Accident and emergency staff's perceptions of deliberate self‐harm: Attributions, emotions and willingness to help

Nadine Mackay · Christine Barrowclough

154 citations0/0 files storedBritish Journal of Clinical Psychology

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Suicide and Self-Harm Studies Psychiatric care and mental health services Mental Health Treatment and Access

Abstract

OBJECTIVES: The study applied Weiner's (1980, 1986) attributional model of helping behaviour to Accident and Emergency (A&E) staff's care of patients presenting with deliberate self-harm. It was hypothesized that where staff attributed precipitants of the act of deliberate self-harm to controllable, internal, and stable patient factors, then staff would display greater negative affect, less optimism, and less willingness to help the patient. DESIGN: Using four hypothetical scenarios in a two-factor between-subjects design, contextual factors describing a self-harm patient were manipulated. METHOD: Participants were 89 A&E medical and nursing staff. They were asked to rate attributions for the cause of the deliberate self-harm and their emotional responses, optimism for change, and willingness to help change the behaviour. Their general attitudes towards deliberate self-harm patients and perceived needs for training in the care of these patients were also assessed. RESULTS: The findings were consistent with Weiner's attributional model of helping. The greater attributions of controllability, the greater the negative affect of staff towards the person, and the less the propensity to help. The higher the ratings of stability of outcome, the less staff optimism for the success of their input. Male staff and medical staff had more negative attitudes, and medical staff saw less need for further training. CONCLUSION: Formulating A&E staff's responses to deliberate self-harm using a cognitive-emotional model offers the possibility of working with staffs' beliefs, emotions, and behaviour to improve the care and treatment of deliberate self-harm patients.

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References

1985An attributional theory of achievement motivation and emotion.1986An Attributional Theory of Motivation and Emotion 1982The attributional Style Questionnaire 1980A cognitive (attribution)-emotion-action model of motivated behavior: An analysis of judgments of help-giving.1996Attempted suicide in Europe: rates, trend.S and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide 1998Deliberate self harm: systematic review of efficacy of psychosocial and pharmacological treatments in preventing repetition 1997Trends in deliberate self-harm in Oxford, 1985–1995 1991Attribution and expressed emotion in the relatives of patients with schizophrenia.

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