Adolescentes que se autolesionam e os sentidos atribuídos ao ato : um estudo em um centro de atenção psicossocial infantil (CAPSI) de um município do Vale do Rio Pardo/RS.

Abstract

Introduction: The human body has always been considered a form of expression; however, in contemporary times, it has become intertwined with self-harm situations during adolescence, a period of life filled with intense transformations and emotions, where the adolescent may resort to the act of hurting themselves without suicidal intent. General Objective: To analyze the meanings produced around non-suicidal self-harm among adolescents. MANUSCRIPT I: Objective: To present a historical overview of self-mutilation and its interfaces with emotional suffering. Method: This is an integrative literature review conducted through the PubMed database, using the Medical Subject Headings terms: Self Mutilation AND Psychiatry. A historical cut was made from the oldest publication until August 2023. Results: A total of 62 publications were found. Of these, 21 met the research objectives and were included in the study. The publication period ranged from 1961 to 2023. The studies show that the emotional, historical, and quality of life aspects of the individual are defining factors in the individual's prognosis. Additionally, several risk factors were identified, such as trauma, bullying, anxiety, distress, depressive symptoms, among others. Conclusions: A historical overview was obtained, in which the background of the theme gradually changed, presenting increasing depth, understanding, and complexity of knowledge about self-mutilation. MANUSCRIPT II: Objective: To identify the frequent psychosocial profile among adolescents at the Child Psychosocial Care Center in a municipality in Rio Grande do Sul, who had at least one episode of non-suicidal self-harm in the last three years. Method: Cross-sectional, quantitative study with semi-structured interviews and frequency analysis using the JASP software. Results: The predominant profile identified: female, heterosexual, white adolescents, attending high school. The episodes occurred more than once, at night, during the week, and at home, involving sharp objects and targeting the arms, motivated by family conflicts. These adolescents had a history of violence, did not use alcohol or drugs, and showed positive results with follow-up in the service. Conclusions: It is crucial to offer listening spaces and family interventions for these young people. MANUSCRIPT III: Objective: This study investigated the discourses of adolescents from the CAPSi in a municipality in Vale do Rio Pardo/RS, who reported non-suicidal self-harm in the last three years. Method: A total of 31 adolescents were interviewed between July and October 2023, in a cross-sectional study with analysis based on Spink's sense production methodology. Results: The discourses revealed emotional impulses, functions of self-harm, regret, helplessness, belonging, and the loss of the function of self-harm. Self-harm was seen as a way of dealing with pain, not as a desire for death, but as an effort to overcome psychic pain and move forward. The reflections were grounded by authors such as Dunker (2015), Demantova (2020), and Falcão (2021). Conclusions: The importance of creating safe spaces for dialogue is highlighted, allowing narratives to name anguish and minimize the negative effects of this practice among young people. Final Considerations: It was observed that self-harm has common functions among adolescents, but there are also specific individual and subjective meanings for each person. This understanding provides a basis for building more effective actions and interventions, as well as providing knowledge about the highest-risk audience, enabling greater targeting towards them. The demand for working on adolescents' emotional skills and resilience was identified, as well as the need for family-directed work. There is also a need for more public policies that can encompass mental health in adolescence, as well as programs and actions for coping with and preventing self-harm.