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Soc Sci Med. 2018 Sep;212:120-128. doi: 10.1016/j.socscimed.2018.07.021. Epub 2018 Jul 19.

An interpretative phenomenological analysis of young people's self-harm in the context of interpersonal stressors and supports: Parents, peers, and clinical services.

Author information

School of Psychology, University Park, The University of Nottingham, Nottingham, NG7 2RD, UK. Electronic address:
School of Neuroscience, Psychology and Behaviour, Centre for Medicine, University of Leicester, University Road, Leicester, LE1 7RH, UK.
Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
Child and Adolescent Mental Health Service, Nottinghamshire Healthcare NHS Foundation Trust, Thorneywood CAMHS, Porchester Rd, Nottingham, NG3 6LF, UK.
Harmless, 7 Mansfield Road, Nottingham, NG1 3FB, UK.
School of Psychology, University Park, The University of Nottingham, Nottingham, NG7 2RD, UK.



Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options.


To explore young women's experience of self-harm in the context of interpersonal stressors and supports.


Fourteen adolescent females (13-18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken.


Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling 'stupid to self-harm'); and 7) 'Empty promises' - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking.


Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports, and emotions. These results have implications for improving support from both informal and clinical sources.


Adolescence; Clinical services; Interviews; Qualitative methods; Self-harm; UK

[Indexed for MEDLINE]

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