Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Suicide in Young Adults

Speaking for Themselves: A Qualitative Study of Young Women Who Self-Injure

A qualitative grounded theory study was conducted with a community sample of young women, ages 18-22 years, who engaged in non-suicidal self-injury (self-cutting or self-burning). Study objectives were: 1) To allow women in the general population the opportunity to "speak for themselves" about their experiences of self-injury; 2)To explore familial, social, and cultural contexts for self-injury; 3)To supplement theories generated by quantitative studies drawn from samples of psychiatric inpatients; 4) To identify interventions to reduce self-injury. Methods: Data were collected through repeated in-depth interviews and were analyzed for codes and themes using constant comparative analysis within a grounded theory approach. A total of 22 interviews were conducted and transcribed verbatim. A feminist perspective informed data collection and interpretation. Strategies used to enhance rigor of the study (Padgett, 1998)included: prolonged engagement (multiple interviews), triangulation of data (interview and observational data), member checking, participation in a peer debriefing support group, and leaving an audit trail (including detailed analytic memos). Results: Study findings emerged according to 3 over-arching themes: Attributed Factors, Phenomenology, and Getting Help. The following are key findings within these themes: 1)Depression, alcohol abuse, the sudden termination of psychotropic medications, and homophobia were reported as attributed factors in self-injury; 2) Stressful life events contributed to the adolescent onset of self-injury; 3) Childhood abuse and peer contagion were not dominant among attributed factors; 4)Shared cutting behavior, indicating risk of HIV transmission, was reported; 5) Dissociation and pain were reported in the experience of self-injury; 6) Alternative means of accessing help, as well as barriers to seeking mental health treatment for self-injury,were reported. Implications for Practice: The results of this study illustrate the need to include education about self-injury in the professional training of clinicians. Information about risk factors for self-injury (depression, alcohol abuse, stressful life events, and the sudden termination of psychotropic medications without medical supervision) is warranted to guide clinical practice with adolescents and college students. Awareness of homophobia as a risk factor in self-injury is indicated for clinical practice with LGBT youth. Study findings underscore the need to educate parents, clinicians, and school personnel about self-injury, including warning signs, in-school interventions, and referral protocols. Specific information about the potential risk for HIV in cutting behavior is indicated in educating young people, parents, teachers, physicians, and mental health professionals about self-injury.

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