Self Harm is defined by the American Journal of Psychiatry (Winchel and Stanley (1991), as: The commission of deliberate harm to ones own body. Deliberate Self Harm is also called as Self Mutilation, Self Harm, Self Inflicted Violence. It comprises of direct intentional tissue damage without suicidal motivation. As self-injury, such as self-inflicted cutting, hitting, burning, and excoriation of wounds, has moved from clinical populations into the general population, there has been an explosion of clinical interest in the phenomena.
Aurélie Lambert and Anton F. de Man, (2007), defines self injury as, “a volitional act to harm one’s own body without intention to cause death.” Deliberate Self Harm differs from the culturally sanctioned means of body modification such as piercings and tattoos as it entails a psychological component to it, mainly comprising of a maladaptive coping style or a tertiary expression of emotions, due to an inability of expression of emotion in words, i.e alexithymia. Hicks and Hincks, (2007) talk about one reason behind the psychology of self injury: “Tissue damage is a visual demonstration of extreme emotional distress, and the physical act of mutilation seems to reconcile this emotion. A release of endorphins after the physical damage contributes to a feeling of relief, and an addictive maladaptive coping cycle of pain, relief, shame and self-hate.”
Self injury promotes the illusion of supreme autonomy and omnipotence, and so can be quite attractive to the needy, vulnerable part of the self that requires protection. If they are deadened by depression or dissociation, bodily pain can jolt them into feeling alive. When suffering the pain of anxious hyperarousal, gliding a razor blade across the skin… can produce a release that is as close to joy as they will get (Faber, 2007). Self Harm often begins as an impulsive, punishing act but continues to be a ritualistic behavior. Often the Deliberate Self Harmers will flamboyantly self mutilate, but carefully hide the scars- thus marking this behavior as intense ambivalence through concealing the evidence of such tribulation. However, the indirect self harm would be such where the self harmer is indirectly attributed to such a situation, and could be recognized as a victim of ‘quasi accidents.’ Here, the self harmer could be mistaken for provoking accidents, fights such that the attribution of the self harm is intentional yet through other indirect means, mainly by inclusion of others in the scenario.
The self destructive pattern of behavior can be explained in many aspects. A victim of Deliberate Self harm could be causing pain to one self to escape the misfortune of a reality where he/she feels dominated, controlled and powerless. Thus, the means of self harming could be the only possibility left to feel in control of one’s own self, body, action and surrounding situation. However, it could also be explained as the victim’s need to escape the encapsulating numbness and feelings of emptiness. In many cases of trauma, self harm can be used as a means of disassociation to return to reality.
Deliberate Self harm can also be used as a form of self-punishment especially by victims of child abuse (ranging from physical abuse, emotional and sexual abuse or neglect) and their need to re-enact the punitive ways to reinforce the idea that ‘I deserve to be punished’ or ‘I am bad,’ or as an expiation for sins. It can also be used as a tool for validating the self in various aspects pertaining to the pertaining to the existence of self, emotions or the past trauma. Sometimes self harm is used as a distraction of other forms of suffering beyond the person’s understanding or coping methods.
Deliberate Self Harm can also be used as a device of manipulation, mostly in sufferers of Borderline Personality Disorder. (Babiker and Arnold, 1997; Gratz, 2003; Williams, 2001). Self Harm can often turn into a repeatable, ritualistic behavior mirroring an addiction as it enables the victim to cope with intense stress and chaos, thus forming a maladaptive coping strategy to problem solving. But, the manipulative ways of a borderline could be a cry of rescue or sympathy, other than an attention seeking gesture.
The most recognized forms of self harm are: major, stereotypic and superficial. Major self mutilation can involve the removal of arms, appendages or other “significant tissue damage” (Lambert, de Man, 2007). Obviously, this type of self mutilation is manly observed during psychosis and intoxication (Lambert, de Man, 2007). However, major self harm is a very rare accounted phenomenon. A stereotypic self mutilator is also associated with severe retardation and is expressed by a repetitive action such as head banging against a hard object or self biting (Lambert, de Man, 2007). A superficial self mutilator has cuts that are not directed at primary danger, but are displacement of psychological pain to physical by one’s own self.
