The aim of this study was to investigate how adults 25 years old and over describe the functions of their non-suicidal self-injury (NSSI) and to explore whether they report any changes in their experience with NSSI as they become older. Qualitative e-mail interviews were used in order to capture the participants’ experiences. The results of the study were analysed based on coping theory and previous research. The results indicate that, consistent with previous literature, adults self-injure for mostly the same reasons as adolescents – however, as the previous research shows adolescents are more likely to hurt themselves in order to communicate with others. The adults in the present sample report using problem-solving coping strategies to the same extent as emotion-focused strategies; a slight deviation from previous research which has suggested that people who self-injure are more likely to employ emotion-focused strategies. The participants of the study generally experience a feeling of increased control and deliberation of their self-injury as they have gotten older; hurting themselves has become a purposeful coping strategy. The results of this study might have implications for treatment of self-injury in adults; focusing the treatment on strengthening the adults’ autonomy and encouraging further problem-solving coping strategies might be beneficial.

Non-suicidal self-injury (NSSI) is a complex and dangerous set of behaviours that has been gaining increased research attention in recent years. Although existing research indicates that NSSI is prevalent among both adolescent and young adult clinical and community samples, few studies have empirically examined models of factors involved in the etiology and maintenance of these behaviours, particularly the role of social factors. Further, although existing research supports the use of NSSI for emotion regulation purposes, less research attention has focused on the impact of emotion reactivity. The focus of the current project was to examine the role of emotional, interpersonal, and subcultural factors in NSSI. Utilizing a sample of 397 university students, Study 1 presents a psychometric re-evaluation of the Emotion Reactivity Scale (ERS; Nock et al., 2008), used to inform the most appropriate use of the measure in the subsequent studies. Results supported the reliability and validity of the ERS and suggested that the ERS is best utilized as a unidimensional measure of emotion reactivity. Study 2 examined an intra- and inter-personal model of NSSI among the same sample of 397 university students. Support was obtained for the Experiential Avoidance Model of NSSI (Chapman et al., 2006) as well as for the mediational influence of interpersonal relationships on NSSI via emotion regulation. Preliminary support was also provided for the influence of identification with more deviant subcultures, including Goth and Emo groups. Finally, Study 3 aimed to replicate support for the model among a sample of 178 members of self-injury internet forums. Contrary to hypotheses, little support was demonstrated for the model, and fewer significant associations were demonstrated for the influence of subcultural identification. Examination of the characteristics of the sample suggested that the online forum members represent a unique group in regard to the severity of their NSSI experiences that has been understudied in the existing literature. Alternative hypotheses to account for the observed findings are presented. Limitations and directions for future research are discussed.

<p>The area of research that was investigated for this study is self-harm, which is also known as non-suicidal self-injury (NSSI). NSSI can be defined as self-injury with no intention of dying. Examples of NSSI are the cutting of one’s skin or banging one’s head against the wall to the point of bruising. Digital self-harm (DSH) can be defined as cyberbullying directed at oneself. DSH is an area within NSSI and self-harm that has not been extensively studied. However, its consequences have already been fatal; in 2013, a 14-year-old suicide in the United Kingdom was linked to DSH. In this case, DSH manifested itself by masking as cyberbullying, when instead it was the individual themselves who was behind the malicious comments. Research shows that there are several risk factors for NSSI, one of which includes borderline personality disorder (BPD). BPD is a type of personality disorder that consists of impulsive and volatile mood. A high percentage of individuals diagnosed with BPD have been found to engage in NSSI. The current study conducted an anonymous Internet survey that measured the following variables: engagement in NSSI, engagement in DSH, what types of NSSI/DSH were engaged in, personality traits, and interpersonal/intrapersonal functions for engaging in NSSI or DSH. The study revealed that among freshmen at a large, Midwestern university (<i>N</i> = 112), individuals who engaged in NSSI were significantly more likely to engage in DSH. The sample included 61 (55%) of students who self-reported engaging in NSSI and 17 (15%) of students who reported engaging in DSH. However, the study did not find that all BPD personality traits correlated with individuals who engaged in DSH. Personality facets and functioning were similar among DSH and NSSI. Differences were found in levels of reinforcement function between individuals who engaged in DSH and NSSI. These results suggested a relationship between DSH behavior and BPD features, as well as the use of maladaptive strategies for self-regulating emotion. The authors conclude that future research should investigate different types of DSH and encourages clinical practitioners to include online behavior questionnaires in their evaluations of at-risk adolescents.</p>

Självskadebeteenden är vanligt förekommande, särskilt bland tonåringar inom psykiatrin. Behandling inriktad specifikt mot självskadebeteenden har under de senaste åren uppmärksammats och undersökts i ökad utsträckning. Hur personer med självskadebeteende själva upplever vården och bemötandet de får är av stor vikt att undersöka för att fortsätta utveckla vården i rätt riktning. Studiens syfte var att undersöka hur personer som under tonåren hade ett självskadebeteende upplevde vården och bemötandet de fick fem år tidigare. Arbetet utgick från semistrukturerade intervjuer med 26 unga kvinnor som under tonåren hade ett aktivt självskadebeteende och fick vård för detta.  Svaren analyserades med tematisk analys och genererade tre huvudteman: Tillbakablickande förståelse, Innehåll och konceptualisering, och Relationens avtryck. Resultaten visade en mognadsprocess som har skett hos deltagarna gällande självbild och inställning gentemot omvärlden och vården. Tydlig struktur och samstämmighet kring behandlingens inriktning och innehåll var avgörande för huruvida den upplevdes som hjälpsam eller inte. Slutligen betonades ett stort behov av en trygg behandlingsrelation som genomsyras av ett från behandlaren validerande förhållningssätt. Resultatens förhållande till tidigare forskning samt kliniska implikationer för vården diskuteras.

