Christabel Owens | University of Exeter (original) (raw)

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Papers by Christabel Owens

Research paper thumbnail of Supportive interchanges and face-work as ‘protective talk’ in an online self-harm support forum

Communication & Medicine, 2013

Research paper thumbnail of Problem presentation and responses on an online forum for young people who self-harm

In this article we investigate the nature of problem presentation and responses on an online foru... more In this article we investigate the nature of problem presentation and responses on an online forum for young people who self-harm. Previous studies have raised concerns about the peer encouragement of self-harming behaviours in online forums, and this analysis considers the nature of peer interaction on a specific forum, 'SharpTalk'. This was a research forum which explored the potential of online communities to foster engagement and shared learning between NHS professionals and young people who self-harm. This analysis draws on conversation analysis methods to study problem presentation and responses, and nature of advice given. Analysis highlighted both the tendency to offer advice where it was not asked for, and the mundane 'safe' nature of advice. This awareness of how young people interact and provide support online is important for those setting up online interventions to support young people who self-harm.

Research paper thumbnail of Membership and Boundary Maintenance on an Online Self-Harm Forum

Research paper thumbnail of Advice, support and troubles telling on a young people's self-harm forum

Research paper thumbnail of Involving service users in intervention design: a participatory approach to developing a text-messaging intervention to reduce repetition of self-harm

Health Expectations, 2011

Research paper thumbnail of Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk)

Journal of medical ethics, 2011

The internet is widely used for health information and support, often by vulnerable people. Inter... more The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report&#x...

Research paper thumbnail of Using Metrics to Describe the Participative Stances of Members Within Discussion Forums

Journal of Medical Internet Research, 2011

Research paper thumbnail of Online discussion forums for young people who self-harm: user views

Research paper thumbnail of User researchers in control

Mental Health Today, Jun 1, 2005

Research paper thumbnail of User researchers in control

Mental health today (Brighton, England), 2005

Research paper thumbnail of Interventions to reduce suicides at suicide hotspots: a systematic review

BMC Public Health, 2013

&... more 'Suicide hotspots' include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention. We searched Medline for studies that could inform the following question: 'What interventions are available to reduce suicides at hotspots, and are they effective?' There are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise. More well-designed intervention studies are needed to strengthen this evidence base.

Research paper thumbnail of How people come to recognise a problem and seek medical help for a person showing early signs of dementia: A systematic review and meta-ethnography

Dementia (London, England), Jan 12, 2016

Evidence suggests that there is usually a long delay between noticing first signs of dementia and... more Evidence suggests that there is usually a long delay between noticing first signs of dementia and seeking medical help. We conducted a systematic review of what people experience and how they make decisions during this time, and used a meta-ethnographic approach to synthesise the findings. Screening and quality assessment resulted in nine studies eligible for inclusion. People with dementia mainly report experiencing memory lapses, while carers focus on more subtle changes in personality. People respond to these changes in one of three ways: 1) they discount them as normal; 2) they reserve judgement as to their cause and significance, or 3) they misattribute them. Pivotal events can finally trigger help seeking. Active reflection and seeking of further evidence may lead to earlier recognition of the possibility of dementia and the need to seek help; it also reduces the risk of a pivotal event. Public education should aim to improve recognition of more subtle signs and to encourage r...

Research paper thumbnail of HOW PEOPLE COME TO RECOGNISE A PROBLEM AND SEEK PROFESSIONAL MEDICAL HELP FOR A PERSON SHOWING THE EARLY SIGNS OF DEMENTIA: A SYSTEMATIC REVIEW AND META-ETHNOGRAPHY

Alzheimer's & Dementia, 2014

Research paper thumbnail of Mad, Bad or Heroic? Gender, Identity and Accountability in Lay Portrayals of Suicide in Late Twentieth-Century England

Culture, Medicine, and Psychiatry, 2012

Research paper thumbnail of Interventions for self-harm: are we measuring outcomes in the most appropriate way? Authors' reply

British Journal of Psychiatry, 2010

Research paper thumbnail of Online discussion forums for young people who self-harm: user views

Research paper thumbnail of Needs and fears of young people presenting at Accident and Emergency department following an act of self-harm: secondary analysis of qualitative data

The British journal of psychiatry : the journal of mental science, Jan 8, 2015

BackgroundPresentation at an accident and emergency (A&E) department is a key opportunity to enga... more BackgroundPresentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood.AimsTo examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter.MethodSecondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm.ResultsParticipants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further ...

