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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

1
School of Psychology, University Park, The University of Nottingham, Nottingham, NG7 2RD, UK. Electronic address: ruth.wadman@york.ac.uk.
2
School of Neuroscience, Psychology and Behaviour, Centre for Medicine, University of Leicester, University Road, Leicester, LE1 7RH, UK.
3
Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
4
Child and Adolescent Mental Health Service, Nottinghamshire Healthcare NHS Foundation Trust, Thorneywood CAMHS, Porchester Rd, Nottingham, NG3 6LF, UK.
5
Harmless, 7 Mansfield Road, Nottingham, NG1 3FB, UK.
6
School of Psychology, University Park, The University of Nottingham, Nottingham, NG7 2RD, UK.

Abstract

RATIONALE:

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.

OBJECTIVE:

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

METHOD:

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.

RESULTS:

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.

CONCLUSION:

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.

KEYWORDS:

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

PMID:
30029090
DOI:
10.1016/j.socscimed.2018.07.021
[Indexed for MEDLINE]

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