ZELFVERWONDEND GEDRAG BIJ ADOLESCENTEN: De relatie met persoonlijkheid, stress en coping

Glenn Kiekens
In een recente studie bij Vlaamse en Nederlandse adolescenten gaf 1 op 4 aan zichzelf ooit opzettelijk te hebben verwond. Adolescenten die zichzelf verwonden verschillen van hun leeftijdsgenoten qua persoonlijkheidskenmerken, ervaren stress en de manier waarop ze omgaan met stressvolle gebeurtenissen.Zelfverwondend gedrag wordt gedefinieerd als “sociaal onacceptabel gedrag waarbij een fysiek letsel opzettelijk en op een directe manier wordt toegebracht zonder een aanwezige intentie tot zelfdoding”.

ZELFVERWONDEND GEDRAG BIJ ADOLESCENTEN: De relatie met persoonlijkheid, stress en coping

In een recente studie bij Vlaamse en Nederlandse adolescenten gaf 1 op 4 aan zichzelf ooit opzettelijk te hebben verwond. Adolescenten die zichzelf verwonden verschillen van hun leeftijdsgenoten qua persoonlijkheidskenmerken, ervaren stress en de manier waarop ze omgaan met stressvolle gebeurtenissen.

Zelfverwondend gedrag wordt gedefinieerd als “sociaal onacceptabel gedrag waarbij een fysiek letsel opzettelijk en op een directe manier wordt toegebracht zonder een aanwezige intentie tot zelfdoding”. Vaak voorkomende voorbeelden zijn zichzelf krassen, snijden, slaan, branden, hoofdbonken en wonden verhinderen te genezen.

Hoe vaak komt zelfverwonding voor? In een recente studie (i.s.m. de Universiteit van Nijmegen) bevroegen we 1013 Vlaamse en Nederlandse adolescenten tussen 12 en 19 jaar en kwamen tot de vaststelling dat bijna één op vier rapporteert zichzelf ooit te hebben verwond. Vlaanderen en Nederland zijn geen uitzondering met deze alarmerende cijfers, internationaal worden immers gelijkaardige bevindingen gerapporteerd. Nederlandse adolescenten starten ongeveer twee jaar vroeger dan hun Belgische leeftijdsgenoten. Hoewel er in het voorkomen geen geslachtsverschillen aanwezig waren, constateerden we wel verschillen qua methoden. Zo werd hoofdbonken meer gehanteerd door jongens dan meisjes, terwijl het omgekeerde gold voor zichzelf snijden of krassen. Gemiddeld genomen gaven jongeren aan twee verschillende methoden te hanteren.

Waarom zelfverwondend gedrag?Uit onderzoek blijkt dat zelfverwondend gedrag het vaakst gehanteerd wordt als een manier om met negatieve gevoelens of stress om te gaan. Daarnaast zijn andere vaak voorkomende functies: een gevoel van controle krijgen, ontsnappen aan eisen uit de sociale omgeving en het gebruik omwille van het verkrijgen van aandacht. Zelfverwonding heeft op korte termijn dus positieve gevolgen voor de adolescent. Op middellange termijn steken negatieve gevoelens als schaamte de kop op, waarna jongeren zichzelf dan mogelijks terug verwonden om met deze negatieve gevoelens om te gaan. Zo kan dit leiden tot een gevaarlijke negatieve bekrachtigende cyclus.

OorzakenDit gedrag ontwikkelt zich meestal tijdens de adolescentie en komt in deze periode dan ook het frequentst voor. In onze onderzoeksgroep gaf meer dan de helft aan zichzelf voor de eerste maal te hebben verwond tussen de leeftijd van 12 en 15 jaar. Het is in onderzoek naar zelfverwonding belangrijk om te beseffen dat één risicofactor nooit aanleiding zal geven tot dit gedrag, het is veelal zo dat een aanwezigheid van verschillende risicofactoren aan de grondslag liggen. Deze risicofactoren zijn omgevingsgebonden, bijvoorbeeld verwaarlozing, misbruik, moeilijkheden in seksuele oriëntatie, gepest worden, etc. Daarnaast kunnen ze ook persoonsgebonden zijn zoals bijvoorbeeld de mate van impulsiviteit.

Mogelijke factoren die wij onderzocht hebben zijn persoonlijkheid, stress en de manier waarop er met stress wordt omgegaan. We stelden onder andere vast dat jongeren met zelfverwondend gedrag een grotere neiging hebben om negatieve emoties te ervaren en zich in een sociale context meer terughoudend en angstig opstellen. Daarnaast scoren adolescenten die zichzelf verwonden lager op persoonlijkheidstrekken zoals optimisme, vriendelijkheid en gewetensvolheid. Verder beschouwen ze hun leven meer onvoorspelbaar en oncontroleerbaar, en ervaren ze dus meer stress dan leeftijdsgenoten zonder dergelijk gedrag. Daarenboven blijken adolescenten met zelfverwondend gedrag eveneens anders om te gaan met stressvolle gebeurtenissen in hun leven. Zo zullen zij bijvoorbeeld minder sociale steun zoeken of geruststellende gedachten ervaren, en zullen ze meer depressief reageren of hun emoties en boosheid uiten.

Het verwerven van inzicht in de ontstaansmechanismen van zelfverwonding is belangrijk. Zo kunnen we leren hoe persoonlijkheidskenmerken of andere factoren kunnen leiden tot een verhoogd of net verlaagd risico op het ontstaan en continueren van zelfverwondend gedrag. We hebben onder andere vastgesteld dat persoonlijkheidsfactoren iemand kwetsbaar kunnen maken voor zelfverwonding via de mate van het ervaren stressniveau, en de manier waarop ze hiermee omgaan. Dit impliceert dat stressregulatie en de manier waarop met stressvolle gebeurtenissen wordt omgegaan twee belangrijke therapeutische thema’s zijn.

Gevolgen op lange termijnHelaas is er voorlopig nog weinig geweten over de impact van zelfverwondend gedrag op langere termijn voor andere levensdomeinen. Zoals de invloed op sociaal leven, academische prestaties, mentale gezondheid, etc. Zo toont onderzoek bijvoorbeeld duidelijk een link aan met suïcidale gedragingen. Echter, gefundeerd inzicht over welke zelfverwondende jongeren later een verhoogd risico lopen suïcidale gedragingen te ontwikkelen vraagt complexer en tijdsintensiever onderzoek. Een financiële investering die maatschappelijk verantwoordbaar en nodig is.

Personalia

Glenn Kiekens schreef zijn masterproef aan de onderzoeksgroep Klinische Psychologie van de Faculteit Psychologie en Pedagogie KU Leuven. Glenn is momenteel doctoraatsstudent aan de onderzoeksgroep Psychiatrie van de Faculteit Geneeskunde KU Leuven, waar hij zelfverwonding bij Leuvense universiteitsstudenten zal onderzoeken. 

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Universiteit of Hogeschool
Klinische en Gezondheidspsychologie
Publicatiejaar
2014
Kernwoorden
Gkiekens
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