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PAPERS: Julia Sinclair and Judith Green Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences BMJ 2005; 330: 1112 [Abstract] [Full text]

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What about those who continue to self harm?

Jatinder P Babbar   (14 May 2005)

Quantitative design for future study

Wen-Hung Kuo   (19 May 2005)

What about those who continue to self harm? 14 May 2005
Jatinder P Babbar, PG Yr 1 Resident UVA Roanoke/Salem Psychiatry Residency Program , 1970 Roanoke Blvd., Salem, VA 24153, USA Send response to journal: Re: What about those who continue to self harm?	The article does provide an alternate perspective but it would have been interesting to know whether resolution of adolescent chaos and recognition of alcohol as a factor was also present in any of the 59 other patients who are still being followed up and continue to self harm and if so why has it not stopped them from repeated self harm. Lack of comparison with the other group limits the significance of the findings. Competing interests: None declared
Quantitative design for future study 19 May 2005
Wen-Hung Kuo, Assistant Professor Temple University, Philadelphia, PA 19017 Send response to journal: Re: Quantitative design for future study	It is rare to see a suicidology study using qualitative methodology like the one by Sinclair and Green (1). It is refreshing to see such topic can be studied in a different perspective. However, three narratives mentioned in this study, family stress, alcoholism, and depression, have long been identified as important risk factors for suicidal behavior. Those risk factors also co-occur often for a same individual who commit self harm. Comorbidity of risk factors was not discussed in this paper. One thing new from this study is how remission ("resolution") from deliberate self harm is perceived by the individual with such history. However, it would be interesting to know how comorbid condition (people with at least two out of the three aforementioned risk factors) might have impeded treatment effectiveness and the "resolution." Also, how frequent for each type of risk factors is distributed among recovering former suicide attempters. To achieve this, a quantitative study design with a much larger sample will still be needed. Mixed study design method with sequential exploratory strategy (2) can be utilized to further advance this study. 1. Sinclair J and Green J. Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences. BMJ 2005; 330: 1112-4 2. Creswell J.W. Research design: qualitative, quantitative, and mixed methods approach. Sage Publications, 2003 Competing interests: None declared