Download MP3 [25:55] Bio
Jennifer Muehlenkamp, PhD, is a clinical psychologist too assistant professor at UW-Eau Claire. She earned her Ph.D. from Northern Illinois University inwards 2005. doc Muehlenkamp specializes inwards agreement too preventing suicidal too non-suicidal self-injury inwards youth. She has published over threescore peer-reviewed articles too bulk chapters on self-injury too suicide inwards adolescents too college students, some of which have got informed the non-suicidal self-injury diagnostic category for DSM-V. doc Muehlenkamp has assisted with the creation too evaluation of the Signs of Self-Injury Prevention Program, is a founding fellow member of the International Society for the Study of Self-Injury, too co-author of a handling bulk titled Non-Suicidal Self-Injury that is component of the Advances inwards Psychotherapy Series. doc Muehlenkamp’s enquiry too clinical guidelines are internationally recognized too have got earned awards frm the American Association of Suicidology.
TRANSCRIPT
Introduction
Jonathan Singer: Today’s Social Work Podcast looks at the number of non-suicidal self-injury, or NSSI. NSSI is a hot topic alongside clinicians / psychotherapists, but this wasn’t e'er the case. Twenty or xxx years ago, the only folks talking most NSSI (alternately refered to every bit Self-Injurious Behavior, or Deliberate Self Harm) were those who worked with Borderline Personality Disorder. This was, inwards part, because BPD is the only DSM-IV-TR diagnosis that includes NSSI every bit a symptom. In fact, self-harm became a red-flag for BPD; if you lot had a customer who engaged inwards NSSI, you’d start with the supposition that he or she had borderline personality disorder.
But times have got changed. While cutting, burning, or other forms of self-injury is to a greater extent than mutual alongside people with psychiatric diagnoses (Klonsky & Muehlenkamp, 2007), the presence of NSSI no longer implies an Axis II diagnosis – or whatever diagnosis at all. Influenza A virus subtype H5N1 2011 study past times David Klonsky flora that nearly 6% of adults inwards the USA reported a lifetime history of NSSI. For US adults nether the historic menstruum of 30 it was 19%. Interestingly, a 2012 study past times today’s guest, Jennifer Muehlenkamp too her colleagues, flora that the international prevalence of NSSI alongside adolescents was 18% - nearly the same every bit inwards US adolescents. For reasons that are non clear, NSSI has moved from beingness a symptom of a serious personality disorder to a coping machinery used past times nearly 1 inwards 5 adolescents. So, NSSI has acquire a hot topic inwards recent years inwards component because it is showing upwards inwards the full general population, rather than merely a modest sub-group of psychiatric patients.
This alter inwards WHO engages inwards NSSI has also renewed involvement inwards the inquiry of WHY people engage inwards NSSI. Are people who self-injure numb too trying to experience something, or are they feeling every bit good much - overwhelmed past times their emotions – too trying to experience less? Is self-injury a pathway towards or pathway away from suicide? In the belatedly 1930s, Karl Menninger suggested that self-injurious deportment was a way to “avert suicide” (Muehlenkamp, 2005). I’ve had a brace of clients for whom that description is accurate. I recollect this i teenager who told me that he would essay everything to acquire suicidal thoughts out of his mind. As a concluding resort, when aught else helped, he’d cutting himself – non to die, but to acquire rid of the ideation. He siad it worked every time. One non-lethal cutting that would trace a modest amount of blood, too the ideation would endure gone – sometimes for upwards to a month. The matter that was so fascinating to me was that he only engaged inwards NSSI when he was overwhelmed past times thoughts of killing himself. So, Menninger’s hypothesis fits this kid. But, it doesn’t seem to gibe for everyone. In fact, enquiry has suggested that the youth who say they engage inwards NSSI too have got thoughts of suicide are at higher remove chances of attempting suicide than youth who study suicidal ideation or NSSI lonely (Claes et al, 2010). So, for the clinician who industrial plant with people who self-injure, agreement the purpose too the pregnant of the self-injury, the remove chances posed past times the self-injury, too how to best address it, are all issues that demand to endure worked out.
If all of this makes NSSI sound complicated, it’s because it is. That’s i of the reasons I spoke with Jennifer Muehlenkamp, associate professor at the University of Wisconsin – Eau Claire, too i of the world’s leading experts inwards NSSI.
