Advanced Health Promotion

This document discusses the importance of psychological well-being and its impact on daily life activities, relationships, and physical health. It explores mental health issues, self-harming behaviors, and interventions for better mental health.

Advanced Health
Promotion

Contents
Introduction......................................................................................................................................3
Main body........................................................................................................................................3
Background......................................................................................................................................3
Discussion........................................................................................................................................5
Intervention......................................................................................................................................9
Critique of planning model............................................................................................................10
Conclusion.....................................................................................................................................17
References......................................................................................................................................18
Book and journals..........................................................................................................................19

Introduction
Psychological well-being incorporates one's mental, enthusiastic and social prosperity –
one's emotional well-being influences how they think, feel and act. It likewise helps in deciding
how one handles pressure, settles on decisions and identifies with others. Emotional wellness can
influence one's everyday life exercises, connections and actual wellbeing. Psychological wellness
alludes to the state of intellectual and conduct prosperity. Now and then the term 'emotional
wellness' is utilized to decide the shortfall of a psychological issue. It is the state of prosperity
whereby every individual understands their latent capacity and can manage life changes and
vulnerability. In contrast to oncologists and cardiologists, who realize that particular kinds of
tumors or coronary illness drastically improve the probability of death, therapists and clinicians
tend not to consider death rates with regards to mental diseases. This has prompted impressive
disarray, just as to an under emphasis on what amount is really thought about self-destruction
from a clinical and scientific perspective. Indeed, we know an extraordinary arrangement.
(Camm-Crosbie,et.al. 2019). Mental health cause number of harmful effext one vital part of ASD
concerns tangible irregularities, which are currently remembered for the DSM 5. Rather than
earlier forms of the DSM which classify subtypes of conditions, the DSM 5 takes a more
dimensional view, perceiving that all people share these regular highlights. Albeit a solid
hereditary reason for ASD has been set up, the causes are indeed heterogeneous. ASD is much of
the time joined by scholarly inability (Cundiff, 2016).
Main body
Background
Proper psychological well-being is fundamental in each phase of life – from youth and
adolescent to adulthood. All through a lifetime, an individual can encounter emotional wellness
issue anytime. This influences their mind-set and conduct as well as changes their perspective, of
taking a gander at life and confronting difficulties.

Despite the fact that emotional wellness is a profoundly close to home thing, what
influences one individual might influence the other individual; notwithstanding, some huge
variables add to psychological well-being issues. These variables incorporate educational
encounters like injury or misuse, organic factors like qualities or science of the mind, and
surprisingly the family background of emotional well-being issues can influence a person. Poor
psychological wellness is likewise connected with upsetting work conditions, quick friendly
changes, sexual orientation segregation, sex separation, social avoidance, actual disease and
basic liberties infringement.
Emotional wellness issues are normal, yet for the most extensive length of time,
individuals have stayed away from its whole idea and underestimated psychological well-being.
At a certain point, emotional wellness was viewed as no-no, and anybody looking for help was
marked as intellectually sick. Psychological wellness and dysfunctional behavior are not
comparative things.
For quite a while, psychological well-being has been characterized as the shortfall of
dysfunctional behaviors like tension and gloom. Psychological maladjustment regularly alludes
to every one of the diagnosable mental problems – ailments that are portrayed by adjustments in
mind-set, thinking and conduct related with disabled working or misery.
Emotional well-being and psychological sickness together go connected at the hip.
People having ideal emotional well-being conditions can likewise confront psychological
instability, where individuals who have no dysfunctional behavior can likewise have poor
psychological well-being. Lately, individuals have begun treating psychological wellness
appropriately and making legitimate strides in managing any emotional well-being issues. Help
is accessible out there; individuals with emotional well-being issues can improve by looking for
help.
Individuals experiencing emotional well-being issues show different side effects like
practically zero energy, driving away individuals and pulling themselves back from customary
exercises, loss of rest or the will to eat, smoking, drinking or taking medications, feeling
vulnerable, hollering and battling, losing temper rapidly, hurting themselves and some more.

