Anticipated Stigma Toward Self-Injury in Young Adulthood: A Thematic Analysis

Publication: Canadian Journal of Community Mental Health
17 December 2024

Abstract

Non-suicidal self-injury (NSSI) is a significant concern on college campuses. Anticipated judgments and negative responses from others may prevent young adults from disclosing NSSI and obtaining help. As this area is poorly understood, the current study qualitatively explored the views of 279 college students (aged 18–25) with a history of NSSI regarding their peers’ perceptions of NSSI. Participants completed an online survey, including open-ended questions addressing anticipated NSSI stigma. These were thematically analyzed, yielding three themes: Perceived Greater Acceptance, Perceived Limited Understanding, and Persistent Stereotypes and Stigma. Results have implications for anti-stigma initiatives and lay groundwork for further work in this new area.

Résumé

L’automutilation non suicidaire (ANS) est un sujet de préoccupation sur les campus universitaires. Les jugements a priori et les réactions négatives des autres peuvent empêcher les jeunes adultes de divulguer l’ANS et d’obtenir de l’aide. Ce domaine étant peu compris, la présente étude a exploré qualitativement les points de vue de 279 étudiants universitaires (âgés de 18 à 25 ans) ayant une expérience vécue d’ANS concernant les perceptions de leurs pairs à l’égard de l’ANS. Les participants ont répondu à un questionnaire en ligne, comprenant des questions ouvertes sur la stigmatisation a priori de l’ANS. Ces questions ont fait l’objet d’une analyse thématique qui a permis de distinguer 3 thèmes : la perception d’une plus grande acceptation, la perception d’une compréhension limitée et la persistance des stéréotypes et de la stigmatisation. Les résultats ont des implications pour les initiatives de lutte contre la stigmatisation et préparent le terrain pour de futures recherches dans ce domaine.

