Understanding the functions of repeated self-harm: A Q methodology approach

Bryant, Louise D.; O'Shea, Roseanne; Farley, Kate; Brennan, Cathy; Crosby, Helen; Guthrie, Elspeth; House, Allan

doi:10.1016/j.socscimed.2020.113527

Cited by 5 publications

(4 citation statements)

References 31 publications

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“… 15 In people with an age range of 19–57 years and history of repeat self‐harm four functions were identified: managing my mental state; communicating distress; distracting from suicidal thoughts; and producing positive feelings. 35 These functions align with the two functions we identified in young people aged 16–25 years: handling emotional states and positive thoughts and protection. This may insinuate that the functions for self‐harm in 16–25 year old young people, particularly around self‐harm as a means of managing emotional distress and protecting from suicide, persist into adulthood and this highlights the importance of identifying and supporting people who self‐harm with their distress and suicidal thoughts as early in their life as possible to prevent ongoing self‐harm behaviour.…”

Section: Discussionsupporting

confidence: 74%

“…The four functions we identified would be classified according to Nock, as intrapersonal functions as opposed to interpersonal functions, suggesting that relationship triggers don't play a substantial role for these young people 15 . In people with an age range of 19–57 years and history of repeat self‐harm four functions were identified: managing my mental state; communicating distress; distracting from suicidal thoughts; and producing positive feelings 35 . These functions align with the two functions we identified in young people aged 16–25 years: handling emotional states and positive thoughts and protection.…”

Section: Discussionmentioning

confidence: 96%

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The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

Mughal

Chew‐Graham

Babatunde

et al. 2023

Health Expectations

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Background: Self-harm in young people is a serious concern but a deeper understanding of the functions of self-harm in young people can tailor care and inform new clinical interventions to reduce repeat self-harm and suicide risk. General practitioners (GPs), as frontline healthcare professionals, have an important role in managing self-harm in young people. This study aimed to explore the functions of self-harm in young people and their perspectives on future GP-led care.Methods: A qualitative study using interviews with young people aged between 16 and 25 years with a personal history of self-harm was conducted. Interviews were transcribed and analysed using reflexive thematic analysis. Findings: Four distinct functions were identified: (1) handling emotional states; (2) self-punishment; (3) coping with mental illness and trauma; and (4) positive thoughts and protection. Young people valued GP-led support and felt future GP interventions should include self-help and be personalised. Conclusions: These findings support clinicians, including GPs, to explore the functions of self-harm in young people aged 16-25 in a personalised approach to self-harm care. It should be noted that self-harm may serve more than one function for a young person and thus interventions should recognise this.Patient and Public Contribution: A group consisting of young people with lived experience of self-harm, carers, the public, and those who work with young people who harm themselves conceived this study idea, informed recruitment methods and the interview topic guide, and supported the interpretation of findings.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 96%

The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

Mughal

Chew‐Graham

Babatunde

et al. 2023

Health Expectations

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Q-methodology has been used to explore adolescents’ attitudes towards suicide ( 20 ) and the reasons for repeated self-harm ( 21 ). For example, Bryant et al ( 21 ) propose that their findings can be used to individualise therapy to better meet the needs and goals of individuals who repeatedly self-harm. Furthermore, within the sphere of perinatal mental health research, Butler et al ( 22 ) used Q-methodology to explore the acceptability and feasibility of a parenting intervention for mothers with perinatal mental health difficulties being delivered on a psychiatric inpatient Mother and Baby Unit (MBU), with samples of 15 mothers and 16 MBU staff ( 23 ).…”

Section: Introductionmentioning

confidence: 99%

Psychological intervention priorities according to perinatal women who experienced suicidal thoughts and perinatal mental health professionals: a Q-methodology study

Reid,

Pratt,

Edge

et al. 2023

Front. Psychiatry

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IntroductionSuicide is the leading direct cause of maternal death in the year following birth and the second leading cause during pregnancy, in the UK and Ireland. Currently no evidence-based psychological interventions exist specifically designed to reduce mothers’ suicidal experiences during the perinatal period. Reducing suicidal ideation and behaviour in mothers is a priority to prevent deaths and lessen the distress felt by mothers and their families. As Q-methodology measures the consensus and disagreement between individuals on a given topic, the current study used Q-methodology to elicit the priorities for a future psychological intervention aimed at reducing suicidal ideation and behaviour during the perinatal period, from the collective perspectives of both mothers and professionals.MethodAs part of this Q-methodology study, we developed a Q-set of 75 statements pertaining to possible elements of a psychological intervention that might help reduce a mother’s suicidal ideation and behaviour during the perinatal period. Mothers and professionals were recruited via perinatal mental health services and social media advertisements.ResultsTwenty-one mothers and 11 perinatal mental health professionals ranked each Q-set statement depending on its perceived importance in developing a new intervention. A centroid factor analysis was conducted and two factors, which accounted for 42% of the overall variance, were identified: Factor 1 “supporting the mother to create distance between herself and the appeal of suicide” and Factor 2 “establishing positive connections with the therapist, the baby and motherhood.” All participants believed that developing plans to keep the mother safe from suicide was the most important aspect for inclusion in a future intervention. Participants who loaded onto Factor 1 also prioritised supporting mothers to learn more about triggers for their suicidal ideation and behaviour. Ensuring a robust therapeutic alliance was more important for those who loaded onto Factor 2.ConclusionThis is the first study using Q-methodology to explore the psychological intervention priorities of mothers and professionals. Findings indicate clear priorities in terms of planning and coping during a crisis, endorsed by all participants, and provide an initial step in the development of a new perinatal suicide prevention intervention.

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What helps people to reduce or stop self-harm? A systematic review and meta-synthesis of first-hand accounts

Brennan

Crosby

Sass

et al. 2022

Journal of Public Health

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Background Self-harm is an important public health problem but therapeutic interventions, particularly for people who have a history of multiple repetition, are not always taken up or effective when they are. The aim of this review is to explore first-hand accounts of what helps outside therapy and identify actions and processes, which can support the reduction or cessation of self-harm. Methods A systematic review and thematic meta-synthesis of the first-person accounts of what has helped to reduce or stop self-harm reported in primary studies. Results The meta-synthesis combined 546 participant excerpts from 56 studies. Two over-arching themes were identified: (i) breaking the chain incorporated actions taken to break the link between a person’s current psychological or social state and the act of self-harm and (ii) building a new foundation for change captured actions over the longer-term, focusing on practical changes in relationships and in a person’s way of life, such as work or living arrangements. Conclusions The results emphasize the importance of interpersonal change in reducing or stopping self-harm. While interpersonal factors are acknowledged as important reasons behind self-harm, they are often under-represented in self-management advice and therapeutic interventions that focus on individual psychopathology.

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Understanding the functions of repeated self-harm: A Q methodology approach

Cited by 5 publications

References 31 publications

The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

The functions of self‐harm in young people and their perspectives about future general practitioner‐led care: A qualitative study

Psychological intervention priorities according to perinatal women who experienced suicidal thoughts and perinatal mental health professionals: a Q-methodology study

What helps people to reduce or stop self-harm? A systematic review and meta-synthesis of first-hand accounts

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