Dealing with emotional well-being not exclusively is finding support from experts when
required yet additionally associating with other, engaging in proactive tasks, helping other
people, getting sufficient rest and remaining positive that there is an exit plan. Positive emotional
wellness permits individuals to understand their maximum capacity, adapt to pressure throughout
everyday life, work beneficially and make significant commitments to the local area. Different
elements in individuals' lives, for example, intrapersonal relations, actual elements, youth injury
and numerous different conditions can disturb psychological well-being conditions. Taking
consideration and caring for one's psychological well-being jam a person's capacity to appreciate
life (Kwon, et.al.2016) Additionally, youngsters tend to "grow out of" them as they create
language and enthusiastic guideline abilities. As per the studies self-damaging practices induce
through poor mental health.
Mental health and suicidal tendencies
Self-damaging practices, some of the time alluded to as self-hurt, can be available in
every one of youth and grown-ups. Mental conditions, for example, marginal behavioral
condition are related with conscious self-hurting conduct without self-destructive expectation,
which is known as non-self-destructive self-injury or NSSI. Instances of these practices
incorporate skin cutting, consuming, or meddling with wound mending (Sumlin, Wall and Sharp,
2020) NSSI in these conditions might be identified with impulsivity, enthusiastic deregulation,
and lacking adapting abilities, and can be found to some extent as a path for a person to achieve
help from or oversee extraordinary adverse feelings. It is likewise essential to perceive that NSSI
can happen in people with ASD.
In an examination by Maddox and associates, a background marked by participating in
NSSI was accounted for by various advanced grown-ups with ASD who were enrolled to finish
an on-line overview about conduct issues. Ladies with ASD were bound to have occupied with
NSSI than men with ASD, recommending that further examination on sex contrasts is justified.
Notwithstanding the above populaces, SIB has a high predominance rate among people with
extreme scholarly handicaps (ID), a large number of whom have co-happening mental imbalance
range problem (ASD), and the effect of this conduct can have pulverizing ramifications for these

people and their guardians (Camm-Crosbie,et.al. 2019) The following areas give data about the
geography, effect, and commonness of SIB in this populace.
SIB is successive in kids and grown-ups with ASD (happening in up to half of the
populace) and can be perceived as existing on a continuum comparable to recurrence and force,
going from gentle and rare to serious and persistent. The last sorts of SIB include powerful
extreme contact with explicit body destinations which can possibly cause enduring actual harm.
Tedious or generalized engine developments are a critical segment of SIB. The actual effect of
SIB has been shown to be of critical worry for the wellbeing and prosperity of the person. For
example, Newell and partners directed a biomechanical investigation of head hitting in grown-
ups with serious ID, and established that the actual effect of their SIB was comparable with the
impacts of boxing punches.
Discussion
Psychological wellness isn't just the mental and enthusiastic prosperity of an individual
yet in addition it is the condition of prosperity where an individual can utilize their passionate
and intellectual capacities to satisfy the needs of regular day to day existence and add to the
general public. Psychological well-being is fundamental in each phase of one's life, beginning
from youth to teenagers up to adulthood. Consistently October tenth is seen as world emotional
well-being day. It was begun as a yearly action by the world league by the delegate secretary-
general of UNO (United Nations Organization) around then for emotional wellness. Emotional
wellness assets in each nation are extraordinary. Simultaneously, created nations of the western
world give emotional well-being projects to each age bunch. In underdeveloped nations where it
turns into a battle to track down the essential requirements of the families, very little significance
is given giving legitimate emotional wellness help (Cundiff, 2016).
Scientists recommend that maybe an inadequacy in serotonin might be simply the
offender of expanded rates hostility. In any case, there is no experimental proof to help the
possibility that the serotonin framework alone underlies self-injury. The narcotic or "habit
theory" recommends that the arrival of sedatives after the torment created by SIB is supporting in
it of itself. This and comparative speculations propose that somebody who self-harms can get
addictive to the narcotics or endorphins delivered and will accordingly take part in self-injury