An estimation of self harm in the U.S population is found by Sivan Kochinski, Steven R. Smith, Matthew R. Baity, and Mark J. Hilsenroth, (2008) which states that nearly 19.5% of female adolescents self mutilate, as opposed to 5.9% of male adolescents. A high rate of self harm amongst female population could be reasoned by poor self image, lack of emotional stability, or experiences of sexual abuse. “When self-mutilators cause tissue damage there is a flood of endorphins, which produces a sense of relief… An addiction comes from wanting to retain this feeling of euphoria. More and more destruction of tissue is needed to achieve relief, with the result of high risk of inflicting a serious or fatal injury. Self-mutilation is more difficult to stop the longer it continues.” (Hicks, Hinck, 2007).
According to the American Journal of Psychiatry, the three components of Self Inflicted Violence acts are: directness, lethality, and repetition. Self-injury was previously thought to be associated with early-life loss and trauma, related functional impairment (Favazza, 1996, 1998; Walsh & Rosen, 1988), and serious mental disorders such as borderline personality disorder, posttraumatic stress disorder, and major depression (Linehan, 1993; Favazza, 1996; Simeon & Hollander, 2001).
According to psychologist Mary Ainsworth, attachment “may be defined as an affection tie that one person or animal forms between himself and another specific one – a tie that binds them together in space and endures over time.” Attachment is defined as the emotional bond with another person, primarily a caregiver at the stage of infancy. John Bowlby was the first attachment theorist, defining attachment as a “lasting psychological connectedness between human beings” (Bowlby, 1969, p. 194). The initial function of attachment is ensuring survival of an infant due to the bond that is formed with the primary care givers. Many researchers such as Bowlby, Ainsworth, Main and Solomon have researched on how the attachment pattern and styles formed between the parent and child can influence the personality, romantic relationships and other aspects of psychological well being later in life.
When the attachment is strong the infant knows that the caretaker is dependable which allows him to explore the world. On the other hand, lack of secure attachment formed between the infant and care taker can lead to character pathologies such as conduct disorder, borderline personality disorder, and oppositional-defiant disorder. It has been suggested that an adult often mirrors the attachment style provided to him/her during his childhood, or the intimacy and attachment between his parents or caretaker in his adult relationships. Thus individuals as infants who experienced secure attachment are able to form long lasting, stable romantic relationships rather than others.
The four key components to attachment are namely: safe haven, secure base, proximity maintenance and separation distress. Safe haven refers to the safe and secure world for the child in his care taker’s space, when he is faced with a distressing, anxious event. Secure base is explained as a secure base for independence and exploration to gaining autonomy and stability, marking the individual’s first step in self concept in his relation to his environment. Proximity maintenance is described as the infant’s needs of staying closer to his care taker, as he has has entrusted him with his security. And finally, separation distress refers to the anxiety faced by the infant when separated from his/her caretaker.
Perhaps the most frequently cited method of assessing attachment is the observational ‘strange situation’ method developed by Mary Ainsworth and colleagues (Ainsworth, Blehar, Waters, & Wall, 1978) In the study, researchers observed children between the ages of 12 and 18 months as they responded to a situation in which they were briefly left alone and then reunited with their mothers (Ainsworth, 1978). The attachment styles thus obtained from the responses were of secure attachment, ambivalent-insecure attachment and avoidant-insecure attachment. Main and Solomon (1986) added a fourth attachment style called disorganized-insecure attachment.
Consistent with Bowlby’s theoretical proposals, these patterns of behaviour have been shown
to be moderately stable over long periods of time under stable family and caretaking conditions (Fraley, 2002; Hamilton, 2000; Lewis, Feiring, & Rosenthal, 2000). Moreover, an affective bond characterized by warmth, availability, trust, and responsiveness with at least one individual throughout the lifespan has been proposed to be important for psychological adjustment (MacDonald, 1992). Indeed, much research has shown such a bond to be an important factor in predicting resilience in individuals faced with substantial adversity ( Cicchetti & Garmezy, 1993; O’Connell-Higgins, 1994).
According to Bowlby (1977, 1988), attachment is adaptive and significant because it
involves a process of natural selection that yields survival advantage. From early experiences between infants and caregivers, infants are believed to adapt to caregivers’ behavioral patterns and to develop internal mental representations of themselves and their surroundings. In this manner, experiences with caregivers influence the degree to which infants become securely attached to their caregivers. As children mature, they increasingly seek the company of their peers, presumably incorporating peer behaviors into their internal working models, based on their earlier attachments to parents (Crowell & Waters, 1994; Hazan & Shaver, 1994). In this manner, parent and peer interactions may interrelate, leading to more generalized working models, which influence individuals’ subsequent adaptation (Kerns, Klepac, & Cole, 1996; Lieberman, Doyle, & Markiewicz, 1999).
