Pathways to Self-Injury: A Qualitative Exploration of Social Psychological Processes

Self-injury is a deviant behavior often understood as the intentional infliction of harm onto one's own body that exists absent of suicidal. This study uses a qualitative methodology to examine the etiology and perpetuation of self-injury using the terminology of relevant social-psychological theories to determine which processes best describe a causal pathway leading to self-injury and its perpetuation after the onset of the behavior. Data obtained from 16 semi-structured interviews with former and current self-injurers indicate that the processes described in general strain theory, social learning theory, and social control theory are all important for understanding the etiology and perpetuation of self-injury. Analytic induction was utilized as the method of analysis in order to parse out only the elements universal to pathways to self-injury evident in all of the examined cases. All participants used self-injury as coping response for mitigating negative affect stemming from strain, thus, implicating general strain theory as important for understanding the onset of self-injury. Participants were categorized into two subtypes of self-injurers based upon the temporal dimension of the social learning process. Future research should attempt to use quantitative methodologies to provide generalizability for the results of this study and examine how changes in risk and protective factors over the life-course modify one's propensity to engage in self-injury. Keywords: Self-Injury, Self-Harm, General Strain Theory, Social Learning Theory, Analytic Induction Self-injurious behavior (SIB) is a phenomenon characterized by the intentional destruction of one's own body tissue (Walsh, 2006). While the behavior may be linked to suicidal intention, it is often conducted in the absence of such ideation (Adler & Adler, 2011). SIB has even been recently recognized as a distinct disorder in the DSM-5, whereas it was only recognized as a symptom of borderline personality disorder in previous versions (American Psychiatric Association, 2013). While SIB is typically understood as a phenomenon separate from suicide, there always exists the possibility of accidental death as a result of SIB. Recent research highlights self-inflicted injury as the eighth-leading cause of death in the United States, with accidental death stemming from several types of self-inflicted injury as a sizable proportion of these deaths (Rockett & Caine, 2015). Even with this growing recognition and understanding of SIB as a relevant phenomenon, there remain questions regarding the etiology of the behavior in dire need of explanation. This research seeks to address the relevant etiological debates by identifying the essential components of a developmental pathway leading to SIB using a qualitative methodology. Historically, there has been difficulty in conceptualizing and operationalizing SIB. This difficulty stems from the lack of a universal definition of SIB. This is evidenced by the varied definitions of SIB in the existing literature on the topic (LeCloux, 2013). For this reason, it is important to concretely define the behavior that this research sought to examine. Theoretically, SIB may indeed take many different forms. If it is simply defined as any act in which an individual causes harm to his or her own body, then the door is opened up for acts such as drug abuse to be considered SIB. Walsh (2006) differentiated between drug use as SIB and more direct forms of SIB. Walsh defined "direct self-harm" as any self-directed behavior that results in immediate tissue damage where the intent of the behavior as SIB is evident. Walsh then went on to define "indirect self-harm" as behaviors in which the harm done to one's body is not as immediate and the intent of the behavior as harm is not as evident. Although this is certainly an area that should be explored further, both in the act of damaging oneself with drugs and also the meaning associated with it, this will not be the focus of this study. …