Research paper thumbnail of Pathways to suicide attempts among male offenders: the role of agency

Sociology of health & illness, Jan 21, 2015

Suicide is common among offenders, who are at increased risk of homelessness, unemployment and me... more Suicide is common among offenders, who are at increased risk of homelessness, unemployment and mental illness and are prone to impulsivity. Release from prison is a particularly vulnerable time. This qualitative study investigated the views of 35 offenders in South-West England prior to and after release from prison, enquiring into their previous suicide attempts and how they saw their future. Semi-structured interviews were analysed thematically, comparing individuals who had made one, more than one, and no suicide attempts. Multiple attempters were often in despair and enmeshed in substance misuse, with little control over their lives. Most of those with one-off or no previous attempts portrayed themselves as having more mastery. One-off attempters described using particularly violent means. The role of different types of agency in pathways to and from suicide is discussed. Iterational agency, the selective reactivation of past patterns of behaviour, appeared to dominate in indivi...

Research paper thumbnail of Guidance on actions to be taken at suicide hotspots

Research paper thumbnail of Communication and interpretation of emotional distress within the friendships of young Irish men prior to suicide: a qualitative study

Health & social care in the community, 2015

The potential for young men in crisis to be supported by their lay networks is an important issue... more The potential for young men in crisis to be supported by their lay networks is an important issue for suicide prevention, due to the under-utilisation of healthcare services by this population. Central to the provision of lay support is the capability of social networks to recognise and respond effectively to young men's psychological distress and suicide risk. The aim of this qualitative study was to explore young men's narratives of peer suicide, in order to identify how they interpreted and responded to behavioural changes and indications of distress from their friend before suicide. In-depth qualitative interviews were conducted during 2009/10 with 15 Irish males (aged 19-30 years) who had experienced the death by suicide of a male friend in the preceding 5 years. The data were analysed using a thematic approach. Through the analysis of the participants' stories and experiences, we identified several features of young male friendships and social interactions that cou...

Research paper thumbnail of Supportive interchanges and face-work as ‘protective talk’ in an online self-harm support forum

Communication & Medicine, 2013

Research paper thumbnail of Problem presentation and responses on an online forum for young people who self-harm

In this article we investigate the nature of problem presentation and responses on an online foru... more In this article we investigate the nature of problem presentation and responses on an online forum for young people who self-harm. Previous studies have raised concerns about the peer encouragement of self-harming behaviours in online forums, and this analysis considers the nature of peer interaction on a specific forum, 'SharpTalk'. This was a research forum which explored the potential of online communities to foster engagement and shared learning between NHS professionals and young people who self-harm. This analysis draws on conversation analysis methods to study problem presentation and responses, and nature of advice given. Analysis highlighted both the tendency to offer advice where it was not asked for, and the mundane 'safe' nature of advice. This awareness of how young people interact and provide support online is important for those setting up online interventions to support young people who self-harm.

Research paper thumbnail of Membership and Boundary Maintenance on an Online Self-Harm Forum

Research paper thumbnail of Advice, support and troubles telling on a young people's self-harm forum

Research paper thumbnail of Involving service users in intervention design: a participatory approach to developing a text-messaging intervention to reduce repetition of self-harm

Health Expectations, 2011

Research paper thumbnail of Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk)

Journal of medical ethics, 2011

The internet is widely used for health information and support, often by vulnerable people. Inter... more The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report&#x...

Research paper thumbnail of Using Metrics to Describe the Participative Stances of Members Within Discussion Forums

Journal of Medical Internet Research, 2011

Research paper thumbnail of Online discussion forums for young people who self-harm: user views

Research paper thumbnail of User researchers in control

Mental Health Today, Jun 1, 2005

Research paper thumbnail of User researchers in control

Mental health today (Brighton, England), 2005

Research paper thumbnail of Interventions to reduce suicides at suicide hotspots: a systematic review

BMC Public Health, 2013

&... more 'Suicide hotspots' include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention. We searched Medline for studies that could inform the following question: 'What interventions are available to reduce suicides at hotspots, and are they effective?' There are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise. More well-designed intervention studies are needed to strengthen this evidence base.