While children with sincere attachment style had a unique bond with their caregiver where they appeared to be severely distressed when their caretaker left, and happily greeted them on their arrival; it proved to show that the infants genuinely depended on their parents for the availability and optimization of needs, and turned to them in moments of seeking comfort and reassurance. The ambivalent attachment style presents children who are distressed while their care taker is away, but has a mixed expression of emotions upon their arrival. Maternal unavailability is said to be a prime causal factor of ambivalent attachment style. The final attachment style noted by Ainsworth is the avoidant-insecure attachment style where the infant shows no difference in expressions during the arrival of a stranger or a care taker, after the departure of the caretaker. Neglect or child abuse is said to set off such an attachment style, where the infant avoids the caretaker to avoid the negative emotions and situations it brings, in return or as a means of showing displeasure etc.
Attachments formed during infancy are not necessarily transient (Bowlby, 1988) or limited to the mother-infant bond (Ainsworth, 1989; Rice, 1990; Trinke & Bartholomew, 1997). Attachment models play an important role in the life scripts of individuals by further determining relationships with peers and the opposite sex.. Adolescents who are securely attached to their parents display higher LS (Armsden & Greenberg, 1987; Nickerson & Nagle, 2004); academic success (Bell, Allen, Hauser, & O’Conner, 1996; Cutrona, Cole, Colangelo, Assouline, & Russell, 1994); interpersonal functioning (Black & McCartney, 1997); self-efficacy (Arbona&Power, 2003; Thompson, 1999); and lower psychological distress (Bradford & Lyddon, 1994). Secure peer attachments are related to adolescents’ global self-esteem (Black & McCartney, 1997); academic achievement(Holahan, Valentiner, & Moos, 1996; Parker & Asher, 1987); and perceived quality of life (Green,Forehand, Beck, & Vosk, 1980).
Although the importance of parental attachment in general seems clear, studies have also begun to investigate which parent serves as the primary attachment figure across the developmental years. To date, evidence suggests that attachment to mothers is higher throughout childhood and adolescence (Freeman & Brown, 2001; Haigler, Day, & Marshall, 1995). Rice, Cunningham, and Young (1997) concluded that father (vs. mother) attachment was more significantly related to social competence in various social situations.
According to Erik Erikson’s stages of human development, a young/ prime adult is generally a person aging from 20 to 40. The young adult stage in human development succeeds adolescence and precedes middle adulthood. A person in the middle adulthood stage is aged between 40 to 64. According to Erikson, in the wake of the adolescent emphasis upon identity formation, by finding the right mate, and give in to intimacy. This is achieved by the loss of ego in situations by accepting the fact that it might finally, end in self abandon and isolation, or the loss of affiliation in orgasms and sexual unions, in close friendship etc. Avoidance of such experiences ‘because of a fear of ego-loss may lead to a deep sense of isolation and consequent self-absorption’. (PSY 345 Lecture Notes – Ego Psychologists, Erik Erikson”. Retrieved 2009-08-11.)
Significance of the Study:
The topic deliberate self harm has been selected for this study, because, Deliberate self-harm in India is an important clinical phenomenon (Romans, Martin, Anderson, Herbison, & Mullen, 1995; Tantum & Whittaker, 1992; Van der Kolk, Perry, & Herman,1991), and tendencies toward repetitive self-harm appear to comprise a distinct component of personality disturbance (Livesley, Jackson, & Schroeder, 1991). Deliberate Self Harm is associated with symptoms of depression and anxiety, eating disorder, personality disorders, anti-social behavior, high-risk alcohol use, cannabis use, and cigarette smoking. Although there is no suicidal intention, the ideation is often present. Deliberate self harm can have serious medical consequences death along with psychopathology such as low blood pressure, haemorrhage and occasionally leading to death.
Research evidence shows insecure attachment style relates to childhood neglect/abuse (Crittendon 1997), poorer support (Hazan & Shaver, 1994; Bartholomew & Horowitz 1997), stress (Mikulciner & Florian, 1998) and psychological disorder in adolescence (Allen, 1998) and
adulthood (Mickelson & Kessler 1997) Offending behaviour (Fonagy et al 19967; van Ijzendoorn et al 1997). Quality of attachment to parents and to a lesser extent, peers, is associated with self-reported tendencies toward the use of more problem-solving coping strategies relative to emotion-managing efforts in stressful situations (Armsden, 1986).