Author: Madeleine Ahlström and Hanna Puonti Title: To meet the invisible population - A qualitative study of men with deliberate self-injury [Att möta de osynliga - En kvalitativ studie om killar med självskadebeteende] Supervisor: Anders Östnäs Assessor: Jan Petersson   This study aims to provide a picture of the underlying causes why men deliberately hurt themselves. It also aims to provide a picture revolving how men self-harm and what the direct effects are from their self-harm. The study describes their behaviour and how the behaviour has evolved over time. There is also a focus in the study to illustrate how society´s operative approach towards men makes their self-harm invisible, and make them an invisible population that neither the scientists nor the general population chooses to see. Self-injury is strongly associated with girls and their way of harming themselves. Men have been excluded from studies of self-injury, also have there been very few scientists that found them of interest to study.   This is a study with a qualitative approach wich executed eight semi-structured interviews with men who have had a behavior of self-injury. The study takes on a hermeneutic approach to knowledge, to have the possibility to interpret in the analysis of the empirics. To analyse the data we have used a qualitative content analysis according to Graneheim and Lundman (2004). The results has been analysed by Antonovsky´s (2005) KASAM theory. The study has found that men have a self-injury that is multifaceted. The men in the study use different behaviours to manage various emotional factors that affect them. Deliberate self-injurious behaviours become a coping strategy for the men when they didn’t have other strategies to cope with when their faced difficulties.

Bakgrund: De senaste åren har flera studier gjorts på den stora mängd självskaderelaterat material som finns på internet i form av bloggar, videos, foton och chatforum. Dessa studier har i huvudsak fokuserat på materialet i sig och funktionen det fyller för de som kommunicerar sitt självskadande på internet. Således finns kunskap om företeelsen i sig men ingen eller ytterst lite kunskap om vårdpersonalens erfarenheter och föreställningar kring självskadekommunikation. Syfte: Att belysa vårdpersonals erfarenheter och föreställningar kring patienters självskadekommunikation på internet. Metod: En kvalitativ metod användes. Data samlades in genom nio halvstrukturerade intervjuer med vårdpersonal inom psykiatrisk verksamhet. Dessa analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Studiens resultat redovisas i de fyra kategorierna; Ovanlig företeelse, som visade att personalen generellt hade lite erfarenhet av patienter som självskadekommunicerar. Internet finns på gott och ont,visade att vårdpersonalen kunde upplevde starka negativa känslor i mötet med dessa patienter samt belyste vårdpersonalens dubbla förhållande till internet. Att försöka förstå, visade att vårdpersonalen hade många föreställningar kring vilka funktioner självskadekommunikationen kunde ha för patienterna. Att ta ansvar,visade att personalen kände ett ansvar för att uppmärksamma patienter som självskadekommunicerar på både ett personligt och organisatoriskt plan. Slutsats: Det visade sig att vårdpersonalen hade begränsad erfarenhet av att möta patienter som kommunicerar sitt självskadebeteende på internet. Vidare tyder resultatet på att vårdpersonalen upplever osäkerhet i mötet med patienter som självskadekommunicerar på internet vilket i sin tur leder till att det sällan ställs frågor kring självskadekommunikation. / Background: Several studies have mapped self-injury related material online, consisting of blogs, videos, photos and chatcommunities. These studies have mainly focused on the material itself as well as the function it has for those who communicate self-injury online. Thus knowledge of the phenomenon itself exists but little or no studies have been made attempting to study the experiences and conceptions of health professionals relating to this phenomenon. Aim: To illuminate health professionals experiences and conceptions of patients self-harm communication on the internet Method: A qualitative approach was applied. Data was collected through nine semistructured interviews with health professionals working in psychiatric care. The data were analysed with qualitative content analysis. Result: The results are presented in the following categories; Unusual phenomenon, wich showed that the staff generally had litlle experience of patients who communicated self-harm online. Internet exists for good and bad, showed that the health professionals could experience strong negative emotions when meeting patients who communicated self-harm online and illuminated the double relationship health professionals described having to the internet. Trying to understand, showed that the health professionals had many conceptions about wich functions the self-harm communication might have for the patients. To take responsibility, showed that the staff experienced a sense of wanting to take responsibility for  these patients.  Conclusion: The study showed that health professionals had limited experience with patients who communicated self-harm online and indicated that the health professionals experienced uncertainty when meeting these patients.