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      “They aren’t all like that”: Perceptions of clinical services, as told by self-harm online communities

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          Abstract

          Self-harm is a critical public health issue, with strikingly low rates of attendance to clinical services. By offering support, anonymity, and open discussions, online communities hold useful insights into the factors which influence help-seeking behavior. We explore the perceptions of clinical services in three self-harm online communities to understand which services are being used and why. Message threads from each community were extracted randomly until saturation, providing 513 messages across 60 threads. A thematic analysis was performed resulting in four key themes: access to appropriate services during an episode of self-harm, service preference, fears surrounding disclosure, and support.

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          Developing rigor in qualitative research: problems and opportunities within sport and exercise psychology

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            Self-harm and suicide in adolescents.

            Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              The online disinhibition effect.

              John Suler (2004)
              While online, some people self-disclose or act out more frequently or intensely than they would in person. This article explores six factors that interact with each other in creating this online disinhibition effect: dissociative anonymity, invisibility, asynchronicity, solipsistic introjection, dissociative imagination, and minimization of authority. Personality variables also will influence the extent of this disinhibition. Rather than thinking of disinhibition as the revealing of an underlying "true self," we can conceptualize it as a shift to a constellation within self-structure, involving clusters of affect and cognition that differ from the in-person constellation.
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                Author and article information

                Journal
                J Health Psychol
                J Health Psychol
                HPQ
                sphpq
                Journal of Health Psychology
                SAGE Publications (Sage UK: London, England )
                1359-1053
                1461-7277
                19 July 2018
                November 2020
                : 25
                : 13-14
                : 2164-2177
                Affiliations
                [1 ]Nottingham Trent University, UK
                [2 ]University of Nottingham, UK
                Author notes
                [*]Emma Nielsen, Self-Harm Research Group, School of Psychology, University of Nottingham, University Park Campus, Nottingham NG7 2RD, UK. Email: emma.nielsen@ 123456nottingham.ac.uk
                Author information
                https://orcid.org/0000-0002-6550-9487
                Article
                10.1177_1359105318788403
                10.1177/1359105318788403
                7583449
                30024273
                854bfb2f-bd83-4d80-8f5e-a65ffc64ec66
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
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                Articles
                Custom metadata
                November-December 2020
                ts1

                Clinical Psychology & Psychiatry
                clinical services,internet,online communities,self-harm,thematic analysis

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