Objectives of the study:
Thus, the objective of this research studying the analysis and assessment of deliberate self harm in relation to parent and peer attachment in young adults is by studying
the frequency and types of deliberate self harm,
the various causes underlying it with response to 13 function scales such as affect regulation, interpersonal boundaries, self punishment, self care, anti-disassociation etc.
The Parent and Attachment is hypothesized to be another factor thus contributing to the act of Deliberate Self Harm in context with the subscales of trust, communication and alienation.
A comparative analysis of the attachment style in the Self- harming population was contrasted with the Non-Self Harming Population on the various subscales of Mother, Father and Peer and Trust, Communication and Alienation to find the factors which are most distinguishable in relation to the Self Harming population.
Review of Literature
The present study aimed to understand the relationship between
Deliberate Self Harm
Quality of Attachment.
The studies below gave us a greater insight and understanding into such concepts.
A. S. Christian and K. M. McCabe studied Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm in the year 2009 where Coping styles was predicted to be a factor to predict whether a depressed individual engaged in DSH. This was because coping resources must be drawn upon in response to depressive symptoms. Research suggested that DSH had association with certain coping mechanisms and also served functions related to a number of coping styles (e.g., Brown, Williams, & Collins, 2008; Evans, Hawton, & Rodham, 2005; James &Warner, 2005).
Self-blame (i.e., cognitively criticizing and admonishing oneself) could increase an individual’s risk for Deliberate Self Harm. This was because DSH could be a means of releasing feelings of blame and guilt directed at the self. In a study conducted in a medium security female psychiatric unit, patients, psychiatrists, nurses, the hospital commissioner, and the clinical nurse manager all endorsed coping with blame and guilt as a function of DSH (James & Warner, 2005). DSH might also be related to self-blame as it can serve as a form of self-punishment, resulting from feelings of blame and guilt. Self-punishment was seen as s function of DSH by 31.8% of participants in one study (Nock& Prinstein, 2004), and 51.0% of female participants and 25.0% of male participants in another study (Rodham, Clinton, & Evans, 2004).
The DSHI operationally defines DSH as “the deliberate, direct destruction or alteration of body tissue without conscious suicidal intent, but resulting in injury severe enough for tissue damage (e.g., scarring) to occur.” (Gratz, 2001, p. 254). The Ways of Coping (Revised) (Folkman, 1986) is a 66-item self-report questionnaire, which explores eight dimensions of internal and/or external strategies for coping with specific stressful events. These were the two questionnaires which found that self-isolation would relate to DSH and mediate the relationship between depression and DSH. Self-isolation was also found to fully mediate the relationship between depressive symptoms and DSH. These finding increased understanding of the risk of DSH in depressed individuals.
Students who self-harm: Coping style, Rumination and Alexithymia was studied by J. Borrilla, P. Foxb, M. Flynna and D. Rogerc. This study examined reported self-harm incidents (scratching, cutting, poisoning, overdose etc) from a sample of 617 university students. 27% reported at least one incident of self harm, with almost 10% having harmed themselves while at university. There were no significant gender differences related to self harm. Participants reporting self-harm scored significantly higher on maladaptive coping styles, rumination, and alexithymia- specifically difficulty in identifying emotions. These differences were most marked for students reporting repetitive and recent self-harm. Rumination and Alexithymia emerged as the most robust factors predicting self harm status.
The two psychometric scales completed by all participants were:. the 39-item Inhibition- Rumination Scale (I-RS), developed by Roger from the earlier ECQ (Emotion Control Questionnaire) (Roger & Najarian, 1989), and . the 41-item Coping Styles Questionnaire 3 (CSQ-3), the latest revision of the Coping Styles Questionnaire, developed by Roger, Jarvis and Najarian (1993), which measured three coping sub-scale styles: avoidance, rational coping, and the bipolar emotion-focussed/detached scale. Small but highly significant mean differences in reported coping style were found between students with a history of any self-harm and those who reported no self-harm.
As predicted, students reporting any self-harm scored significantly higher on the Avoidance Coping subscale of the CSQ-3 (t¼3.26, df¼590, p50.0001) and significantly lower on the Rational Coping subscale (t¼4.05, df¼598, p50.0001) compared with those with no reported self-harm. The self-harmers also scored significantly lower on the bipolar detached vs emotion coping subscale (t¼5.38, df¼567, p50.0001) indicating greater focus on reducing emotional arousal.
