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The aim of this study was to systematically review the literature pertaining to family dynamics in the adult self‐harming population. PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Applied Social Sciences Index and Abstracts (ASSIA) were searched for studies containing two keywords, one relating to self‐harm and the second relating to a family relationship. The final search was run on 4 August 2017. The electronic search yielded a total of 2,623 studies; 119 texts were selected for full review and twenty‐seven articles were included in the analysis. Thematic analysis was used to synthesize the results. Results indicated that insecure parental attachments, neglectful, overprotective, disempowering and abusive parenting were associated with self‐harm. Similarly, insecure attachments and abusive relationships with romantic partners were linked to self‐harm. Finally, self‐harm was found to be related to poor family functioning.

Integration of intrapersonal, interpersonal and environmental factors has been proposed to enhance understanding of psychological quality of life (QOL) in adults with severe and enduring mental illness (SMI). This study examined the contribution of factors such as self-stigma, coping style and personal recovery orientation to psychological QOL in SMI; compared QOL outcomes to norms from the general population; and examined the association between personal recovery orientation and overall QOL. 70 participants with SMI completed measures of QOL (including psychological QOL), personal recovery orientation, coping, perceived stigma, psychological distress and demographic variables. Regression analysis found that only adaptive coping and psychological distress contributed significantly to psychological QOL. Personal recovery orientation was significantly associated with overall subjective QOL. Participants had lower QOL in the psychological and social relationships domains compared to the general population. Findings support the positive contribution of adaptive coping to psychological QOL, and the positive association between personal recovery orientation and overall QOL.

The aim of the present study was to explore the experience of family relationships in an adult self-harm population. Relationships are concerned with the connection between two or more individuals and therefore a multi-perspective phenomenological design was employed to explore the perspectives of both adults who self-harm and their family members. Semi-structured interviews were conducted with twelve adults: six who attend a community mental health service and engage in self-harm and six of their family members. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Four superordinate themes emerged within the data: family and societal culture, coping with traumatic relationships, inner conflict and the generational impact. Findings highlight the importance of considering family relationships in the treatment of selfharm in adults. The impact of self-harm on family members is also illuminated, in addition to the need to develop and assess interventions for family members.Practitioner points • Self-harm in adults can impact family units as a whole, resulting in changes in family dynamics and conflicting emotions of fear, resentment and empathy in family members • Preliminary research suggests that interventions examining the role of family dynamics and their relationship with self-harming behaviours may be beneficial • Education and interventions are needed for families of such adults to help build their awareness of self-harm • This helps families address complex emotions such as guilt, shame and resentment which have been found to arise in this cohort