• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.459-468
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• 2009

Purpose: The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Methods: Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). Results: The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Conclusion: Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

• Child Health Nursing Research
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• v.29 no.4
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• pp.271-279
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• 2023

Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.128-135
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• 2021

Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘²=14.397, p<0.001; 𝛘²=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.3
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• pp.59-66
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• 2022

Objectives: This study aimed to investigate the clinical characteristics of adolescents hospitalized through the emergency room for intentional self-harm or suicide attempts. Methods: This retrospective study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted between 2006 and 2018 for individuals aged 10-24 years. The clinical characteristics of the patients were analyzed and compared across sex and age groups using the Rao-Scott chi-square tests and multiple logistic regression analysis for complex survey data. Results: The most common psychiatric diagnosis was mood disorder (22.0%), and more female patients were diagnosed with it than male patients (p=0.010). The 19-24 years age group was diagnosed with mood disorder the most compared to other younger groups (p=0.012). Male patients used lethal methods more than female patients (p=0.008), and the 19-24 years age group used more drug poisoning and cutting or piercing (p<0.001) for intentional self-harm or suicide attempts than younger groups. Conclusion: Adolescents hospitalized for intentional self-harm or suicide attempts showed significant differences in clinical characteristics across sex and age groups. These findings suggest that measures for preventing self-harm or suicide attempts need to be differentiated according to the sex and age of adolescents.

• Korean Journal of Culture and Social Issue
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• v.29 no.1
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• pp.147-170
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• 2023

This study explored keywords and key topics by collecting posts related to 'self-Iinjury' and 'suicide' through Twitter. The study subjects were selected as posts containing related hashtags related to self-injury and suicide from October 29, 2019 to November 30, 2020. Text mining based on collected posts resulted in a total of 11 key topics: -6 related to 'self-Iinjury' and 5 related to 'suicide'. The main message in the topic is as follows. First, looking at the main messages contained in the topic, they honestly expressed self-harm and suicide experiences that are difficult to express offline online, and used SNS as a channelpath for requesting help requests. Second, there were common and discriminatory characteristics in posts related to 'self-Iinjury' and 'suicide'. Although topics related to 'self-Iinjury' mainly revealed emotional control and interpersonal functions of self-harm, messages related to 'suicide' showed more clearly messages about suicide prevention addressing and social problems. These results are meaningful in that they can understand the opinions of people who have experienced self-harm and suicide accidents and the public voice on self-harm and suicide-related issues could be better understood, and that this study seeks for effective self-harm and suicide prevention and intervention measures for self-harm and suicide issues.

• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.69-80
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• 2023

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

• Industry Promotion Research
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• v.8 no.2
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• pp.141-148
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• 2023

The purpose of this study is to analyze NSSI (Non-suicidal Self-Injury) and upcoming papers to review research achievements and endpoints and current problems. Analysis data necessary for the study were collected through the classification procedure as domestic suspension during the mandatory period related to self-harm from 2010 to the present. As a result of analysis according to classification categories (general characteristics, study subjects, research variables, program utilization), first, domestic studies related to non-suicidal self-harm increased steadily through 2019 and 2022 after increasing in 2017 (three articles) showing shape. Second, changes in the characteristics of the research subjects began to appear. If previous studies had mainly focused on adolescents who experienced self-harm, it was expanded to early adulthood (college students), and the subjects of the study diversified to include those who had experienced self-harm cessation, counselors, and parents. Third, various research methods began to appear. Compared to 2017, when quantitative research was active, research was conducted that applied various qualitative research methods (narrative, phenomenology, grounded theory, meta-analysis, case study). Finally, discussion of the research results and suggestions for future research were added.

• Journal of the Korean Society of School Health
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• v.30 no.3
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• pp.295-305
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• 2017

Purpose: This study was conducted to evaluate the effect of Mindfulness-based Emotion Management Training for adolescents immersed in self-harm behaviors. Methods: The participants were 61 middle school students located in Seoul. Thirty students were assigned to the Mindfulness-based Emotion Management Training (M-EMT) group and the other 31 students were assigned to the waitlist group. The students in the M-EMT group participated in a total of 12 sessions, twice a week, for 6 weeks. The modules of the program comprised of mindfulness for emotion, mindfulness for behavior/impulse, mindfulness for thought, and coping with self-harming behavior. The Distress Tolerance Scale, Deliberate Self-Harm Inventory, Cognitive Emotion Regulation Questionnaire, and Scale Suicidal Ideation were assessed at baseline and post-intervention. Results: Compared to the waitlist group, the intervention group exhibited a statistically significant improvement in distress tolerance and cognitive emotion regulation and a statistically significant reduction in self-harming behaviors and suicidal ideation. Conclusion: These results support the hypothesis that mindfulness-based emotional management training has a positive effect on reducing self-harming behaviors and enhancing distress tolerance and cognitive emotional regulation.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• v.14 no.4
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• pp.275-284
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• 2010

Deliberate self-harm (DSH) is the act of deliberately harming your own body, such as cutting or burning yourself, without suicidal intent. It has especially become a problem among adolescents and college-age students in institutional settings such as boarding schools, Greek houses, detention centers and hospitals. We focus on contagion of DSH among adolescents and young adults by creating a deterministic epidemiological model. We study the impact of actual peer pressure, virtual peer pressure (the Internet) and treatment analytically in terms of a basic reproduction number through stability analysis of a system of ordinary differential equations. All parameters are approximated and results are also explored by simulations. The model shows that DSH is present in an endemic state in the population considered, and the control strategies are discussed.

• The Korean Society of Law and Medicine
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• v.21 no.2
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• pp.105-162
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• 2020

In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.