significantly more. Narcotics are addictive for everybody, thus by a similar rationale one could
contend that those with BPD likewise participate in SIB since they are dependent on the arrival
of sedatives after the agony created by SIBs (Sumlin, Wall and Sharp, 2020) In any case, exact
proof and general help for these theories don't exist to apply this examination to SIBs in any
populace (counting the mentally unbalanced populace) with any unwavering quality.
A meaning of emotional well-being is close to home and dependent on ones singular
educational encounters and life setting. "Emotional well-being can be impacted by our sexual
orientation, social class race, strict convictions, and experience of everyday life". "Emotional
well-being has been depicted as multi-layered with six measurements conduct, full of feeling,
profound, intellectual, mental, and socio-political". The Health Education Authority
characterized psychological wellness in 1997 as "the enthusiastic and otherworldly versatility
which empowers us to endure torment, disillusionment and trouble". "It is a crucial faith in our
own and others' poise and worth". (Stream J. Lougher L. 2006)
The Mental Health Foundation has characterized an intellectually sound individual as one
who can "Be certain and decisive; Develop inwardly, innovatively, mentally and profoundly;
Initiate, create and support commonly fulfilling individual connections; Be mindful of others and
relate to them; Face issues, resolve them and gain from them; Use and appreciate isolation; Play
and have a good time; Laugh, both at themselves and at the world".
The shortfall of psychological sickness and passionate wellbeing alludes to the presence
of a positive brain, enabling you to giggle and "they can continue with their ordinary lives"
(Jackson-Triche M., Wells K.B., Minnium K., 2002)
Individuals who have great wellbeing can in any case have basic enthusiastic issues and
mental issues. This can be brought about by an actual lopsidedness in the cerebrum, stress,
family issues and upsetting work/schooling can exacerbate it.

These psychological and actual sentiments can make the individual become isolated and
carry on with a different life from others in the public arena. The pessimism of a psychological
wellness issue will block the people inherent possibilities in life early instruction, work, conjugal
and get unsociable (Guntrip H. 1964) Lots of individuals who are sincerely sound have figured
out how to adapt to their burdens and issues by looking for help from the specialist. Being
intellectually or genuinely sound is vastly improved for every person than being a victim of
gloom, nervousness, dementia, Alzheimer and other mental issues. One approach to manage
pressure is the capacity to have the option to learn and change ones way of life, in a positive way
and having the option to keep a satisfying glad relationship hence giving you fearlessness (Beck
A.T.1987) To improve and keep a fair emotional wellness you need to deal with yourself
ordinary and attempt to follow a system of rest, great sustenance, and exercise, limit liquor and
make an effort not to utilize cigarettes or medications. Central issues that can intensify somebody
with a metal medical condition can be on getting terrible news like repetition, separation,
mourning or monetary circumstances can contribute adversely to an individual fostering a
psychological well-being issue (Holmes and Rahe 1967). Emotional well-being is anything but a
weakening condition and with the right assistance and backing an individual can lead a full
cheerful and significant way of life.
Psychological maladjustment might be capable by individuals who have an emotional
wellness issue so extreme that they may get an analysis as having a dysfunctional behavior,
which will include the administrations and backing of an expert psychological wellness care
group. It ought to be recalled that psychological sickness is inclined to error as often as possible
individuals who experience a psychological well-being issue show sporadic or uncommon
conduct, have an erroneous impression of the real world or express perspectives which vary from
most of the remainder of society, subsequently they can be mistaken for individuals who are
offbeat, or whose way of life and perspectives contrast from those of others (Hart 2004) It can be
an ongoing encounter from mental prosperity through to a serious and suffering dysfunctional
behavior influencing an individual's generally passionate and mental condition. Thus, a few
groups with psychological sickness will require no help, others may require just intermittent
help, and still others may require more significant, progressing backing to keep up their personal

satisfaction. "To comprehend the distinction between psychological well-being and
psychological instability explicitly identifies with both the period of time and seriousness of the
progressions to an individual's conduct thought examples and show of feelings. The more serious
and extensive the effect of these changes, the more an individual may battle to deal with their
regular daily existence and the more prominent the odds of them fostering a dysfunctional
behavior.
Intervention
Most theories and exploration encompassing SIB withinside the Autism population were
gotten from Applied Behavioral Analysis (ABA), explicitly via the usage of a Functional
Behavioral Analysis (FBA), lately depicted. Albeit the FBA became created to assess outdoor
practices and improvements, it's been improperly implemented to supply SIB to create
speculations regarding the inner, imperceptible cycles internal a child to determine why they're
collaborating in SIB (Kwon, et.al.2016).
Psychological maladjustment might be capable by individuals who have an emotional
wellness issue so extreme that they may get an analysis as having a dysfunctional behavior,
which will include the administrations and backing of an expert psychological wellness care
group. It ought to be recalled that psychological sickness is inclined to error as often as possible
individuals who experience a psychological well-being issue show sporadic or uncommon
conduct, have an erroneous impression of the real world or express perspectives which vary from
most of the remainder of society, subsequently they can be mistaken for individuals who are
offbeat, or whose way of life and perspectives contrast from those of others (Hart 2004).
It can be an ongoing encounter from mental prosperity through to a serious and suffering
dysfunctional behavior influencing an individual's generally passionate and mental condition.
Thus, a few groups with psychological sickness will require no help, others may require just
intermittent help, and still others may require more significant, progressing backing to keep up
their personal satisfaction. "To comprehend the distinction between psychological well-being
and psychological instability explicitly identifies with both the period of time and seriousness of
the progressions to an individual's conduct thought examples and show of feelings. The more
serious and extensive the effect of these changes, the more an individual may battle to deal with

