The Usefulness of the Classification and Categorization of Self-Harming Behaviors - Essay Example

On the Usefulness of the ification and Categorization of Self-Harming Behaviors: Critical Discussion Table of Contents I. Introduction 3 II. Discussion 4 III. Conclusion 9 References 11 I. Introduction This paper answers the question of whether or not there is usefulness in the categorization and classification of different kinds of self-harming behavior, leveraging the existing academic psychological literature on the subject matter to undertake a critical discussion on the question. Self-harm is a recognized term in psychology, and one that is common, referring to a large set of intentions as well as behaviors that are prompted by inner tensions of an uncontrollable and intolerable nature. These behaviors include deliberate self-poisoning driven by impulse, hanging attempts, and self-cutting. In the west, rates of self-harm are said to vary between five percent to nine percent of adolescents in the middle of the past decade, and these rates are different for other countries, with the country culture said to either promote higher or lower rates of suicide and self-harm, accounting for wide variations of incidences of self-harming behavior. That said, the consequences of self-harm are said to be severe, with repeats of such behavior being likely, and that about five percent of those who harm themselves are said to be on the path to committing suicide within nine years from the occurrence of the self-harm. This latter figure is for those who were hospitalized for self-harm injuries. Psychiatric disorders constitute a single lark risk factor for the infliction of self-harm, together with being at the raw end of a socioeconomic imbalance. Among psychiatric disorders, the abuse of illegal substances as well as anxiety illnesses and depression are prime risk factors for the infliction of self harm. On the other hand, among those who inflict harm on themselves, certain risk factors are associated with higher likelihoods of the commission of suicide, including the setting up of hindrances to the discovery of an act, the use of highly lethal forms of self-harm and the presence of psychiatric disorders in patients (Skegg, 2005: Owens, Horrocks and House, 2002; Hawton et al., 1998; Klonsky, Oltmanns and Turkheimer, 2003; Hawton, Zahl and Weatherall, 2003; Cooper et al., 2005; King et al. 2008). Taking a step back, literature exists that classifies self-harm as one among many categories of what are termed self-destructive behaviors (Sansone, Wiederman and Sansone, 1998; Forman and Kalafat, 1998; Kam, 2014). II. Discussion A discussion on the usefulness of categorizing and classifying self-harm behaviors touches on the pros and cons of classifying psychological illnesses in general, and here the debate is on the basis of whether such work has benefits to patients and the academic and medical community in general, or else generates more harm than good. The literature citations above indicate that there is a vibrant academic and medical interest in self-harm and the psychological conditions and health conditions revolving around self-harm, and this in turn necessitates a more rigorous and more structured way to go about the research and to go about the discussions on self-harm. In this sense there may be room for an ordered classification and categorization of behaviors, conditions and related concepts and practices tied to self-harming behaviors. Taking a step back, the debate on the usefulness of classifying psychological illnesses in general favor the position that such classification systems help in allowing psychiatric professionals to discuss and communicate, and to come up with proper diagnoses and interventions for a range of conditions, even as there is the recognition that individual cases are unique. The experience on the field, on the other hand, indicate that the use of classification systems for psychiatric conditions in general have so far resulted in very specific and tailored diagnoses and interventions for different individuals, even as some problems persist with regard to some of the classifications not being able to totally identify and treat certain individuals and conditions properly. The thinking is that in general, coming up with systems of classifying and categorizing psychological disorders has led to many positive benefits to the practice of psychiatry and the treatment of individuals suffering from a host of conditions, and this can be extrapolated to say that those same benefits should accrue to the classification and categorization of self-harming behaviors (Mental Health Professional Online Development, 2013; Goldberg, 2010; Henley, Ramsey and Algozzine, 2010; Skegg, 2005: Owens, Horrocks and House, 2002). From a more general perspective, classifying work implies labeling and grouping certain conditions into categories. First the labeling work has to be done. The question then can be construed in terms of whether there is use in labeling different self-harming behaviors and putting them in new or existing contexts in psychiatry. Here there is no question that labeling has general advantages in psychiatry and for the general community. Labeling conditions has the benefit of psychiatrists being able to talk about disorders and conditions in a uniform manner, in ways that allow them to understand each other as they undertake their practices and do their