The experience of the psychiatric interview following self-harm: factors which influence this experience and the potential impact of it

Abstract

A proportion of individuals who are seen at accident and emergency following deliberate self-harm (DSH) are admitted to the medical wards where they are psychiatrically assessed. This exploratory study investigated the interaction between the psychiatrist who conducts this interview and the patient. A sample of 60 DSH patients were seen immediately following their interview with the psychiatrist. They completed questionnaires which assessed personality disturbance and were asked questions regarding their experience of the interview. At the same time the psychiatrist completed parallel measures which assessed their experience of the interview. The comparison group consisted of 30 new Psychology out-patients. They were recruited and assessed in the same way as the experimental group. It was predicted that personality disorder / disintegration would be associated with poorer therapeutic alliance and a repetition of particular patterns of interactions (including avoidance, hostility or rescue). If demonstrated this would support the hypothesis that the experience of the psychiatric interview may inadvertently perpetuate the individual's view of the interpersonal world, which could then increase their likelihood of further dysfunctional coping and decrease the likelihood of them gaining constructive mental health.The study also investigated the attitudes of staff working with this client group. Based on previous research it was predicted that staff would hold quite negative attitudes about deliberate self-harm. Within its theoretical framework, the study considered how such attitudes may be present and how they may contribute to the interaction patterns described above.