their regular daily existence and the more prominent the odds of them fostering a dysfunctional
behavior. As a rule, individuals with a lower pressure limit are more helpless to fostering a
psychological instability". (Wong 2006) Dementia is the most genuine type of memory issues.
There are a few reasons for dementia with the most well-known being Alzheimer's illness, this
causes a reformist scholarly decay from mental deficiencyaid.
Critique of planning model
Some regular theories got from the use of a FBA recommend the capacity of SIB is likely
friendly consideration, admittance to substantial prizes, to get away or stay away from specific
exercises or circumstances, or because of inside self-incitement (Somma, et.al., 2019) For a
comprehension of why the FBA is improper, allowed us to analyze the end that SIB is utilized
for task evasion. Consider an understudy who hits his own head when the advisor gives him a
troublesome errand to perform. One presumption would be that the understudy would not like to
do the errand so the SIB is an outflow of assignment evasion.
Another supposition could be that the introduction of the troublesome assignment set off a
pressure reaction or potentially an agony reaction (Galfalvy, et.al.2017) Inside the ASD/ID
populace, head banging is quite possibly the most widely recognized types of SIB; different
structures incorporate head hitting, gnawing, scratching or picking the skin, hair pulling, eye
jabbing, heaving/rumination, and ingestion of non-consumable substances, known as pica.
People regularly take part in more than one type of SIB.
In spite of the fact that NSSI doesn't generally advance to or foresee future self-destructive
practices, there is accepted to be a interface between the two, which makes this a significant
patient security concern. NSSI has been seen in both the local area and the clinical setting, in
spite of the fact that paces of NSSI are higher inside the mental population.2, 3 NSSI may
present as a manifestation of various mental conditions, including nervousness messes;
disposition issues; substance misuse; dietary problems; and behavioral conditions, for example,
marginal behavioral condition (BPD) (Cullen, et.al.2020) Despite the fact that clinicians once
considered NSSI fundamentally with regards to BPD, NSSI was added as a particular condition
in the Diagnostic and Statistical Manual of Mental Disorders, fifth Edition (DSM-5) in 2013.

In 2019, experts at the Patient Safety Authority (PSA) directed and distributed an investigation
of occasions submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS)
including patient self-hurt in the non-psychiatric setting. Nonetheless, an examination of
occasions in PA-PSRS including self-harm, and all the more explicitly NSSI, in the mental
setting had at this point to be embraced (Cundiff, 2016) In this examination, it led an in depth
audit and investigation of patient security occasions including NSSI among youngsters and
teenagers in the inpatient mental setting that occurred in 2019. Mental imbalance range problem
is a neurodevelopmental condition that is described by friendly correspondence shortfalls and
firm, dreary examples of conduct that are available from right off the bat throughout everyday
life and which bring about huge constraints in versatile working.
One vital part of ASD concerns tangible irregularities, which are presently remembered for the
DSM 5. Rather than earlier forms of the DSM which classify subtypes of conditions, the DSM 5
takes a more dimensional view, perceiving that all people share these basic highlights. Albeit a
solid hereditary reason for ASD has been set up, the causes are truth be told heterogeneous
(Camm-Crosbie,et.al. 2019) ASD is oftentimes joined by scholarly inability. The reason for this
examination was to inspect patient-explicit variables, for example, age and sex, just as other
contributing conditions, like relational associations, that may accelerate NSSI in this
understanding populace. For regulating patients with basic passionate deregulation, current
treatment methodologies that depend on psychological or rationalistic social treatment are liked
over different intercessions. For SIB in patients with ASD, a mix of conduct medicines is
regularly first-line, and pharmacologic treatment might be added if social medicines alone have
fizzled. To guard patients during inpatient stays in mental offices or units, future examination
should zero in on anticipation systems that lessen hazard of NSSI among kids and youths.
In an investigation of patients with ASD and other formative issues hospitalized in specific
mental offices in the United States, animosity and SIB were the most basic explanations behind
hospitalization (Baiden, 2017) Additionally, patients with ASD who occupied with self-hurt in
our examination were most regularly portrayed as forceful. To gauge the pace of SIB among
patients with ASD, specialists led a meta-investigation of 37 essential examinations that included
14,379 patients; 42% of patients with ASD occupied with SIB, thought about to 8% of kids and
teenagers in everybody. An investigation of kids and teenagers with ASD conceded to inpatient