research. Labeling is something fundamental to the processes related to thinking, talking, and doing science. In terms of being able to undertake research work, labeling allows researchers to build bodies of literature that other researchers can then build on to advance knowledge on certain conditions. This is true in psychology and true too for all kinds of science work. One can see from the available research on self-harm that already established labels such as depression, and specialized concepts related to suicide, inform the research on self-harm. The establishment of labels and categories of self-harming behaviors should also allow psychologists and other practitioners to talk about the same thing and to investigate the same sets of phenomena and symptoms related to specific disorders. This has implications in research, and also in crafting specific interventions to help patients suffering from various conditions that lead to self-harm. Elsewhere, in the general community and for patients, labeling too has the benefit of allowing loved ones coworkers, co-students, teachers and other interested parties to understand what a person is going through, to aid in understanding and to help in intervening properly. Classifying different forms of self-harming behaviors then has these benefits, from just the point of view of labeling them to further research and treatments and the understanding of patients and their communities. Therefore from this line of reasoning, such work is very useful. To be sure the labeling and classification work has its dark side, among them being that conditions that are labeled lead to people being labeled and treated negatively and discriminated against by their communities, but such is true for all kinds of conditions already labeled by mainstream psychology and psychiatry. On the other hand, the harm to all who suffer from various conditions that lead to self-harming behaviors, in terms of continued suffering and the risk of suicide, outweigh the potential harms from labeling that leads to discrimination and negative social outcomes for persons who are identified as suffering from labeled behaviors and conditions (Forman and Kalafat, 1998; Kam, 2014; Goldberg, 2010; Henley, Ramsey and Algozzine, 2010; Skegg, 2005: Owens, Horrocks and House, 2002; Skegg, 2005: Owens, Horrocks and House, 2002). Taking a step back, the question of whether or not it is useful to undertake a categorization and classification of behaviors of self-harm center around whether or not there is value in such a classification exercise. Looking at the sampling of the academic literature on the subject, one can see that self-harming behaviors are understood not just in the context of a single psychiatric condition, for instance depression, but is actually understood from a wider psychological context that takes into consideration a host of complex psychological concepts and analyses. This implies for one that self-harming behavior already, when it is discussed in the psychological literature, situated in a context where classifying and categorizing conditions is a prerequisite to it being discussed by academics and psychology/psychiatry practitioners. From a necessity point of view, therefore, there is value in categorizing different forms of self-harming behaviors, because such classification is the only way in which self-harming conditions can properly be discussed and treated as part of an overall discipline. Without such classification work, self-harming behaviors cannot be properly researched and discussed. Therefore, for these purposes alone, the classification work for different self-harming behaviors already has use and great value (Goldberg, 2010; Henley, Ramsey and Algozzine, 2010; Skegg, 2005: Owens, Horrocks and House, 2002; Forman and Kalafat, 1998; Kam, 2014). From the point of view of saving lives and getting people out of crippling mental conditions such as depression, there is value too in being able to better understand self-harming behaviors via better classification and categorization methods for the different symptoms and conditions associated with such behaviors. The literature already notes that for one, people who harm themselves in various ways and varying intents are many factors more likely to commit suicide compared to the general population, and that a large proportion of such people are more likely to end up ending their lives or doing serious harm to themselves in repeat fashion for the rest of their lives. As already discussed above, being able to do a better classification of self-harming behaviors allow such behaviors to be better understood in terms of established literature and practices in mainstream psychology and psychiatry. Mainstream psychological literature is a bulwark of established, proven associations of knowledge bases for different psychological conditions. These can be utilized to further understanding and research on self-harming behaviors. Being able to properly label and classify different self-harming behaviors then opens up patients to the wealth of wisdom and knowledge already established, so that such patients may be saved from crippling conditions such as depression and from elevated risks of suicide moving forward (Goldberg, 2010; Skegg, 2005: Owens, Horrocks and House, 2002; Forman and Kalafat, 1998; Kam, 2014; Klonsky, Oltmanns and Turkheimer, 2003). Some cases prove the above point with regard to the value of classification