Deliberate Self-Harm in 14-Year-Old Adolescents: How Frequent Is It, and How Is It Associated with Psychopathology, Relationship Variables, and Styles of Emotional Regulation was studied by J. Bja¨rehed and Lars-Gunnar, Lundh Department of Psychology, Lund University, Sweden. Deliberate self-harm was studied in 14-year-old adolescents with a test-retest design, using a nine-item version of the Deliberate Self-Harm Inventory. 40.2% of the adolescents indicated deliberate self-harm on at least one occasion compared with 36.5% at Time 2. Test-retest data verified high reliability 2 months in duration.
Cross-validation of the results from the two time periods showed robust correlations between deliberate self-harm and general psychopathology, relative absence of positive feelings toward parents, and a ruminative style of emotional regulation. Negative thinking and a relative absence of positive feelings toward parents were also predictors of self-harm independently of general psychopathology. Self-harm correlated with symptoms of eating disorder and negative body esteem. For correlations between DSHI and negative emotional tone with parents compared with peers, there was found to be significant differences. The DSHI-9 showed consistent correlation with rumination/negative thinking but no significant correlations with distraction or positive thinking.
K. L. Gratz and M. T. Tull studied The Relationship Between Emotion Dysregulation and Deliberate Self-Harm Among Inpatients with Substance Use Disorders. The study examined if emotion dysregulation is higher among SUD inpatients with (vs. without) DSH. The significant association between DSH and emotion dysregulation when controlling for their shared association with risk factors for both, including borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), childhood abuse, and substance use severity was also studied. Findings indicated higher emotion dysregulation among SUD patients with (vs. without) DSH, and provide evidence of a unique association between emotion dysregulation and DSH when controlling for BPD, PTSD, childhood abuse, and substance use severity.
Findings also highlighted the particular relevance of three dimensions of emotion dysregulation to DSH among SUD patients: i) limited access to effective emotion regulation strategies, ii) difficulties engaging in goal-directed behaviors when distressed, iii) emotional nonacceptance.
The Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004) was administered, hat assesses individuals’ typical levels of emotion dysregulation across six domains: nonacceptance of negative emotions, difficulties engaging in goal-directed behaviors when experiencing negative emotions, difficulties controlling impulsive behaviors when experiencing negative emotions, limited access to emotion regulation strategies perceived as effective, lack of emotional awareness, and lack of emotional clarity. Substance users with a history of DSH (vs. those without DSH) reported significantly higher levels of overall emotion dysregulation.
Attachment Quality, Parental Monitoring, and Peer Relations as Predictors of Risky behavior among ethnic minority youth was studied by D. M. Reese. The middle adolescent sample was used for this study with eighty three participants. The distribution of attachment styles in this study’s population was hypothesized to show that ambivalent adolescents would have high rates of behavior and peer relations problems and low levels of parental monitoring;
avoidant adolescents would have high to moderate rates of behavior and peer relation problems and low levels of parental monitoring; and secure adolescents would have low rates of behavior and peer relation problems and high levels of parental monitoring The relationship between attachment and risky behavior would be mediated by parental monitoring and peer relationships.
A Pearson correlation coefficient determined that there was no relationship between attachment and risky behaviors.Therefore, no other analysis was completed using the mediation model. However, this study did show that there was a significant positive relationship between parental monitoring and attachment. There were no significant correlations between peer relations and other study variables. An independent t-test analysis was conducted to explore whether risky behaviors occurred more with the male or female population in this study. Results showed that females presented with more internalizing behaviors than males as well as more overall risky behaviors than males.
A Comparison of Invalidating Family Environment Characteristics Between University Students Engaging in Self-Injurious Thoughts & Actions and Non-Self-Injuring University Students was studied by J. Martin , J.Franc¸ois Bureau and P. Cloutier , M.F, Lafontaine. Non-suicidal self-injury (NSSI) is defined as the purposeful destruction or alteration of body tissue severe enough for tissue damage to occur, performed without suicidal intent, using methods that are not sanctioned by society (Nixon and Heath 2009). The study aimed at determining how three groups of university students differed in their reported quality of childhood relationships with parents, and histories of physical and sexual abuses.
