Self-harm in a dangerous and severely personality disordered population

Abstract

The present paper reports on a total of 309 incidents of self-harm recorded between October 2004 and September 2007, for a group of male patients deemed to be dangerous and severely personality disordered (DSPD), within the Peaks Unit at Rampton high security hospital. The first part of this paper describes self-harm within this group of patients, to see whether, as well as posing danger to the public, these patients also pose a risk of harm to themselves. Second, the paper investigated the antecedents of the self-harm incidents recorded. Finally, statistical analyses were conducted to assess the relationships between self-harm and patient/environmental characteristics. No significant differences were found between those who self-harmed and those that did not, although some differences were found within the self-harming group. Implications for future research and treatment are discussed.

Keywords:

• self-harm
• DSPD
• antecedents
• predictors
• personality
• personality disorder

Acknowledgements

I would like to thank Kevin Howells, Richard Howard, and Matthew Tonkin for their comments and support. Opinions or points of view expressed are those of the author and do not necessarily reflect the official position or policies of Nottinghamshire Healthcare NHS Trust or any other agency.

Notes

1. The IPDE data for the remaining 16 patients were not available due to the patient having not yet been assessed at the time of writing, the patient refusing to participate in the assessment, or the death or transfer of a patient before their assessment was completed.

2. These six patients received no definite diagnosis for a PD according to the IPDE assessment. However, they were deemed personality disordered by clinicians.

3. This includes the ward garden, on transfer to therapy, or when out of Rampton Hospital on a hospital or court visit.