Family factors associated with self‐harm in adults: a systematic review

Buckmaster, Ruth; McNulty, Muireann; Guérin, Suzanne

doi:10.1111/1467-6427.12232

Cited by 10 publications

(17 citation statements)

References 44 publications

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“…Looking specifically at self-harm outcomes, our findings agree with results from small, cross-sectional studies with university student samples, showing that those who engage in self-harm report a poorer quality of attachment to parents compared to those who do not (Buckmaster, McNulty, & Guerin, 2019). The shared feature of emotional dysregulation found with both insecure attachment and self-harm (Gratz & Roemer, 2008) offers a possible explanation: when faced with stress, individuals with emotion dysregulation may be less able to tolerate difficult emotions, and more likely to internalise distress, subsequently releasing it in the form of self-injuring behaviour (Ross & Heath, 2002).…”

Section: Discussionsupporting

confidence: 85%

Is attachment style in early childhood associated with mental health difficulties in late adolescence?

Clery

Rowe²,

Munafò

et al. 2021

Preprint

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Background Although existing research has suggested an association between insecure attachment styles and mental health difficulties, these studies often have small sample sizes, use cross-sectional designs, and measure attachment as a discrete variable at a single point. It is also unclear whether these associations persist into late adolescence. In this prospective study we aimed to determine whether insecure attachment style in early childhood is associated with depression and self-harm at 18 years. Methods We used data from the Avon Longitudinal Study of Parents and Children cohort. Mothers completed attachment related questionnaires when their child was 18, 30, and 42 months old. Offspring depression and lifetime self-harm was assessed at 18 years using the Clinical Interview Schedule-Revised. Attachment was derived as a latent variable in a structural equation modelling framework. Logistic regression was performed on participants with complete attachment data (n=7032) to examine the association between attachment style and depression and self-harm, with adjustment for potential confounders. Differential dropout was accounted for using multiple imputation. Results We found some evidence for an association between attachment quality and depression and self-harm. In the fully adjusted imputed model, a one standard deviation increase in insecure attachment was associated with a 13% increase in the odds of depression at age 18 (OR=1.13; 95%CI=1.00 to 1.27) and a 14% increase in the odds of self-harm at age 18 (OR=1.14; 95%CI=1.02 to 1.25). Conclusions Our findings strengthen the evidence suggesting that an insecure attachment style assessed in early childhood is associated with mental health difficulties in late adolescence. If this association is causal, policies to support parenting or attachment-based interventions to improve attachment quality could help reduce mental health difficulties in adolescence/young adulthood. Keywords ALSPAC, attachment, depression, self-harm, longitudinal, structural equation modelling Abbreviations ALSPAC: Avon Longitudinal Study of Parents and Children; SEM: Structural Equation Modelling

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Section: Discussionsupporting

confidence: 85%

Is attachment style in early childhood associated with mental health difficulties in late adolescence?

Clery

Rowe²,

Munafò

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…A semi-structured interview format was used. The interview scheduled (see Table 2) was derived from theoretical underpinnings of the subject areas and from topics identified by a recent systematic review of the literature (Buckmaster et al, 2019). Interviews were conducted by the first author and were audio recorded and later transcribed verbatim by the third author.…”

Section: Methodsmentioning

confidence: 99%

“…However, research in the area of family factors associated with self-harm in adults is in the preliminary stage. A recent systematic review identified twenty-seven studies which examined the phenomenon, twenty-three of which were cross-sectional studies and fifteen of which were conducted with a sample of university students (Buckmaster et al, 2019). The review indicated that insecure attachment to parents and romantic partners is associated with self-harm.…”

Section: Contextmentioning

confidence: 99%

“…Literature examining the experience of family members of those who self-harm in the adult population is lacking. A systematic review of the literature on family relationships in adults who self-harm (Buckmaster et al, 2019) identified twenty-seven studies, of which only one study focused on the perspectives of family members of those who self-harm. Lindgren et al (2010) explored the experiences of six parents of adult children who self-harm in the context of their daughter's professional help-seeking.…”

Section: Contextmentioning

confidence: 99%

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Exploration of family dynamics in adults who self‐harm: a multi‐perspective approach

Buckmaster

Guérin

O’Leary

et al. 2020

Journal of Family Therapy

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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

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“…Less empirical research exists in the field of adult self-harm and family relationships. However, findings from a systematic review of family relationships for adults who self-harm (Buckmaster et al 2019) identified 27 studies which explored this phenomenon. This review indicated that insecure attachment to parents and romantic partners is associated with self-harm.…”

mentioning

confidence: 99%

An exploration of family dynamics in adults who self-harm

Buckmaster

McNulty

Guérin

2021

Ir. j. psychol. Med.

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Objectives: The aim of the present study was to explore how adults who self-harm experience family relationships. Methods: A phenomenological design was employed to examine the dynamic relationship between self-harm and family systems. Semi-structured interviews were conducted with six female adults who attend a community mental health service and engage in self-harm. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Results: Four superordinate themes emerged from the data and two subordinate themes emerged within each superordinate theme: family interactive patterns (subordinate themes: enmeshed patterns and culture of ‘getting on with it’), searching for meaning (subordinate themes: expressing emotional turmoil and engrained worthlessness), relating to others (subordinate themes: guilt and feeling misunderstood) and journey towards life without self-harm (subordinate themes: acceptance and family support). Conclusions: Findings emphasise the role of family systems in understanding self-harm in adults. The study highlights the need for family-based interventions for family members who support adults that self-harm.

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Family factors associated with self‐harm in adults: a systematic review

Cited by 10 publications

References 44 publications

Is attachment style in early childhood associated with mental health difficulties in late adolescence?

Is attachment style in early childhood associated with mental health difficulties in late adolescence?

Exploration of family dynamics in adults who self‐harm: a multi‐perspective approach

An exploration of family dynamics in adults who self-harm

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