units in specific mental offices distinguished likely indicators for self-injury, and specialists
tracked down that scholarly incapacity was the most well-known indicator of SIB among this
patient populace.
Treatment of SIB in patients with ASD can be testing since these practices are accepted to be
molded, fortified, and kept up through both positive and negative support, and now and again
may even act naturally building up. Empiric examination upholds the utilization of conduct
medicines for SIB in patients with ASD, which are planned to expand positive, versatile conduct
or abatement unwanted conduct (Cullen, et.al.2020) Social treatment for SIB in patients with
ASD depends on the standards of support, termination, discipline, and expertise building, and
these are regularly utilized in blend to accomplish the ideal impact.
Pharmacologic medicines might be gainful in treating SIB in patients with ASD, particularly in
blend with social medicines at the point when they have bombed as immunotherapy; the most
normally utilized classes of drugs are specific serotonin reuptake inhibitors (SSRIs), like
fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft); abnormal antipsychotics, for
example, risperidone (Risperdal) and clozapine (Clozaril); furthermore, narcotic enemies, like
naltrexone (Somma, et.al., 2019).
Conclusion
NSSI among kids and young people is accounted for much of the time by mental
emergency clinics and units across Pennsylvania; what's more, our information is likely just a
preview of what really happens. NSSI has been noticed all the more regularly in females than
guys in the young adult populace. The most well-known strategies for NSSI among teenagers
incorporate hitting, punching, kicking, or body hammering a surface; scratching or on the other
hand cutting self with fingernails or an item; and head banging.
Despite the fact that NSSI brought about just minor wounds to patients in our
investigation, a few patients may incidentally cause more genuine mischief than expected,
particularly as self-harmful practices heighten. Likewise, research has appeared that NSSI and
self-destructive practices co-happen in youths also, that NSSI might be an indicator of suicidal

further down the road. In any work on setting, ID of patients who may be in danger for NSSI, for
example, teenagers who are locked in in or who are the subjects of tormenting may give a chance
to forestall and treat these practices before they progress to more genuine wounds or suicidal
sometime down the road.
References
Book and journals
Camm-Crosbie, L., Bradley, L., Shaw, R., Baron-Cohen, S. and Cassidy, S., 2019. ‘People like
me don’t get support’: Autistic adults’ experiences of support and treatment for mental health
difficulties, self-injury and suicidality. Autism, 23(6), pp.1431-1441.
Kwon, A., Song, J., Yook, K.H., Jon, D.I., Jung, M.H., Hong, N. and Hong, H.J., 2016.
Predictors of suicide attempts in clinically depressed Korean adolescents. Clinical
psychopharmacology and neuroscience, 14(4), p.383.
Wirrell, E.C., Bieber, E.D., Vanderwiel, A., Kreps, S. and Weaver, A.L., 2020. Self‐injurious
and suicidal behavior in young adults, teens, and children with epilepsy: A population‐based
study. Epilepsia, 61(9), pp.1919-1930.
Sumlin, E., Wall, K. and Sharp, C., 2020. The moderating role of dissociation in the relation
between borderline features and factors of self‐injury in adolescents. Personality and mental
health, 14(2), pp.215-226.
Cundiff, A.W., Acute Emergencies in Behavioral Health Patients.
Kwon, A., Song, J., Yook, K.H., Jon, D.I., Jung, M.H., Hong, N. and Hong, H.J., 2018.
Predictors of suicide attempts in clinically depressed Korean adolescents. Clinical
psychopharmacology and neuroscience, 14(4), p.383.