Research paper thumbnail of How people come to recognise a problem and seek medical help for a person showing early signs of dementia: A systematic review and meta-ethnography

Dementia (London, England), Jan 12, 2016

Evidence suggests that there is usually a long delay between noticing first signs of dementia and... more Evidence suggests that there is usually a long delay between noticing first signs of dementia and seeking medical help. We conducted a systematic review of what people experience and how they make decisions during this time, and used a meta-ethnographic approach to synthesise the findings. Screening and quality assessment resulted in nine studies eligible for inclusion. People with dementia mainly report experiencing memory lapses, while carers focus on more subtle changes in personality. People respond to these changes in one of three ways: 1) they discount them as normal; 2) they reserve judgement as to their cause and significance, or 3) they misattribute them. Pivotal events can finally trigger help seeking. Active reflection and seeking of further evidence may lead to earlier recognition of the possibility of dementia and the need to seek help; it also reduces the risk of a pivotal event. Public education should aim to improve recognition of more subtle signs and to encourage r...

Research paper thumbnail of HOW PEOPLE COME TO RECOGNISE A PROBLEM AND SEEK PROFESSIONAL MEDICAL HELP FOR A PERSON SHOWING THE EARLY SIGNS OF DEMENTIA: A SYSTEMATIC REVIEW AND META-ETHNOGRAPHY

Alzheimer's & Dementia, 2014

Research paper thumbnail of Mad, Bad or Heroic? Gender, Identity and Accountability in Lay Portrayals of Suicide in Late Twentieth-Century England

Culture, Medicine, and Psychiatry, 2012

Research paper thumbnail of Interventions for self-harm: are we measuring outcomes in the most appropriate way? Authors' reply

British Journal of Psychiatry, 2010

Research paper thumbnail of Online discussion forums for young people who self-harm: user views

Research paper thumbnail of Needs and fears of young people presenting at Accident and Emergency department following an act of self-harm: secondary analysis of qualitative data

The British journal of psychiatry : the journal of mental science, Jan 8, 2015

BackgroundPresentation at an accident and emergency (A&E) department is a key opportunity to enga... more BackgroundPresentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood.AimsTo examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter.MethodSecondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm.ResultsParticipants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further ...

Research paper thumbnail of Pathways to suicide attempts among male offenders: the role of agency

Sociology of health & illness, Jan 21, 2015

Suicide is common among offenders, who are at increased risk of homelessness, unemployment and me... more Suicide is common among offenders, who are at increased risk of homelessness, unemployment and mental illness and are prone to impulsivity. Release from prison is a particularly vulnerable time. This qualitative study investigated the views of 35 offenders in South-West England prior to and after release from prison, enquiring into their previous suicide attempts and how they saw their future. Semi-structured interviews were analysed thematically, comparing individuals who had made one, more than one, and no suicide attempts. Multiple attempters were often in despair and enmeshed in substance misuse, with little control over their lives. Most of those with one-off or no previous attempts portrayed themselves as having more mastery. One-off attempters described using particularly violent means. The role of different types of agency in pathways to and from suicide is discussed. Iterational agency, the selective reactivation of past patterns of behaviour, appeared to dominate in indivi...

Research paper thumbnail of Guidance on actions to be taken at suicide hotspots

Research paper thumbnail of Communication and interpretation of emotional distress within the friendships of young Irish men prior to suicide: a qualitative study

Health & social care in the community, 2015

The potential for young men in crisis to be supported by their lay networks is an important issue... more The potential for young men in crisis to be supported by their lay networks is an important issue for suicide prevention, due to the under-utilisation of healthcare services by this population. Central to the provision of lay support is the capability of social networks to recognise and respond effectively to young men's psychological distress and suicide risk. The aim of this qualitative study was to explore young men's narratives of peer suicide, in order to identify how they interpreted and responded to behavioural changes and indications of distress from their friend before suicide. In-depth qualitative interviews were conducted during 2009/10 with 15 Irish males (aged 19-30 years) who had experienced the death by suicide of a male friend in the preceding 5 years. The data were analysed using a thematic approach. Through the analysis of the participants' stories and experiences, we identified several features of young male friendships and social interactions that cou...