European Child & Adolescent Psychiatry

, Volume 20, Issue 8, pp 413–418

Positive attitudes and self-harming behavior of adolescents in a juvenile detention house in Taiwan

  • Mei-Hua Tsai
  • Kai-Chi Fang
  • Chia-Hui Lu
  • Chih-Dao Chen
  • Chi-Pan Hsieh
  • Tsung-Tai Chen
Original Contribution


This study aimed to evaluate the less stigmatizing positivity construct screening measurement and its association with recent self-harming behaviors among adolescents. Participants were 193 detained Taiwanese adolescents. Questionnaires consisted of a deliberate self-harm inventory, a positivity construct measurement, a depression scale, data concerning risky health behaviors and demographics. The prevalence rate of recent self-harming behavior among adolescents in the detention house was 43.5%. The logistic model showed that age, gender and level of positivity demonstrated significant odds ratios for self-harm behavior. Results showed that younger age and female gender increased self-harming behavior. In addition, low score on positivity construct screening measurement increased the probability of self-harming behavior. Furthermore, these adolescents also engaged in risky health behaviors and were more depressed. Parental and school awareness for these risky behaviors should be enhanced and appropriate early interventions implemented to prevent negative health outcomes.


Self-harming behavior Positive attitudes Detained adolescents Taiwan 


  1. 1.
    Nock MK (2010) Self-injury. Annu Rev Clin Psychol 6:339–363PubMedCrossRefGoogle Scholar
  2. 2.
    O’Connor RC, Rasmussen S, Miles J, Hawton K (2009) Self-harm in adolescents: self-report survey in schools in Scotland. Br J Psychiatry 194(1):68–72PubMedCrossRefGoogle Scholar
  3. 3.
    Liu X, Tein JY, Zhao Z, Sandler IN (2005) Suicidality and correlates among rural adolescents of China. J Adolesc Health 37(6):443–451PubMedCrossRefGoogle Scholar
  4. 4.
    Shin YM, Chung YK, Lim KY, Lee YM, Oh EY, Cho SM (2009) Childhood predictors of deliberate self-harm behavior and suicide ideation in Korean adolescents: a prospective population-based follow-up study. J Korean Med Sci 24(2):215–222PubMedCrossRefGoogle Scholar
  5. 5.
    Matsumoto T, Imamura F, Chiba Y, Katsumata Y, Kitani M, Takeshima T (2008) Prevalences of lifetime histories of self-cutting and suicidal ideation in Japanese adolescents: differences by age. Psychiatry Clin Neurosci 62(3):362–364PubMedCrossRefGoogle Scholar
  6. 6.
    Hawton K, Fagg J, Simkin S (1996) Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976–1993. Br J Psychiatry 169(2):202–208PubMedCrossRefGoogle Scholar
  7. 7.
    Ross S, Heath N (2002) A study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolesc 31(1):67–77CrossRefGoogle Scholar
  8. 8.
    Muehlenkamp JJ, Gutierrez PM (2004) An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide Life Threat Behav 34(1):12–23PubMedCrossRefGoogle Scholar
  9. 9.
    Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML (2007) Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med 37(8):1183–1192PubMedCrossRefGoogle Scholar
  10. 10.
    McLaughlin J, Miller P, Warwick H (1996) Deliberate self-harm in adolescents: hopelessness, depression, problems and problem-solving. J Adolesc 19(6):523–532PubMedCrossRefGoogle Scholar
  11. 11.
    Sim L, Adrian M, Zeman J, Cassano M, Friedrich W (2009) Adolescent deliberate self-harm: linkages to emotion regulation and family emotional climate. J Res Adolesc 19(1):75–91CrossRefGoogle Scholar
  12. 12.
    Matsumoto T, Yamaguchi A, Chiba Y, Asami T, Iseki E, Hirayasu Y (2005) Self-burning versus self-cutting: patterns and implications of self-mutilation; a preliminary study of differences between self-cutting and self-burning in a Japanese juvenile detention center. Psychiatry Clin Neurosci 59(1):62–69PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson M, Standen PJ (2007) Attitudes towards suicide among nurses and doctors working with children and young people who self-harm. J Psychiatr Ment Health Nurs 14(5):470–477PubMedCrossRefGoogle Scholar
  14. 14.
    Crawford T, Geraghty W, Street K, Simonoff E (2003) Staff knowledge and attitudes towards deliberate self-harm in adolescents. J Adolesc 26(5):623–633PubMedCrossRefGoogle Scholar
  15. 15.
    McHale J, Felton A (2010) Self-harm: what’s the problem? A literature review of the factors affecting attitudes towards self-harm. J Psychiatr Ment Health Nurs 17(8):732–740PubMedCrossRefGoogle Scholar
  16. 16.
    Ireland JL, Quinn K (2007) Officer attitudes towards adult male prisoners who self-harm: development of an attitudinal measure and investigation of sex differences. Aggress Behav 33(1):63–72PubMedCrossRefGoogle Scholar
  17. 17.
