems approach with the adolescent and family by identifying and bringing empathy to difficult family dynamics - fears, tensions, unresolved conflicts, unspoken anxieties - most of which are present to some degree in all families, whether a family member has a mental health diagnosis or not. This is done by working cooperatively with the ...
The National Dissemination Center for Children with Disabilities (NICHCY) has identified the following characteristics and behaviors as typical of children with emotional disturbances: * Inappropriate types of behavior under normal circumstances, such as aggression or self-injurious behavior * Hyperactivity (sh
The following report on a 7-month trial of Peptizyde and HN-Zyme is reprinted with the kind permission of the Enzymes and Autism Board, hosted by Yahoo Groups. The overwhelming majority of respondents saw noticeable improvements with Peptizyde and HN-Zyme Prime. Of 260 total respondents (100%) using these products for at least 3 weeks, 235 (90%) reported positive results, 14 (6%) reported negative results, and 11 (4%) reported inconclusive results.. Significant improvements were seen in eye contact, language, humor, foods tolerated, foods accepted, sleep, weight gain or loss, digestion, stools/bowels, overall appearance, transitioning, socialization, awareness, problem solving, short-term memory, flexibility in routine, range of interests, sound and light tolerance, sensory integration, spontaneous affection, and energy level among others.. Significant decreases were seen in aggression, hyperness, anxiety, self-stimming, self-injurious behavior, pain, and headaches among others.. Most positive ...
I was in a really foul mood yesterday. Well, Elijah was grumpy, which was the main reason for my sourness. His self-injurious behavior has ramped up again recently, which is really hard on me. Thats probably an obvious statement, but sometimes it isnt so obvious to me. Ill start feeling down, oblivious to the reason, until I finally realize its because Eli is having a hard time dealing with his frustrations. To let out his feelings, he bites his hand. This behavior had almost completely disappeared until the last few weeks, thus my feelings of despair (and if Im honest, one of the reasons I dont blog as much. When Im sad its hard to write). When he hurts himself, I kind of feel like someone is repeatedly punching me in the face (well, emotionally anyway). Yeah, its not exactly a pleasant experience. No wonder I was feeling grumpy ...
Nonetheless, medicines such as risperidone and aripiprazole can be beneficial in ways that can assuage these gist symptoms, because relieving irritability again improves sociability while reducing tantrums, pushy outbursts and self-injurious behaviors. Accommodating be supportive of and succour is the crest priority for PhRMAs member companies, who are working hard to give a new lease of patients lives through the detection and condition of unheard of medicines and treatments. Where do blackcaps discolour and what markets are served buy discount levitra extra dosage 40mg on line impotence and depression. For your medical supplies, you can reckon on CCS Medical seeking propitious and guarded home execution that meets your needs and protects your privacy. Your members longing help from our industry-leading bloke ceremony, quality medical supplies, and convenient on- everything place delivery. No greasy meats buy generic tadacip 20mg on line erectile dysfunction causes in young males. Repayment ...
The most coherent explanation for these self-mutilative abortions is evident in the very damage that they do to the womans body. These self-abortion attempts are most likely manifestations of self-injury, a phenomenon seen in women (and occasionally men) with certain types of mental illness. The injuries range from bruises and scratches to amputation, putting out eyes, or castration. Some of the reasons people self-injure include easing tension, expressing emotional pain or rage, self-punishment, expressing or repressing sexuality, or manipulating others. Its easy to see how a woman who is already predisposed to self-harm might respond to pregnancy with self-injury purely because thats her usual coping mechanism anyway. (Self-harm behaviors also show signs of being contagious, with members of a social group imitating others who self-harm ...
Faculty: Barent Walsh, Ph.D., has written extensively and presented internationally on the topic of self-destructive behavior. He is the author of Treating Self-Injury: A Practical Guide 2nd edition, Guilford Press, (2014). This volume has been translated into Polish and Japanese. In addition, Dr. Walsh is co-developer (with Screening for Mental Health of Wellesley, MA) of "Act to Prevent Self-Injury," a prevention program with DVD for high schools.. Dr. Walsh has presented on self-injury in London, Edinburg, Vienna, Stuttgart, Ulm, Oslo, Dubai, Tokyo, Beijing, Montevideo, Mexico City, Montreal, Toronto, Winnipeg, and throughout the United States.. Dr. Walsh is the Executive Director Emeritus and Senior Consultant at The Bridge, a human service agency headquartered in Worcester, MA. He is also a Lecturer on Psychiatry, Harvard Medical School at Cambridge Health Alliance, Cambridge, MA.. Cancellation Policy: Cancellations must be requested via email or phone prior to March 6, 2020. A refund minus ...
Self-harm is increasingly common in many countries, is often repeated and is associated with a range of other problems including an increased risk of suicide. A review of the international literature on service users satisfaction with clinical services looked at 31 studies. Service users experiences had a lot in common all over the world. Poor communication between patients and staff and a perceived lack of knowledge of staff were common themes and many participants suggested that psychosocial assessments and access to after-care needed to be improved ...
Appropriate follow up with identified students of concern as well as with their friends, members of their living units, and with families of endangered students are important roles of the Dean of Students and members of the Division of Student Affairs.. Suicidal and self-harming behaviors seriously affect the quality of life in a residential community. These behaviors not only affect the injured person, but the many concerned people around that student are impacted as well. All Student Affairs staff members (including student staff) are required to submit a Self Harm Report (SHR) to the Self Harm Review Team (HIRRT) when they have credible information that a student has threatened or attempted suicide, or has engaged in self-injuring behavior. Other faculty and staff are encouraged to submit SHRs. This documentation is to be completed and turned in to the Dean of Students Office as soon as possible after learning about a potentially suicidal student.. SIRs are reviewed by the SIRRT in a timely ...
In this final of a 3-part podcast series, Brian Smith, MD, discusses the hows, the whys, and the treatment options for adolescents who harm themselves.
Higher Dose Antidepressant Initiation Can Up Suicidal Behavior in Youths Initial prescriptions for high-dose antidepressants in children and young adults should raise some red flags. Thats according to a new study that finds that prescriptions at higher dosages than normal can elevate the risk of suicidal behavior in youths up to age 24. How much was the risk of deliberate self-harm increased? ...
Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged >= 75 years between 2006 and 2014 (N = 1,413,806). Using personal identity numbers, we linked individuals data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case-control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic ...
Over the last couple decades, more young people appear to be pulling out razor blades and lighters in order to injure themselves, according to anecdotal reports from counselors.
Hi Thanks very much for your letter. It sounds like you re really worried about how people will react if they notice your cuts and scars when you have your tetanus injection. It s good to hear that you ve felt able to tell your mum about your self-harm. I would always encourage people to ask for some support, rather than trying to manage self-harm on their own. Scars do fade with time, so marks from new cuts will generally be more visible than old ones. Not everyone will react negatively to seeing your scars, but I can hear that that s something you re worried about. Before you have your injection, is there a way you or your mum could ask the school nurse if you could have the injection in private? You could explain that you have scars on your arms that you are self-conscious about, and see what they say?. Finding a way to reduce or stop your self-harming is an important thing to think about in the longer term. While you are still working on managing your self harm, having a bit more control ...