Accident and emergency staff's perceptions of deliberate self‐harm: Attributions, emotions and willingness to help

Mackay, Nadine; Barrowclough, Christine

doi:10.1348/014466505x29620

Cited by 154Suicide and Self-Harm StudiesMental Health Treatment and AccessPsychiatric care and mental health services

Accident and emergency staff's perceptions of deliberate self‐harm: Attributions, emotions and willingness to help

Mackay, Nadine, Barrowclough, Christine·2005·British Journal of Clinical Psychology

DOI 10.1348/014466505x29620

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Abstract

Objectives The study applied Weiner's (1980, 1986) attributional model of helping behaviour to Accident and Emergency (A&E) staff's care of patients presenting with deliberate self-harm. It was hypothesized that where staff attributed precipitants of the act of deliberate self-harm to controllable, internal, and stable patient factors, then staff would display greater negative affect, less optimism, and less willingness to help the patient. Design Using four hypothetical scenarios in a two-factor between-subjects design, contextual factors describing a self-harm patient were manipulated. Method Participants were 89 A&E medical and nursing staff. They were asked to rate attributions for the cause of the deliberate self-harm and their emotional responses, optimism for change, and willingness to help change the behaviour. Their general attitudes towards deliberate self-harm patients and perceived needs for training in the care of these patients were also assessed. Results The findings were consistent with Weiner's attributional model of helping. The greater attributions of controllability, the greater the negative affect of staff towards the person, and the less the propensity to help. The higher the ratings of stability of outcome, the less staff optimism for the success of their input. Male staff and medical staff had more negative attitudes, and medical staff saw less need for further training. Conclusion Formulating A&E staff's responses to deliberate self-harm using a cogni…

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Mackay 2005 found the greater the attributions of controllability to self-harming patients, the less the propensity to help.
“The greater the attributions of controllability to self-harming patients, the greater the negative affect of staff towards the patient as measured across subjects, and the less the propensity to help.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [26]
Mackay 2005 found the greater the attributions of controllability to self-harming patients, the greater the negative affect of staff towards the patient as measured across subjects.
“The greater the attributions of controllability to self-harming patients, the greater the negative affect of staff towards the patient as measured across subjects, and the less the propensity to help.”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [26]
Many assumption studies attempted to make their vignettes as realistic as possible by having them validated by clinicians and by having participants view/read the vignettes as part of a normal day at work.
“many of the assumption studies attempted to make their vignettes as realistic as possible by having them validated by clinicians [25–41] and also by having participants view/read the vignettes as part of a normal day at work [27–36, 39, 41].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [26]
In one study, male staff were significantly less sympathetic and more frustrated than female staff with self-harming patients presenting in A&E.
“In one study, male staff were significantly less sympathetic and more frustrated than female staff with self-harming patients presenting in A&E [26].”
From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [26]

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Accident and Emergency staff's response to deliberate self-harm: attributions, emotions and willingness to help
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Self-citation
Bemötande av självskadebeteende ur omvårdnadspersonalens perspektiv : En litteraturstudie.
Andersson, K., & Follrud, S. (2007) · Högskolan Kristianstad Publikationer
Staff attitudes, beliefs and responses towards self-harm: a systematised literature review
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Authors: Mackay, N., & Barrowclough, C.
Affiliations: Pennine Care NHS Foundation Trust (GB)
University of Manchester (GB)
Corresponding author: Barrowclough, Christine
ORCID: Barrowclough, Christine
Venue: British Journal of Clinical Psychology
Publisher: Wiley
Published: 2005-06
Volume: 44
Issue: 2
Pages: 255-267
ISSN: 0144-6657 (ISSN-L)
2044-8260
DOI: 10.1348/014466505x29620
OpenAlex: W2113682793
Cited by: 154
References: 29
Citations by year: 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 13 · 2017: 11 · 2016: 6 · 2015: 7 · 2014: 9 · 2013: 11 · 2012: 9
FWCI: 5.79
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2052 d)
Locations: British Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: self-harm, helping behavior, employee attitudes, negative affect, optimism, willingness to help, staff training needs, employee perceptions
MeSH terms: Workforce, Adult, Affect, Attitude of Health Personnel, Attitude to Health, Emergency Medical Services, Female, Helping Behavior, Humans, Male, Professional-Patient Relations, Surveys and Questionnaires, Self-Injurious Behavior

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Accident and emergency staff's perceptions of deliberate self‐harm: Attributions, emotions and willingness to help

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