In today’s episode, Jennifer too I talked most the Definition of NSSI, the intersection betwixt suicidal too non-suicidal self-injury, too some things that clinicians should too should non exercise when working with clients who self-injure. We ended our conversation with some speculation on the futurity of NSSI every bit a stand-alone psychiatric disorder inwards the DSM-5.
Jennifer too I spoke inwards Apr 2012 at the American Association of Suicidology conference. I cornered her every bit she was waiting for an get upwards inwards betwixt conference sessions too asked her if she’d endure willing to verbalize most NSSI for the podcast. Now, nosotros don’t truly know each other. Without batting an eyelash, too without whatever prep time, she agreed too nosotros had the conversation you’re most to hear. During our conversation she never i time mentioned that she was at the conference inwards component to have i of the most prestigious awards inwards the plain of suicidology: the Schneidman Award for outstanding contributions inwards enquiry inwards the plain of suicidology past times an early on phase investigator (click hither to consider a re-create of Jennifer too her award: http://suicidology.smugmug.com/Other/45th-Annual-Conference-Day-3/i-SC3TR7c/0/Ti/DSC3788-Ti.jpg). Her generosity extended beyond the interview: She position together an outstanding listing of scholarly books, peer-review magazine articles, too memoir most NSSI that you lot tin discovery on the Social Work Podcast website. afterward I returned from the conference, my colleagues over at the Living Proof Podcast published a wonderful episode on NSSI with i of Jennifer’s colleauges, Janis Whitlock.
So, without farther ado, on to Episode 73 of the Social Work Podcast: Non-suicidal Self-injury: Interview with Jennifer Muehlenkamp.
Interview
Jonathan Singer: Jennifer, thank you lot so much for beingness hither too talking with us on most non-suicidal self-injury. The start inquiry is what, is non-suicidal self-injury?
Jennifer Muehlenkamp: Well, non-suicidal self-injury is a deportment too the way nosotros define it inwards the plain correct at nowadays is that it's the deliberate or the intentional devastation of trunk tissue without suicidal intent too the deportment is non done for socially approved reasons. So that agency things similar tattooing too trunk piercing exercise non count every bit self-injury. And so, self-injury, some other key slice to it is that with it beingness bodily tissue damage, it agency that the harm is immediate. So sometimes people volition enquire me “so is binge drinking too disordered eating - are those examples of self-injury?” And nosotros consider those indirect forms of full general self harm because non-suicidal self-injury truly results inwards immediate tissue damage.
Jonathan Singer: So, like, somebody burning themselves with a cigarette or cutting themselves with a knife?
Jennifer Muehlenkamp: Yes, exactly. And what nosotros discovery is that cutting is i of the most mutual behaviors specially alongside adolescents, specially alongside immature adult females whereas things such every bit intentional banging or punching objects inwards social club to get a bruise, banging behaviors are to a greater extent than mutual inwards males every bit good every bit the punching too the banging mightiness endure taking one’s, let's say wrist, too slamming against the side of a tabular array or slamming it against the side of a wall or something similar that a few times inwards social club to acquire a bruise to create some variety of sensation. I had i customer who would non only cutting himself which is a piffling chip unlike for males, but non only cutting himself, but when he acquire truly upset is that he would accept his fist too he would bang it on the corner of his desk at schoolhouse too he would exercise it in all probability v or half dozen times. He said it felt numb too variety of tingly too so he would endure done.
Jonathan Singer: So clearly that’s self-injury too it's non suicidal, similar you lot can't kill yourself by, you lot know, banging your fist against the side of a desk, right? So clearly that’s non-suicidal. But if you lot were working with somebody who came inwards too had, you lot know, cutting marks on their arm, like, how would you lot know that that’s non-suicidal self-injury?
Jennifer Muehlenkamp: That’s a truly goodness question. One of the start things you lot truly demand to exercise correct is enquire people because nosotros know that most adolescents too immature adults, the people who engage inwards this deportment volition endure upfront too say no, I'm non trying to kill myself. They oftentimes engage inwards this deportment to acquire by with their distress. And it helps them acquire by with emotions. And some of the key emotions that they human face upwards are things similar anger too anxiety. Influenza A virus subtype H5N1 lot of them volition say that they engage inwards this deportment sometimes to punish themselves because they don’t think they're worthy or they did something wrong. And so if you lot enquire them inwards a gentle way variety of around the line of you lot know, “so tell me what does self-injury exercise for you,” “like how does this deportment assist you?” so you'll start intermission downward some barriers too acquire someone to endure to a greater extent than willing to accept to you lot most it, but so you'll also acquire to consider it.
