The interpersonal processes of non‐suicidal self‐injury: A systematic review and meta‐synthesis

Abstract

Background. Understanding the processes underlying non-suicidal self-injury (NSSI) is important given the negative consequences of this behaviour. Qualitative research has the potential to provide an in-depth exploration of this. There has been limited research regarding the interpersonal processes associated with NSSI; therefore, a meta-synthesis was conducted to investigate this.Methods. A search of PsycINFO, MEDLINE, Web of Science, and CINAHL electronic databases from date of inception to November 2020 was conducted. In total, 30 papers were included in the final review. A meta-ethnographic approach was utilized to synthesize the data.Results. Twooverarchingthemeswerefound.Within'Powerfulrelationaldynamics',NSSI was cited as a response to participants becoming stuck in aversive or disempowering relational positions with others. Within the 'Taking matters into their own hands' subtheme, NSSI was reported as a way for participants to get interpersonal and emotional needs met.Limitations. Several included papers did not comment on the researcher-participant relationship, which may have affected qualitative results. A small number of potentially eligible papers were unavailable for synthesizing. Conclusion.Findings provide a more nuanced investigation of the interpersonal processes underlying NSSI. Consistent with relevant theories, NSSI appears to be a way of mitigating difficult interpersonal experiences or getting interpersonal needs met. NSSI may be engaged in as a substitute to other, less damaging ways to cope. An argument is made for a more empathetic understanding of NSSI and the use of relational interventions.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Commentary: Bringing together lived experience, clinical and research expertise – a commentary on the May 2022 debate (should CAMH professionals be diagnosing personality disorder in adolescence?)

“…More effective, acceptable and accessible treatments for self-harm in young people are sorely needed (All-Party Parliamentary Group on Suicide and Self-Harm Prevention, 2020; Witt, et al, 2021), although do not require the use of the BPD construct. Self-harm represents a functional response to essential human needs, the meeting of which is often thwarted by social contexts (Baker, Shaw and Biley 2013;Peel-Wainwright et al, 2021), therefore more personalised, relational and holistic forms of support are warranted.…”

Lived experiences of parents providing care to young people who self-harm: a protocol for a meta-aggregative synthesis of qualitative studies

“…41 For example, a recent qualitative systematic review, from the perspectives of those who engaged in NSSI, has shed light on our understanding of the important role of interpersonal processes in the occurrence of NSSI, which further highlights the potential benefits of relational therapies for clinicians. 42 Among the previously published systematic reviews of qualitative literature concerning parents whose child SHs, 16 43 44 one has mainly focused on parent-related factors for SH (eg, poor parent–child communication, lack of parental support, parental loss or separation/divorce), the role of parents in help-seeking and the impact of youth SH on parents’ well-being and parenting, yet it does not have a specific focus on parents’ overall experiences and perceptions. 16 Another review 44 examined the experiences and perspectives of both young people and parents; it took the form of a narrative synthesis and failed to employ the method of systematic review, subjecting the findings to limited inclusiveness and comprehensiveness.…”

“…A synthesis of multiple qualitative studies can create a new or heightened understanding of a phenomenon and identify gaps and areas of ambiguity in the existing literature, thereby revealing directions for future research and informing decision-making by policymakers and healthcare practitioners 41. For example, a recent qualitative systematic review, from the perspectives of those who engaged in NSSI, has shed light on our understanding of the important role of interpersonal processes in the occurrence of NSSI, which further highlights the potential benefits of relational therapies for clinicians 42. Among the previously published systematic reviews of qualitative literature concerning parents whose child SHs,16 43 44 one has mainly focused on parent-related factors for SH (eg, poor parent–child communication, lack of parental support, parental loss or separation/divorce), the role of parents in help-seeking and the impact of youth SH on parents’ well-being and parenting, yet it does not have a specific focus on parents’ overall experiences and perceptions 16.…”

Effect of Social Support on Anxiety of Medical Staff One Year after COVID-19 Outbreak: A Moderated Mediating Model

“…Social support refers to the material or spiritual resources that individuals receive or feel from others or organizations that can help them solve problems in their work 3 , including actual and PSS 4 . During the epidemic, there was a surge in public care and protection for health care workers, creating an integrated, systematic, and e cient social support system 5 . During the formative phase, the social support perceived by health care workers may have increased.…”