What factors contribute to someone hurting themselves? A study published in Clinical Psychology & Psychotherapy attempts to answer this by examining the differences between people who have mental illness and self-harm, people who have mental illness but do not self-harm, and mentally healthy individuals.
Deliberate self-harm means harming yourself without fatal outcome. Examples can include cutting yourself, ingesting substances in high doses, or even jumping from a non-lethal height. Self-harm that is not intended to be fatal is linked to future suicide attempts, and previous research on intentional self-harm has linked it to poor emotional regulation and social communication skills. This study attempts to understand the links between self-harm, child abuse, and negative self-concepts.
Study author Magnus Nilsson and colleagues used 34 female psychiatric patients with self-injurious behavior, 31 female psychiatric patients without self-injurious behavior, and 29 community controls to serve as a sample for this study. To be included in the self-harm group, participants had to have self-injured at least 3 times over 6 months at some point in their lives and at least once in the past 6 months.
“We believe that the strength of this study lies in the use of an appropriate clinical comparison group that is gender specific and has similar age and depressive symptoms, which we believe improves 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 in which [deliberate self-harm] is an essential part of the individual clinical picture.”
Participants completed a neuropsychiatric interview, attitude measurements, a depression scale, a self-injury measurement, and a childhood trauma questionnaire.
The researchers found that participants who had a history of intentional self-harm reported higher levels of childhood abuse and a more negative self-concept. This was significant for higher levels of emotional abuse and higher levels of self-loathing. This is consistent with the findings that self-punishment was a common reason for participating in intentional 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 just as damaging or even more damaging to the development of self-harm in women.
“Our impression is that emotional abuse is more often overlooked when evaluating people with psychiatric disorders compared to sexual or physical abuse. This study specifically highlights the potential adverse effects of emotional abuse. Therefore, we would recommend physicians to screen individuals for it as part of their routine assessment process,” wrote Nilsson and colleagues.
This study made progress to better understand the links between self-harm, child abuse, and self-concept. Still, it has some limitations. The study focused exclusively on women and did not take into account gender differences. It is unclear whether the results would generalize to male or non-binary participants.
The study “Childhood abuse and self-loathing as characteristic features of psychiatric patients with self-harm: A comparison with clinical and healthy controls” was authored by Magnus Nilsson, Lars-Gunnar Lundh and Sofie Westling.