And so you lot tin merely enquire them, you lot know, “were you lot wanting to move from this? Did you lot desire to kill yourself every bit a termination of this behavior?” And they’ll oftentimes tell you lot no. The other matter is that nosotros know that people who move from suicide or who brand rattling piffling suicide attempts oftentimes exercise non exercise so through cutting, which I think a lot of people are rattling concerned most because cutting is potentially rattling damaging too you lot tin have got rattling severe wounds, but it's rattling difficult too it's rattling rare to move from cutting. And so, of those individuals who exercise engage inwards self-injury too rattling severe self-injury who exercise brand a suicide endeavor oftentimes the endeavor is through a unlike agency or a unlike method than what the self-injury was. So, the start pace is truly to enquire them most their intent too what the deportment does for them.
Jonathan Singer: So truly if somebody comes inwards too I consider that they’ve got cutting marks on their arm, I could of course of study gently, correct with rapport too exercise all this therapeutic things that nosotros do, but eventually acquire around to proverb so I noticed that you lot have got cutting marks on your arm, you lot know, what were you lot intending to do, something similar that, right?
Jennifer Muehlenkamp: Mm-hmm. Yeah.
Jonathan Singer: So, you lot know, i of the things that I've heard most cutters (right - this is a generic term for non-suicidal self-injuries, kids who cutting but don’t desire to die), is that they cutting because the hurting of the cutting is something that they tin bargain with, but the hurting within is something that they can't. So, it's sort of similar it transfers the pain. Is that right? I hateful is that, you lot know, that’s what I've heard on the street variety of matter from other therapists, but I approximate my inquiry is why exercise people engage inwards NSSI?
Jennifer Muehlenkamp: What we're finding inwards the enquiry there's a lot of reasons why people engage inwards self-injury too what you lot said too what you lot described is I would say somewhat accurate. So, in that location are a lot of people too what nosotros know is that the emotional solid ground correct before an deed to self-injury is oftentimes i of intolerable distress. And similar nosotros said oftentimes rattling negative emotions, intense emotions. Sadness is non existent common. Influenza A virus subtype H5N1 lot of people are similar “oh, they're so depressed too that’s why they exercise it.” No. What the enquiry shows is it's to a greater extent than of the high tension, high arousal variety of negative emotion, so the anger, the anxiety, the frustration too what nosotros discovery is that the kids too the people who engage inwards this deportment merely can't – they discovery it rattling overwhelming. And so engaging inwards the deportment non only produces a piffling chip of relief, but it also variety of gives them an immediate solution. And I know to people who don’t engage inwards the behavior, that tin seem sort of bizarre, but nosotros also know physiologically what happens when you lot acquire a wound is that non only exercise you lot have got a release of endorphins inwards your trunk which are experience goodness chemicals, but nosotros also acquire a release of cortisol which helps us to focus our attention. So, some people volition also engage inwards the deportment because things seems so out of control, they don’t know how to work solve, self-injury truly calms them downward too they tin at nowadays focus too truly perchance so start to engage inwards to a greater extent than adaptive work solving.
So, sometimes it is to externalize the pain. I had i customer who would verbalize most how she would experience so numb within that she would self-injure inwards social club to experience hurting to remind herself that she is endure too she is a person. But a lot of the clients that I piece of work with it was truly to a greater extent than along the lines of “let me variety of acquire rid of this negative emotion correct away,” so variety of that immediate gratification so “then I tin displace on” rather than variety of riding out the slower tide of emotions that nosotros demand to allow dissipate.
Jonathan Singer: Do you lot discovery that kids who start out cutting or doing some other sort of NSSI–
Jennifer Muehlenkamp: It's a difficult term [laughing]
Jonathan Singer: [lauging] It is. It is. – proceed to acquire suicidal? Like is in that location a trajectory? Because I know that’s something that parents too sort of the full general world is concerned about.