    Pannell J, Howells K, Day A (2003) Prison officer’s beliefs regarding self-harm in prisoners: an empirical investigation. Int J of Forensic Psychol 1(1):103–110Google Scholar
  18. 18.
    Atkins S (2004) Developing underlying skills in the move towards reflective practice. In: Bulman C, Schutz S (eds) Reflective practice in nursing, 3rd edn. Blackwell, Oxford, pp 25–44Google Scholar
  19. 19.
    Fliege H, Kocalevent RD, Walter OB, Beck S, Gratz KL, Gutierrez PM, Klapp BF (2006) Three assessment tools for deliberate self-harm and suicide behavior: evaluation and psychopathological correlates. J Psychosom Res 61(1):113–121PubMedCrossRefGoogle Scholar
  20. 20.
    Rohde P, Seeley JR, Mace DE (1997) Correlates of suicidal behavior in a juvenile detention population. Suicide Life Threat Behav 27(2):164–175PubMedGoogle Scholar
  21. 21.
    Bjarehed J, Lundh LG (2008) Deliberate self-harm in 14-year-old adolescents: how frequent is it, and how is it associated with psychopathology, relationship variables, and styles of emotional regulation? Cogn Behav Ther 37(1):26–37PubMedCrossRefGoogle Scholar
  22. 22.
    Lundh LG, Karim J, Quilisch E (2007) Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the Deliberate Self-Harm Inventory. Scand J Psychol 48(1):33–41PubMedCrossRefGoogle Scholar
  23. 23.
    Chen KH (2001) The development of a suicide screening instrument–the “My Life Inventory”. J Res Meas Stat 9:47–80 (Chinese)Google Scholar
  24. 24.
    Bland JM, Altman DG (1997) Cronbach’s alpha. BMJ 314(7080):572PubMedGoogle Scholar
  25. 25.
    Chien CP, Cheng TA (1985) Depression in Taiwan: epidemiological survey utilizing CES-D. Seishin Shinkeigaku Zasshi 87(5):335–338 (Japanese)PubMedGoogle Scholar
  26. 26.
    Hamilton LC (1992) Regression with graphics: a second course in applied statistics. Brooks/Cole Pub. Co., Pacific GroveGoogle Scholar
  27. 27.
    Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley series in probability and statistics. Texts and references section, 2nd edn. Wiley, New YorkGoogle Scholar
  28. 28.
    Steyerberg EW, Vickers AJ, Cook NR, Gerds T, Gonen M, Obuchowski N, Pencina MJ, Kattan MW (2010) Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology 21(1):128–138PubMedCrossRefGoogle Scholar
  29. 29.
    Naylor PB, Cowie HA, Walters SJ, Talamelli L, Dawkins J (2009) Impact of a mental health teaching programme on adolescents. Br J Psychiatry 194(4):365–370PubMedCrossRefGoogle Scholar
  30. 30.
    Chowanec GD, Josephson AM, Coleman C, Davis H (1991) Self-harming behavior in incarcerated male delinquent adolescents. J Am Acad Child Adolesc Psychiatry 30(2):202–207PubMedCrossRefGoogle Scholar
  31. 31.
    Hawton K, Rodham K, Evans E, Weatherall R (2002) Deliberate self-harm in adolescents: self-report survey in schools in England. BMJ 325(7374):1207–1211PubMedCrossRefGoogle Scholar
  32. 32.
    Nixon MK, Cloutier P, Jansson SM (2008) Nonsuicidal self-harm in youth: a population-based survey. CMAJ 178(3):306–312PubMedGoogle Scholar
  33. 33.
    Rodham K, Hawton K, Evans E (2004) Reasons for deliberate self-harm: comparison of self-poisoners and self-cutters in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry 43(1):80–87PubMedCrossRefGoogle Scholar
  34. 34.
    Glenn CR, Klonsky ED (2010) The role of seeing blood in non-suicidal self-injury. J Clin Psychol 66(4):466–473PubMedGoogle Scholar
  35. 35.
    Campbell PA (2008) Evaluating teen self-injury: comorbidities and suicide risk. Curr Psychol 7(2):69Google Scholar
  36. 36.
    Patterson P, Whittington R, Bogg J (2007) Testing the effectiveness of an educational intervention aimed at changing attitudes to self-harm. J Psychiatr Ment Health Nurs 14(1):100–105PubMedCrossRefGoogle Scholar
  37. 37.
    Brunner R, Parzer P, Haffner J, Steen R, Roos J, Klett M, Resch F (2007) Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents. Arch Pediatr Adolesc Med 161(7):641–649PubMedCrossRefGoogle Scholar
  38. 38.
    Dugan S, Lloyd B, Lucas K (1999) Stress and coping as determinants of adolescent smoking behavior. J Appl Soc Psychol 29(4):870–886CrossRefGoogle Scholar
  39. 39.
    Loeber R, Stouthamer-Loeber M (1986) Family factors as correlates and predictors of juvenile conduct problems and delinquency. In: Toury M, Morris N (eds) Crime and justice, vol 7, University of Chicago Press, pp 29-149Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Mei-Hua Tsai
    • 1
  • Kai-Chi Fang
    • 2
  • Chia-Hui Lu
    • 3
  • Chih-Dao Chen
    • 1
  • Chi-Pan Hsieh
    • 1
  • Tsung-Tai Chen
    • 4
  1. 1.Department of Family MedicineFar Eastern Memorial HospitalTaipeiTaiwan
  2. 2.Department of PsychiatryFar Eastern Memorial HospitalTaipeiTaiwan
  3. 3.Taipei Juvenile Detention HouseTaipeiTaiwan
  4. 4.Department of Healthcare AdministrationYanchao Campus, I-Shou UniversityKaohsiungTaiwan

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