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An interpretative phenomenological analysis of young people’s self-harm in the context of interpersonal stressors and supports: parents, peers and clinical services

Wadman, Ruth; Vostanis, Panos; Sayal, Kapil; Majumder, P.; Harroe, C.; Clarke, David; Armstrong, Marie; Townsend, Ellen


Ruth Wadman

Panos Vostanis

Professor of Child and Adolescentpsychiatry

P. Majumder

C. Harroe

David Clarke

Marie Armstrong


Rationale: Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options. Objective: To explore young women’s experience of self-harm in the context of interpersonal stressors and supports. Method: Fourteen adolescent females (13 – 18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken. Results: Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling ‘stupid to self-harm’); and 7) ‘Empty promises’ - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking. Conclusion: Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports and emotions. This has implications for improving support from both informal and clinical sources.


Wadman, R., Vostanis, P., Sayal, K., Majumder, P., Harroe, C., Clarke, D., …Townsend, E. (2018). An interpretative phenomenological analysis of young people’s self-harm in the context of interpersonal stressors and supports: parents, peers and clinical services. Social Science and Medicine, 212, (120-128). doi:10.1016/j.socscimed.2018.07.021. ISSN 0277-9536

Journal Article Type Article
Acceptance Date Jul 13, 2018
Online Publication Date Jul 19, 2018
Publication Date Sep 30, 2018
Deposit Date Jul 17, 2018
Publicly Available Date Jul 20, 2019
Journal Social Science & Medicine
Print ISSN 0277-9536
Electronic ISSN 0277-9536
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 212
Pages 120-128
Keywords UK; self-harm; adolescence; clinical services; qualitative methods; interviews
Public URL
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Copyright Statement Copyright information regarding this work can be found at the following address:
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