Jennifer Muehlenkamp: Sure. And what I tin say is that it's goodness to endure concerned too if you're working with someone who’s engaging inwards self-injury to enquire them periodically. And what you lot desire to exercise is enquire them most alert signs that you lot consider if they start to experience to a greater extent than hopeless, trace away from people. So, if you lot consider basic suicide alert signs, endure concerned. With that said, there's a large percentage of adolescents who engage inwards this deportment who are never suicidal. We don’t have got non bad longitudinal studies. Of the cross-sectional studies nosotros have, which agency that you lot study variety of i grouping inwards fourth dimension too so you lot enquire them, you lot know, “when did you lot start self injuring? If you’ve attempted suicide when did you lot endeavor suicide?”
What nosotros discovery is the historic menstruum at which they engage inwards self-injury tends to endure significantly younger than the historic menstruum at which they brand their start suicide attempt. So, that would suggest that self-injury mightiness Pb into suicidal deportment if they acquire to a suicidal state. I know of i longitudinal study inwards college students, which I spill out to endure involved in, that nosotros did discovery longitudinally over a three-year menstruum that of the college students who engage inwards twenty or to a greater extent than acts of self-injury inwards their lifetime that that predicted over a three-year fourth dimension menstruum who is probable to engage inwards either making a suicidal innovation or attempting suicide.
And so in that location is a predictive human relationship there, but what nosotros oftentimes consider is that things acquire a lot worse for the individual. And anecdotally, so I'm all the same trying to discovery information for it, but i of the things I've heard clinically is that when self-injury doesn’t piece of work anymore for the individual. That’s when I’d endure most concerned because that’s their coping strategy too if it's non working anymore, they're going to acquire to that ultimate desperation too acquire to a greater extent than suicidal.
Jonathan Singer: So, when you lot have got somebody that engages inwards NSSI every bit a coping strategy - you lot know, [NSSI as] perchance the start pace inwards work solving every bit you lot were describing before - what are some things to exercise with that customer to assist them to develop perchance ameliorate coping skills rather than self-injurious behavior? Rr exercise you lot say self-injurious deportment is non truly that bad if it helps them exercise what they demand to exercise too displace on?
Jennifer Muehlenkamp: Mm-hmm. I think you're raising a primal inquiry that goes dorsum to all kinds of dysfunctional behaviors, so at what indicate exercise nosotros truly demand to intervene, when is it a work too so on.
Jonathan Singer: Sort of abstinence versus harm reduction–
Jennifer Muehlenkamp: Right.
Jonathan Singer: But yeah.
Jennifer Muehlenkamp: Right. And I know in that location are some people inwards Commonwealth of Australia who are truly advocating a harm reduction model which I discovery interesting. I'm variety of inwards the army camp that suggests that self-injury is a pretty – I don’t desire to say – it's non truly invasive. It tin be, but it's a pretty extreme deportment for coping too so to a greater extent than oftentimes than non what I recommend clinically is i of the start things you lot tin exercise is non straightaway enquire the soul to stop. It's truly unsettling every bit a clinician, every bit a parent, every bit a friend to sentinel someone intentionally, correct cutting themselves, give the axe themselves, you lot know, exercise something rattling damaging, but what's truly of import is to start recognize that it is their coping strategy.
So, merely similar if you lot move dwelling line of piece of work solid too what your coping strategy is merely to accept a dainty warm shower, correct or to boot dorsum too you lot know, sentinel Family Guy (http://en.wikipedia.org/wiki/Family_Guy) or whatever it mightiness be, correct too all of a abrupt you lot say – your therapist says you lot can't sentinel Family Guy anymore, right. You can't accept a warm shower, you're going to either halt therapy or things are non going to move good for you.
So, what you lot desire to exercise is start gradually, too you lot tin exercise some of the basic variety of behavioral strategies to start to address you lot know their thoughts that they mightiness endure having to assist them think most what other things could you lot do. Where I oftentimes start to endure honest, is to piece of work on delaying. And so not, you lot know, means removal too non agency restriction, but basically start with delay. “Can you lot engage too essay some of these other behaviors, coping strategies start too you lot know, start with i too if that doesn’t piece of work so perchance you lot tin self-injure,” so you lot extend that, right? So, so in that location are 2 or 3 things. And so if that doesn’t work, you’ve got your self-injury. So you lot piece of cake variety of cook the steps away from the self-injury too allow them consider that the other things exercise piece of work if you lot give them time.