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References

American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association, D. S. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American Psychiatric Association.
Batejan K. L., Jarvi S. M., and Swenson L. P. 2015 Sexual orientation and non-suicidal self-injury: A meta-analytic review Archives of Suicide Research 19 2 131 -150
Braun V. and Clarke V. 2006 Using thematic analysis in psychology Qualitative Research in Psychology 3 2 77 -101 https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2022). Thematic analysis: A practical guide. Sage. London, UK.
Buelens T., Costantini G., Luyckx K., and Claes L. 2020 Comorbidity between non-suicidal self-injury disorder and borderline personality disorder in adolescents: A graphical network approach Frontiers in Psychiatry 11 580922 -580922 https://doi.org/10.3389/fpsyt.2020.580922
Burke T. A., Piccirillo M. L., Moore-Berg S. L., Alloy L. B., and Heimberg R. G. 2019 The stigmatization of nonsuicidal self-injury Journal of Clinical Psychology 75 3 481 -498 https://doi.org/10.1002/jclp.22713
Chamberlain, K. (2015). Epistemology and qualitative research. In P. Rohleder, & A. Lyons (Eds.), Qualitative research in clinical and health psychology (pp. 9-28). Bloomsbury.
Corrigan P. W. and Watson A. C. 2002 Understanding the impact of stigma on people with mental illness World Psychiatry 1 1 16
Crotty, M. (1998). Foundations of social research: Meaning and perspective in the research process. Routledge.
Dovidio, J. F., Major, B., & Crocker, J. (2000). Stigma: Introduction and overview. In T. F. Heatherton, R. E. Kleck, M. R. Hebl, & J.G. Hull (Eds.), The social psychology of stigma. (pp. 2–3). Guilford Press.
Franklin J. C., Ribeiro J. D., Fox K. R., Bentley K. H., Kleiman E. M., Huang X., and Nock M. K. 2017 Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research Psychological Bulletin 143 2 187
Gayfer B. L., Mahdy J. C., and Lewis S. P. 2020 Peer reactions to non-suicidal self-injury disclosures: A thematic analysis Counselling Psychology Quarterly 33 1 79 -99 https://doi.org/10.1080/09515070.2018.1536647
Gibson R., Carson J., and Houghton T. 2019 Stigma towards non-suicidal self-harm: Evaluating a brief educational intervention British Journal of Nursing 28 5 307 -312
Gillies D., Christou M. A., Dixon A. C., Featherston O. J., Rapti I., Garcia-Anguita A., and Christou P. A. 2018 Prevalence and characteristics of self-harm in adolescents: Meta-analyses of community-based studies 1990–2015 Journal of the American Academy of Child & Adolescent Psychiatry 57 10 733 -741
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon & Schuster.
Hamza C. A., Robinson K., Hasking P. A., Heath N. L., Lewis S. P., Lloyd-Richardson E., Whitlock J., and Wilson M. S. 2021 Educational stakeholders’ attitudes and knowledge about nonsuicidal self-injury among university students: A cross-national study Journal of American College Health, ahead-of-print(ahead-of-print) 1 -11 https://doi.org/10.1080/07448481.2021.1961782
Hasking P. and Boyes M. 2018 Cutting words: A commentary on language and stigma in the context of nonsuicidal self-injury The Journal of Nervous and Mental Disease 206 11 829 -833
Hasking P., Lewis S. P., and Boyes M. E. 2019 When language is maladaptive: Recommendations for discussing self-injury Journal of Public Mental Health 18 2 148 -152
Hasking P., Staniland L., Boyes M., and Lewis S. P. 2022 Adding insult to injury: The accumulation of stigmatizing language on individuals with lived experience of self-injury The Journal of Nervous and Mental Disease 210 9 645 -649 https://doi.org/10.1097/NMD.0000000000001524
Hasking, P., Kenny, T. E., & Lewis, S. P. (2023). Lived Experience Perspectives on Self-Injury: Current Evidence and Practical Applications. In J. Whitlock, E. Lloyd-Richardson, & I. Baetens (Eds.), The Oxford Handbook of Nonsuicidal Self-Injury. Oxford University Press.
International Society for the Study of Self-Injury. (2024). What is non-suicidal self-injury? https://itriples.org/category/about-self-injury/
Klonsky E. D. and Glenn C. R. 2009 Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS) Journal of Psychopathology and Behavioral Assessment 31 215 -219
Klonsky, E. D., Muehlenkamp, J., Lewis, S. P., & Walsh, B. (2011). Nonsuicidal self-injury (Vol. 22). Hogrefe Publishing.
Klonsky E. D., Victor S. E., and Saffer B. Y. 2014 Nonsuicidal self-injury: What we know, and what we need to know Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 59 11 565 -568 https://doi.org/10.1177/070674371405901101
Kruzan K. P., Whitlock J., Chapman J., Bhandari A., and Bazarova N. 2023 Young adults’ perceptions of 2 publicly available digital resources for self-injury: Qualitative study of a peer support app and web-based factsheets JMIR Formative Research 7 1 e41546
Lewis S. P. and Hasking P. A. 2021 Understanding self-injury: A person-centered approach Psychiatric Services 72 6 721 -723
