Bryant, LD orcid.org/0000-0002-1972-7395, O'Shea, R, Farley, K orcid.org/0000-0001-6993-9065 et al. (4 more authors) (2021) Understanding the functions of repeated self-harm: A Q methodology approach. Social Science & Medicine, 268. 113527. ISSN 0277-9536
Abstract
Background
Multiple repetition of self-harm is common and is associated with poor quality of life and with an increased risk of suicide. Treatment outside specialist clinics rarely takes account of what is known about the varied and conflicting reasons for multiple repetition. We aimed to identify ways in which individuals who self-harm make sense of their motivations for repetition.
Methods
In 2018/2019 we recruited 59 participants from NHS services, support organizations in England and via social media into a Q-methodology study. Participants sorted, ranked and commented on 46 separate functions of self-harm according to whether they agreed or disagreed with them as reasons for their own self-harm. The functions were identified from a range of academic sources and first-person accounts.
Results
Principal Component Analysis was used to identify four distinct accounts for repeated self-harm: 1) Managing my mental state, 2) Communicating Distress, 3) Distract from suicidal thoughts or feelings and 4) Producing positive feelings. There were no clear links between account and gender or other respondent characteristic, although those who self-harmed most regularly and frequently (‘so many times I've lost count’) were mostly in Accounts 1 and 4.
Conclusions
This is the first study to use Q methodology to explore reasons for repeated self-harm. The accounts identified can help in personalizing therapy by going beyond models that focus on a single function such as affect regulation or experiential avoidance, while reducing the field to a manageable number of points of view that can be explored in therapy.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Keywords: | Self-harm; Q methodology; Repetition; Therapy |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research Not Known |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Jan 2021 16:27 |
Last Modified: | 06 Jan 2021 16:27 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.socscimed.2020.113527 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:169481 |