Another strategy that I've used too I tin tell you lot about, I've used it with 2 clients pretty successfully. And there's a i customer that truly comes heed who had engaged inwards rattling very severe self-injury for many years too she wasn’t – nosotros were at the indicate where nosotros were talking about, you lot know, “are you lot willing to acquire rid of your razor blades or not?” And she said no. And so I respected that. But what nosotros did is nosotros took her razor blades too nosotros position them inside, basically a coping box is what nosotros telephone yell upwards them, too she had a box of things where she had motion painting of her sisters, pictures of friends, notes that when she was doing good, that she would write to herself to remind herself most what's good. So, nosotros position all those things inwards in that location too that she also position the box inwards the dorsum of her cupboard where she told me was truly messy too so inwards social club – when she would acquire truly distressed too desire to cutting herself, she would have got to move to the closet, dig to the dorsum to trace a box out too so she would encounter all those pictures, her positive coping statements too things similar that that would brand her think most to a greater extent than of the long term consequences of the self-injury because she was committed to non engaging inwards the self-injury too that truly was a huge pace for her too truly worked good for her.
Jonathan Singer: That’s amazing. You know inwards damage of suicide prevention, I'm thinking of the – what they did inwards England most making Tylenol only available inwards bubble packs.
Jennifer Muehlenkamp: Right.
Jonathan Singer: You know, if you lot have got to popular i out, each i out, it's rattling unlike than opening upwards a bottle. Like if you lot have got to move at the dorsum of a messy cupboard too dig out a box to acquire your razor blades, merely in all probability that fourth dimension delay was an of import way to exercise some delaying–
Jennifer Muehlenkamp: Yeah.
Jonathan Singer: – every bit you lot said.
Jennifer Muehlenkamp: Yeah. I think so too I think some other large component of it is that she was rattling connected to her identify unit of measurement too friends inwards wanting to brand a difference. And so I think if you lot tin discovery that long term destination that a customer is truly striving to too arrive straightaway salient to them - because a lot of times people who self-injure are so focused on the immediate distress that they position off their long term destination for the immediate distress relief - that if you lot tin convey that long term destination to the immediate, you're also to a greater extent than probable to so trigger adaptive work solving too variety of promote to a greater extent than of a delayed gratification so to speak.
Jonathan Singer: So, non-suicidal self-injury is defined past times beingness non suicidal, correct –
Jennifer Muehlenkamp: Mm-hmm.
Jonathan Singer: too is that something that people are talking most inwards damage of similar the terminology or would it – how it sort of defines the behaviors past times what it's not. And I approximate a bigger question, is in that location whatever displace to brand non-suicidal self-injury similar its ain disorder, diagnosis similar anything similar that? Is anything coming downward the pike?
Jennifer Muehlenkamp: Yes. In fact, if anyone has been sort of next the APA or the American Psychiatric Association’s revision of the DSM-5, what you'll consider too it has been somewhat of a controversial give-and-take is that they are proposing a non-suicidal self-injury disorder for DSM-5, too it is primarily based on the fact that this is a deportment distinct from suicide that could endure its ain remove chances element for suicide, too that nosotros consider this deportment inwards many people who exercise non encounter diagnostic criteria for borderline personality disorder which is what the deportment is normally been associated with too inwards fact the highest rates where you lot consider this deportment inwards damage of the disorder is truly alongside individuals with bulimia nervosa. And so eating disorders have got the highest charge per unit of measurement of self-injury every bit good every bit individuals who are suffering from post service traumatic stress disorder or PTSD every bit good every bit some of the depression on the other anxiety disorders.
So, the deportment is definitely defined past times what it's non too that’s a key scrap that’s out in that location inwards the plain every bit far every bit – because nosotros know suicidal deportment oftentimes is associated with ambivalent intent, fluctuating intent, i infinitesimal you lot desire to die, the adjacent infinitesimal you lot don’t too in that location are some people who exercise depict that during their acts of self-injury, they mightiness have got a fleeting thought most suicide, but the deportment was non engaged inwards with the intent to die, so it adds a lot ambiguity. And so I think that’s where every bit a clinician, it's truly of import to verbalize with your clients too to fifty-fifty enquire them “at whatever indicate inwards your self-injury did thoughts of suicide come upwards up?” And if they say “yes,” so that’s a doorway to enquire good how strong were they, correct so that you lot tin variety of monitor for it without I approximate negating the fact that the private proverb I'm non suicidal, right, but you lot tin all the same exercise your assessment inwards that way.