Cullen, K.R., Schreiner, M.W., Klimes-Dougan, B., Eberly, L.E., LaRiviere, L.L., Lim, K.O.,
Camchong, J. and Mueller, B.A., 2020. Neural correlates of clinical improvement in response
to N-acetylcysteine in adolescents with non-suicidal self-injury. Progress in neuro-
psychopharmacology and biological psychiatry, 99, p.109778.
Somma, A., Fossati, A., Ferrara, M., Fantini, F., Galosi, S., Krueger, R.F., Markon, K.E. and
Terrinoni, A., 2019. DSM‐5 personality domains as correlates of non‐suicidal self‐injury
severity in an Italian sample of adolescent inpatients with self‐destructive
behaviour. Personality and mental health, 13(4), pp.205-214.
Baiden, P., 2017. Non-Suicidal Self-Injury and Suicidal Behaviours among Children and
Adolescents: The Role of Adverse Childhood Experiences and Bullying
Victimization (Doctoral dissertation).
Jackson, L., Keville, S. and Ludlow, A.K., 2020. Mothers’ experiences of accessing mental
health care for their child with an autism spectrum disorder. Journal of Child and Family
Studies, 29(2), pp.534-545.
Masi, G., Scullin, S., Narzisi, A., Muratori, P., Paciello, M., Fabiani, D., Lenzi, F., Mucci, M.
and D'Acunto, G., 2020. Suicidal Ideation and Suicidal Attempts in Referred Adolescents
with High Functioning Autism Spectrum Disorder and Comorbid Bipolar Disorder: A Pilot
Study. Brain Sciences, 10(10), p.750.
Galfalvy, H., Brodsky, B., Oquendo, M. and Stanley, B., 2017. 179. Childhood Maltreatment
Moderates Antidepressant Treatment Response for Self-Injury in Borderline Personality
Disorder. Biological Psychiatry, 81(10), pp.S74-S75.
Conner, C.M., Golt, J., Righi, G., Shaffer, R., Siegel, M. and Mazefsky, C.A., 2020. A
comparative study of suicidality and its association with emotion regulation impairment in
large ASD and US census-matched samples. Journal of autism and developmental disorders,
pp.1-16.

Celia, T., Freysteinson, W., Fredland, N. and Bowyer, P., 2020. Battle weary/battle ready: A
phenomenological study of parents' lived experiences caring for children with autism and
their safety concerns. Journal of advanced nursing, 76(1), pp.221-233.
Warrier, V., Greenberg, D.M., Weir, E., Buckingham, C., Smith, P., Lai, M.C., Allison, C. and
Baron-Cohen, S., 2020. Elevated rates of autism, other neurodevelopmental and psychiatric
diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature
communications, 11(1), pp.1-12.
Brager-Larsen, A., Zeiner, P., Klungsøyr, O. and Mehlum, L., 2021. Is Age of Self-Harm Onset
Associated With Increased Frequency of Non-Suicidal Self-Injury and Suicide Attempts in
Adolescent Outpatients?.
Jaffe, A., 2020. The moderating effect of physical health on the relationship between coping
style and engagement in non-suicidal self-injury.
South, M., Costa, A.P. and McMorris, C., 2021. Death by suicide among people with autism:
beyond zebrafish. JAMA network open, 4(1), pp.e2034018-e2034018.
Strang, J.F., Meagher, H., Kenworthy, L., de Vries, A.L., Menvielle, E., Leibowitz, S., Janssen,
A., Cohen-Kettenis, P., Shumer, D.E., Edwards-Leeper, L. and Pleak, R.R., 2016. Initial
clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or
incongruence in adolescents. Journal of Clinical Child & Adolescent Psychology.
Chandna, P., Srivastava, N., Adlakha, V.K. and Panthri, P., 2016. Non suicidal self injury
resulting in dental trauma in an adolescent. Dental traumatology, 32(6), pp.510-513.
Fredlund, C., Svedin, C.G., Priebe, G., Jonsson, L. and Wadsby, M., 2017. Self-reported
frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and
association to sociodemographic factors, sexual behaviors, abuse and mental health. Child
and adolescent psychiatry and mental health, 11(1), pp.1-11.