What factors contribute to someone committing self-harm? A study published in Clinical Psychology & Psychotherapy attempts to answer this by exploring differences between people who have a mental illness and self-harm, people who have a mental illness but don’t self-harm, and mentally healthy individuals.
Deliberate self-harm is causing harm to oneself without a fatal outcome. Examples can include cutting oneself, ingesting substances in high doses, or even jumping from a non-lethal height. Self-injury that is not meant to be fatal is linked to future suicide attempts, and previous research on deliberate self-harm has linked it to poor emotional regulation and social communication skills. This study seeks to understand the relationships between self-harm, childhood maltreatment, and negative self-concepts.
Study author Magnus Nilsson and colleagues utilized 34 female psychiatric patients with self-harm behavior, 31 female psychiatric patients without self-harm behavior, and 29 controls from the community to serve as their sample for this study. To be included in the self-harm group, participants needed to have self-harmed on at least 3 occasions over 6 months at some point in the lifespan as well as at least once in the last 6 months.
“We perceive that the strength of this study is the use of an adequate clinical comparison group that is gender matched and similar in age and depressive symptoms, which we believe increases the clinical application of the results,” the researchers said. “Since [deliberate self-harm] is common in the general population but even more so in young clinical populations, we wanted to study a population where [deliberate self-harm] is a significant part of the individual clinical presentation.”
Participants completed a neuropsychiatric interview, attitude measures, a depression scale, a self-harm measure, and a childhood trauma questionnaire.
The researchers found that participants who had a history of deliberate self-harm reported higher levels of childhood maltreatment and more negative self-concept. This was significant for higher levels of emotional abuse and higher levels of self-hatred. This is consistent with the results that self-punishment was a common reason to partake in deliberate self-harm.
Previous research has highlighted sexual abuse as a particularly salient risk factor for self-harm, but this study suggests that other types of abuse may be as damaging or even more so in the development of self-harm behaviors in females.
“It is our impression that emotional abuse, as compared to sexual or physical abuse, more often is overseen when assessing individuals with psychiatric disorders. This study highlights the potential detrimental effects of emotional abuse specifically. Thus, we would suggest clinicians to screen individuals for this as part of their routine assessment procedure,” Nilsson and colleagues wrote.
This study took strides into better understanding the relationships between self-harm, childhood maltreatment, and self-concept. Despite this, it has some limitations. The study focused solely on females and did not allow for gender differences. It is unclear if the findings would generalize to male or nonbinary participants.
The study, “Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls“, was authored by Magnus Nilsson, Lars-Gunnar Lundh, and Sofie Westling.