I think with the potential for the non-suicidal self-injury disorder to come upwards to fruition is that clinicians volition endure able to hopefully acquire some to a greater extent than precise preparation on it, to start to await at the deportment every bit a behavioral work because a lot of the treatments that nosotros have got out in that location piece of work with behavioral methods to cut the deportment too i time nosotros have got an identified disorder too it's non wrapped upwards inwards some other stigmatized disorder, nosotros tin I think endure to a greater extent than effective inwards both our handling too our prevention.
Jonathan Singer: So, are in that location whatever other things that clinicians should think most or know about, endure aware of with regards with folks who engage inwards NSSI?
Jennifer Muehlenkamp: I think in that location are in all probability a brace of other things that come upwards to heed that I've been asked before past times clinicians. One is that a lot of times clinicians enquire me “well, if I'm disgusted past times the deportment or I discovery the deportment difficult to bargain with or merely difficult to understand, what should I do?” Because sometimes it's difficult to handgrip dorsum your visceral reaction to things too I think the start matter to recognize is that those are mutual responses that people volition have got too it's also the fourth dimension where you lot desire to do, you lot know, variety of position on your clinical face, correct too exercise the best you lot tin to internally monitor recognize that that’s your reaction too so also recognize that individuals who are sharing this deportment discovery those, you lot know, variety of subtle reactions too so they’ll truly trace dorsum if they think you're scared or it's every bit good much or your disgusted past times it.
So, i of the things nosotros truly recommend is that the way you lot enquire most the behavior, afterward you lot enquire most it, inquire a piffling chip to a greater extent than from their perspective saying, you lot know, “oh, you lot know, that surprises me most you.” If you're truly shocked past times it too so enquire them to explicate to a greater extent than most the deportment for them, so to discovery a gentle way to acquire inwards into it. The other matter that I'm almost e'er asked is “should I await at the wounds?” And I volition tell you lot in that location is some scrap inwards the plain most whether or non you lot should. I think I'm a bulk of people say exercise non await at the wounds too there's a brace of reasons for that. One is –well, start of all, if it's a identify that they're injuring that’s inappropriate, you lot have got to non await at it, right. It's inappropriate you lot don’t desire to–
Jonathan Singer: I'm cutting on the within of my leg, right, yeah. [laughing]
Jennifer Muehlenkamp: [lauging] Right, yeah. So, don’t await at it. The other component is that if it's, you lot know, forearms, calves too things similar that that are piece of cake is that for some people they believe if you lot await at it, you lot mightiness inadvertently reinforce the deportment because for some people they exercise it every bit a signal to others to say I'm inwards a lot of distress, assist me out. And so, every bit a therapist, if that’s the way you lot communicate most the self-injury, you lot mightiness truly growth the self-injury because that’s how they’ll tell you lot most their distress instead of learning their emotion words.
And the other matter is that if you're worried most the severity, I merely enquire my clients to report. So, I'll enquire my customer who says, you lot know, “I cutting myself the other hateful solar daytime too I think it was pretty bad.” And so I'm non a medical provider too they know that upfront. And I'll say “I'm non a medical provider, but tin you lot tell me, you lot know, how badly did it bleed? Was in that location a large gap, you lot know, did it truly halt haemorrhage too you lot could consider tissue underneath?” I had i customer who cutting so deeply to the indicate where it truly stopped haemorrhage too so she was inwards the adjacent hateful solar daytime fortunately too I said “you demand to move to the emergency subdivision to acquire stitches. I'm pretty sure.” And so merely shout for things most that or if they give the axe themselves. You know, are you lot getting blisters, is it oozing similar that variety of materials merely to acquire a basic assessment too so know if you lot have got to refer him to a medical provider.
Jonathan Singer: Such non bad information. Jennifer, give thank you lot you so much for taking the fourth dimension to verbalize with us today most non-suicidal self-injury. I truly appreciate it.