Lewis, S. P., & Hasking, P. A. (2023). Understanding self-injury: A person-centered approach. Oxford University Press.
Lewis S. P. and Seko Y. 2016 A double-edged sword: A review of benefits and risks of online nonsuicidal self-injury activities Journal of Clinical Psychology 72 3 249 -262
Lewis S. P., Heath N. L., Hasking P. A., Whitlock J. L., Wilson M. S., and Plener P. L. 2019 Addressing self-injury on college campuses: Institutional recommendations Journal of College Counseling 22 1 70 -82 https://doi.org/10.1002/jocc.12115
Lewis S. P., Heath N. L., and Whitley R. 2022 Addressing self-injury stigma: The promise of innovative digital and video action-research methods Canadian Journal of Community Mental Health 40 3 45 -54
Lewis S. P., Hasking P., Staniland L., Boyes M., Collaton J., and Bryce L. 2023 Self-injury in the news: A content analysis Basic and Applied Social Psychology 1 -14
Lewis S. P., Mahdy J. C., Michal N. J., and Arbuthnott A. E. 2014 Googling self-injury: The state of health information obtained through online searches for self-injury JAMA Pediatrics 168 5 443 -449
Mirichlis S., Hasking P., Lewis S. P., and Boyes M. E. 2022 Correlates of disclosure of non-suicidal self-injury amongst Australian university students Journal of public mental health 21 1 70 -81
Mirichlis S., Boyes M., Hasking P., and Lewis S. P. 2023 What is important to the decision to disclose nonsuicidal self-injury in formal and social contexts? Journal of Clinical Psychology 79 8 1816 -1825
Mitten N., Preyde M., Lewis S., Vanderkooy J., and Heintzman J. 2016 The perceptions of adolescents who selfharm on stigma and care following inpatient psychiatric treatment Social Work in Mental Health 14 1 1 -21
Morse J. M. 2015 Critical analysis of strategies for determining rigor in qualitative inquiry Qualitative Health Research 25 9 1212 -1222
Pritchard, T. P. & Lewis, S. P. (2023). Self-injury and the internet: Research, outreach, and practice. In J. Whitlock, E. Lloyd-Richardson, & I. Baetens (Eds.), The Oxford University Press Handbook of Nonsuicidal Self-injury. Oxford University Press.
Quinn D. M. and Chaudoir S. R. 2009 Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health Journal of Personality and Social Psychology 97 4 634 -651
Rojas-Velasquez D. A., Pluhar E. I., Burns P. A., and Burton E. T. 2021 Nonsuicidal self-injury among African American and Hispanic adolescents and young adults: A systematic review Prevention Science 22 367 -377
Rosenrot S. A. and Lewis S. P. 2020 Barriers and responses to the disclosure of non-suicidal self-injury: A thematic analysis Counselling Psychology Quarterly 33 2 121 -141
Roulston K. and Shelton S. A. 2015 Reconceptualizing bias in teaching qualitative research methods Qualitative Inquiry 21 4 332 -342
Scambler G. 1998 Stigma and disease: Changing paradigms The Lancet 352 9133 1054 -1055
Simone A. C. and Hamza C. A. 2020 Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature Clinical Psychology Review 82 101907 -101907 https://doi.org/10.1016/j.cpr.2020.101907
Staniland L., Hasking P., Lewis S. P., Boyes M., and Mirichlis S. 2022 Crazy, weak, and incompetent: A directed content analysis of self-injury stigma experiences Deviant Behavior 1 -18 https://doi.org/10.1080/01639625.2022.2038022
Staniland L., Hasking P., Boyes M., and Lewis S. 2021 Stigma and nonsuicidal self-injury: Application of a conceptual framework Stigma and Health (Washington, D.C) 6 3 312 -323 https://doi.org/10.1037/sah0000257
Staniland L., Hasking P., Lewis S. P., Boyes M., and Mirichlis S. 2023 Crazy, weak, and incompetent: A directed content analysis of self-injury stigma experiences Deviant Behavior 44 2 278 -295
Stirling F. J. and Lewis S. P. 2024 Broadcasting self-injury for change: Exploring the presentation of advocacy strategies on YouTube Deviant Behavior 1 -17
Swannell S. V., Martin G. E., Page A., Hasking P., and St John N. J. 2014 Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression Suicide and Life-Threatening Behavior 44 3 273 -303
Westers N. J., Lewis S. P., Whitlock J., Schatten H. T., Ammerman B., Andover M. S., and Lloyd-Richardson E. E. 2021 Media guidelines for the responsible reporting and depicting of non-suicidal self-injury The British Journal of Psychiatry 219 2 415 -418
Yip S. Y. 2024 Positionality and reflexivity: Negotiating insider-outsider positions within and across cultures International Journal of Research & Method in Education 47 3 222 -232

Information & Authors

Information

Published In

cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 43Number 3September 2024
Pages: 75 - 89

History

Version of record online: 17 December 2024

Key Words

  1. non-suicidal self-injury
  2. anticipated stigma
  3. college students
  4. mental health

Mots-clés

  1. automutilation non suicidaire
  2. stigmatisation a priori
  3. étudiants universitaires
  4. santé mentale

Authors

Affiliations

Sarah Henshaw
Olga A. Smoliak
Stephen P. Lewis [email protected]
Nancy L. Heath
Rob Whitley

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