of self-harming behaviors in rescuing people from suicidal episodes and much internal suffering and pain. At present the literature on self-harming behavior is still evolving, so that one can say that studies linking hospital-treated episodes of self-harm on the one hand and suicide incidences on the other arguably can benefit from being able to further group different self-harming behaviors into well-understood categories. In a 2005 study, all of the incidences of self-harm were generally lumped together, even if other factors such as whether patients lived alone or with family, the patients’ socioeconomic condition, and the like were factored in. Subsequent investigations into suicide rates would probably be better informed by a more thorough grouping of various episodes of self-harm into better understood categories. The general idea is that research, knowledge and interventions to prevent suicide and help patients who harm themselves become more effective with better methods for classifying and naming the different self-harming behaviors (Goldberg, 2010; Skegg, 2005: Owens, Horrocks and House, 2002; Forman and Kalafat, 1998; Kam, 2014; Klonsky, Oltmanns and Turkheimer, 2003). III. Conclusion This critical discussion makes it clear that there is value in the work of the classification and categorization of various forms of self-harming behaviors. From the point of view of research and clinical practice, classification work opens up self-harming behaviors to more informed research, and to being understood in terms of concepts and practices that already have deep roots in practice as well as in the psychological literature. For instance, available research on self-harm incorporates well-researched and thoroughly discussed concepts such as depression and suicide. This being the case, self-harming behaviors research becomes informed by the many insights from practice into these realities, and also allows research to build on existing research in the literature to further understanding. The end result as this discussion makes clear is that patients are saved from ending their own lives and are also saved from the pain and suffering that push them to inflict harm on themselves. In other words a better understanding of self-harming behaviors result from being able to better classify and talk about them in practice and in research. For these reasons the classification work is very useful (Goldberg, 2010; Skegg, 2005: Owens, Horrocks and House, 2002; Forman and Kalafat, 1998; Kam, 2014). References Cooper, J. et al. (2005). Suicide After Deliberate Harm: A 4-Year Cohort Study. American Journal of Psychiatry. Retrieved from http://journals.psychiatryonline.org/article.aspx?volume=162&page=297 Forman, S. and Kalafat, J.(1998). Substance Abuse and Suicide: Promoting Resilience Against Self-Destructive Behavior in Youth. School Psychology Review 27 (3). Retrieved from http://woodknot.wce.wwu.edu/Depts/SPED/Forms/Kens%20Readings/Violence/Suicide/Substance%20Abuse%20and%20Suicide%20v.%2027%20iss.3.pdf Goldberg, D. (2010). The classification of mental disorder: a simpler system for DSM-V and ICD-11. Advances in Psychiatric Treatment 16. Retrieved from http://apt.rcpsych.org/content/16/1/14.full Hawton, K. et al. (1998). Deliberate self-harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition. BMJ 317 (7156). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28637/?rendertype=abstract Hawton, K., Zahl, D. and Weatherall, R. (2003). Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. British Journal of Psychiatry 182. Retrieved from http://www.phru.net/mhin/suicideprevention/SPPG%20Evidence%20SubGroup%20References/Hawton%20BJP%202003%20rates%20of%20suicide%20following%20DSH.pdf Henley, M., Ramsey, R. and Algozzine, R. (2010). Labeling and Disadvantages of Labeling. Education.com. Retrieved from http://www.education.com/reference/article/advantages-disadvantages-labeling/ Kam, K. (2014). Depression and Risky Behavior. WebMD. Retrieved from http://www.webmd.com/depression/features/depression-and-risky-behavior King, M. et al. (2008). A systematic review of mental disorder, suicide, and deliberate self-harm in lesbian, gay, and bisexual people. BMC Psychiatry 8:70. Retrieved from http://www.biomedcentral.com/1471-244X/8/70/ Klonsky, E., Oltmanns, T. and Turkheimer, E. (2003). Deliberate Self-Harm in a Non-Clinical Population: Prevalence and Psychological Correlates. American Journal of Psychiatry 160. Retrieved from http://journals.psychiatryonline.org/article.aspx?articleid=176381 Mental Health Professional Online Development (2013). Classification of Mental Disorders. MHPOD. Retrieved from http://www.mhpod.gov.au/assets/sample_topics/Classification_of_Mental_Disorders.html Owens, D., Horrocks, J. and House, A. (2002). Fatal and non-fatal repetition of self-harm. British Journal of Psychiatry. Retrieved from http://bjp.rcpsych.org/content/181/3/193.full Sansone, R., Wiederman, M. and Sansone, L. (1998). The Self-Harm Inventory (SHI): Development of a Scale for Identifying Self-Destructive Behaviors and Borderline Personality Disorder. Journal of Clinical Psychology 54 (7). Retrieved from http://pavlov.psyc.vuw.ac.nz/courses/Psyc%20325/Lab%20reports/Eat%20and%20OCD%20report/98%20JClinPsyc%20Sansone%20SHI%20development.pdf Skegg, K. (2005). Self-Harm. The Lancet 366. Retrieved from http://dnmeds.otago.ac.nz/departments/psychological/pdf/skegg_lancet%20seminar.pdf Read More