Jennifer Muehlenkamp: Yeah. Well, give thank you lot you. I truly enjoyed talking to you.
End of Interview
Recommended Books
Klonsky, E.D., Muehlenkamp, J. J., Lewis, S., & Walsh, B.W. (2011). Advances inwards Psychotherapy: Nonsuicidal Self-Injury. Hogrefe Press.
Nixon, M.K. & Heath, N.L. (2008). Self-injury inwards youth. New York: Routledge.
Nock, M.K. (Ed.). (2009). Understanding nonsuicidal self-injury: Origins, assessment too treatment. Washington, DC: APA.
Hollander, M. (2008). Helping teens who cut. New York: Guilford.
Gratz, K.L. & Chapman, A.L. (2009). Freedom from self-harm: Overcoming self-injury with skills from DBT too other treatments. Oakland, CA: New Harbinger.
Walsh, B. (2012). Treating self-injury: Influenza A virus subtype H5N1 practical guide. New York: Guilford.
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. New York: Guilford Press.
Joiner. T. (2007). Why people exceed suicide. Cambridge, MA: Harvard University Press.
Peer-Review Journal Articles
Muehlenkamp, J. J. (in press). Body regard inwards non-suicidal self-injury: Theoretical explanations too handling decisions. Journal of Cognitive Psychotherapy.
Muehlenkamp, J.J. & Kerr, P.L. (February 2010). Untangling a complex web: How non-suicidal self-injury too suicide attempts differ. The Prevention Researcher, 17(1), 8-10.
Muehlenkamp, J. J. (2006). Empirically supported treatments too full general therapy guidelines for non-suicidal self-injury. Journal of Mental Health Counseling, 28, 166-185.
Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012). International prevalence of adolescent non-suicidal self-injury too deliberate self-harm. Child too Adolescent Psychiatry too Mental Health, 6(1), 1 - 9. doi:10.1186/1753-2000-6-10
Klonsky, E.D. (2011). Non-suicidal self-injury inwards United States of America of America adults: Prevalence, sociodemographics, topography, too functions. Psychological Medicine, 41, 1981-1986. doi:10.1017/S0033291710002497
Klonsky, E. D. & Muehlenkamp, J.J. (2007). Non-suicidal self-injury: Influenza A virus subtype H5N1 enquiry review for the practitioner. Journal of Clinical Psychology/ In session, 63, 1045-1056.
Klonsky, E. D. (2007). The functions of deliberate self-injury: Influenza A virus subtype H5N1 review of the evidence. Clinical Psychology Review, 27, 226-239.
Whitlock, J, Muehlenkamp, J., Purington, A., Eckenrode, J., Barreira, J., Abrams, G.B., Marchell, T., Kress, K., Girard, K., Chin, C., Knox, K. (2011). Non-Suicidal Self-Injury inwards a College Population: General Trends too Sex Differences. Journal of American College Health, 59, 691-698.
Memoirs of Interest
Kettlewell, C. (1999). Skin game: Influenza A virus subtype H5N1 Cutter’s Memoir. New York: St. Martin’s Press.
Audio resources
Episode 95 - doc Janis Whitlock: The Cutting Edge: Self-Injurious Behavior inwards Adolescents too Young Adults. (2012, Apr 30). Living Proof Podcast Series. [Audio Podcast] Retrieved from http://www.socialwork.buffalo.edu/podcast/episode.asp?ep=95
Gibson, T. (Host). (2011, Oct 13). Episode 5 – Cutting, Burning, NSSI too Our Kiddos. The Family Podcast Network. [Audio Podcast] http://thefamilypodcastnetwork.com/episode-5-cutting-burning-nssi-and-our-kiddos
Smith, B. (n.d.) The Practice of Nonsuicidal Self-injury inwards Adolescents—Part 1. ConsultantLive.com [Audio Podcast] Retrieved on August 13, 2012 from http://www.consultantlive.com/multimedia/content/article/10162/1858142
APA (6th ed) citation for this podcast:
Singer, J. B. (Host). (2012, August 10). Non-suicidal self-injury (NSSI): Interview with Jennifer Muehlenkamp, Ph.D. [Episode 73]. Social Work Podcast. Podcast retrieved Month Day, Year, from
/search?q=non-suicidal-self-injury-nssi-interview
Buat lebih berguna, kongsi:
