What about the boys?
Svein Øverland
clinical psychologist
Child and Adolescent/forensic psychology
Superego AS
Superego.as
Gender inequality
Gender stereotypes and men
The fear of low testosteron level
Even heroes fall down
The breakdown in meaning
Pornofication
• Pornography in it self doesnt seem to increase risk
for sexual violence,
• with the exception of men with misogynic attitudes
and severe personality disorders (Nøttestad, Hald &
Øverland, 2010)
• Girls report feeling physically inferior to the women
they view in pornographic material, while boys fear
they may not be as virile or able to perform as the
male characters (Owens et. al 2012)
• For both gender, pornography use is associated with
higher incidence of depressive symptoms and
decreased emotional bonding with caregivers
Harming others – harming himself
• Aggression can be directed both inwards and
outwards
 From grafitti to vandalism and arson
 From risky driving to deliberate self harm
 From rape and partner violence to murder
• Or both
 murder-suicide
Partner violence
•Borderlinepreget type
Only partner type
Moderate/serious violence
 Low frequency
Seldom outside home
 At home
History of relational problem
 Stress related
unsecure attachment/jealous
Unhappy/impulsive
• Antisocial
type
 Moderate to serious violence
 Antisocial, angry, drug problems and general
psychopathology
 Low level og empathy and regret
From shame to violence
…and to self harm and suicide
Last chance: Eldar Rønning has one last chance of winning the Gold
Medal in the Olympics
Thats why Eldar hits himself before starting the run.
Uses the pain to motivate himself
Suicide per age and gender in Norway
Gender differences in suicide versus
suicide attemps
Suicide
 Men
 All ages
 Dangerous
methods
 Shooting/hanging
 > 50 % die at first
attempt
Suicide attempt
 Women
 young
 Less dangerous
methods
 poison
 repetetive
Definition of self-harm
• A class of actions with the common features of
self inflicted intense bodily or psychological pain
with the intent of changing a negative emotion,
cognition or difficult relationship
(Øverland 2008)
Gender perceptions
• But why isnt hitting the wall as hard as you can,
regarded as deliberate self harm?
 It hurts
 It is deliberate
 But it is social acceptable
Gender differences in
deliberate self-harm
%
DSH
Suicide attempt
Girls
Boys
Girls
Boys
Depression
59
40
26
17
Poor self esteem
64
52
28
24
Negative body image
53
42
21
25
Without problems
14
8
3
3
N= 4066
Gender differences in risk for
Deliberate Self-harm
(McMahon et. al. 2010)
• Drug use and having a friend with deliberate selfharm enhance risk for self-harm in both sexes
• Poor self esteem, trauma, self-harm in family, and
problems with friends and family enhances risk for
self-harm in girls
• Being bullied, problems at school, impulsivity and
anger, enhances self-harm in boys
Positive and negative masculinity and
femininity (Straiton, Roen & Hjelmedal, 2012)
• Negative femininity positively predicted self-harm
and recent suicidal ideation status
• Positive masculinity was negatively related to suicidal
ideation and self-harming while negative masculinity
was negatively related to self-harming
• The findings suggest that it is not the conventional
feminine gender role per se that is associated with
suicidality, but specific negatively evaluated aspects.
Homosexuality og trans-sexuality
• Increased risk of DSH in homosexual boys
(Skegg m.fl 2003)
• Increased risk of DSH in trans-sexual boys
(Anderssen m.fl 2013)
• Classroom intervention reduces risk for health
problems in general for adolescents
(Rosa kompetanse/Pink competence)
Warning signals
Haavisto et.al. 2005:
 Less than 16 percent of boys with severe DSH had
received any form of mental health services a year
before
 DSH was associated with anxiety and aggression
 Self reported symptoms of depression was predictive
of DSH in adolescence
No sleep
C
O
N
T
R
O
L
Loosing control
1
Surpriseparty
Meeting the
2 family
I have to
pretend..
3 Bus back to
institution
I am a looser
Nothing
gonna help
TIME
Suicide attemt
Improving health services for boys
It doesnt have to be complicated
• More than 50 % of the youth in Norway uses the
”youth health station” – a free drop-in service
• But far less boys than girls
• And even less boys from low socio-economic status
(Jensen/SSB, 2009)
• Organizing special weekdays as ”boys days”, specific
topics increase use of service
• Anonymity seems more important for boys
• Boys prefer meeting same gender nurse and doctor
How to approach the boys?
• Start by finding an ”open arena”
• Target his and your own nonverbal and paraverbal
communication
• Normalize having problems
• and stress the importance of acknowledging
problems as strength of character
And as always…
• More research is needed
• And the willingness to have an interest in the health
and well being of boys, even though they dont ”cry
for help” to often and dont always cooperate to well