Engaging in NSSI behaviors places adolescents at increased risk for both social difficulties and physical injuries, and frequently co-occurs with other mental health problems, such as depression and anxiety (Ross and Heath 2003).Results indicated that individuals experiencing NSSI thoughts only, and those engaging in NSSI actions reported poorer relationships with parents and more physical abuse than the No NSSI group; however, NSSI thoughts and NSSI action groups had similar outcomes to one another for most variables. These findings suggest that individuals experiencing only NSSI thoughts share similar negative childhood environments associated with engagement in NSSI action and that they should be included in future research, particularly investigations aimed at identifying protective factors that could prevent them from engaging in NSSI.
Dissociation, Traumatic Attachments, and Self-Harm: Eating Disorders and Self-Mutilation was studied by S. K. Farber. Brickman (2004) argues that an image of the ‘typical self-injurer’ emerged out of clinical psychiatric literature in the 1960s which sought to describe and interpret self-cutting as feminine – thus the genesis of thephrase “delicate self-cutting” (p. 91, emphasis added). However, despite more recent claims that self-cutting is not “simply a problem of suburban teenage girls,” this image has been widely accepted and reproduced by both the medical profession and in popular culture (Brickman 2004, p. 87). The ‘typical self-cutter’ is presented as female, white, young and middle-class in many different disciplinary literatures, and accepted as such by researchers and commentators alike (Froeschle & Moyer, 2004; Schoppmann, Schrock, Schnepp & Buscher, 2007; Shaw, 2002, Zila & Kiselica 2001). Much research is therefore carried out on exclusively female samples, which only serves to reinforce the view that self-cutting and self-injury are overwhelmingly female activities (Abrams & Gordon, 2003; Alexander & Clare 2004; Simeon, Stanley, Frances, Mann,Winchel, & Stanley, 1992).
In every act of self-harm there are at least two participating, but dissociated, self-states. There is the dissociated part of the self-being abused and another dissociated part doing the abusing (Sachs 2004). This ”inner predator” is a dissociated (split off) identification with the aggressor that maintains the attachment to the abusive or neglectful, but still loved parent. The patient usually experiences this inner predator as alien, as ”not me” (Bromberg 1998). Many who have developed traumatic attachments are predisposedto violent behavior toward others (largely males) and/or themselves (largely females) (Farber 1995, 2000; Fonagy and Target 1995; Lyons-Ruth and Jacobwitz 1999).
A study of adolescent separation anxiety found that selfdestructive tendencies emerged in early adolescence in response to separations (Hansburg 1986). The frequency of self-mutilation in adolescents in residential treatment was found to increase significantly when a staff member announced that he would be leaving his job (Rosen et al. 1990).
The Cutting Edge: Non-Suicidal Self-Injury in Adolescence by J. Whitlock was studied. There is broad agreement that the average age of onset is 14-16, but it is also true that individuals can begin injuring in childhood and adulthood. At least two college studies show that about a quarter of those reporting self-injury started in the college years (Whitlock, Eckenrode, et al., 2006; Jacobson & Gould, 2007; Whitlock, Muehlenkamp, et al., 2009). It is widely agreed, though, that self-injury is much more visible among females than among males (Whitlock, Muehlenkamp, et al., 2009).
Self injury is seen as more common in middle-class groups in literature which draws on a psychoanalytic or psychotherapeutic perspective (Zila & Kiselica, 2001). In contrast, where psychiatric literature mentions the social class of patients, it is usually to note that the majority have low incomes or are unemployed (Hawton et al., 2004; Suyemoto, 1998). It is possible that these conclusions are more suggestive of the differential impact of social class on access to psychiatric/ or psychotherapeutic interventions (Pilgrim & Rogers, 1999, p. 35). Indeed, Briere and Gil’s (1998) general population study found no difference in income between those who reported self-injury and those who did not.
Since the 1980s, references to NSSI in media stories and popular culture have risen sharply, and may be contributing to an increase in prevalence (Whitlock, Eells, Cummings, & Purington, 2009). Self-injury appears to be more common among youth with high exposure to NSSI images, stories, or messages (Whitlock, Purington, et al., 2009; Whitlock, Powers, & Eckenrode, 2006). Although we can never empirically know whether media has influenced the spread of self-injurious behavior, many studies have shown that media do play a significant role in the spread of related behaviors such as suicidality, violence, and disordered eating (Whitlock, Purington, et al., 2009).
Statement of Research Problem:
To analyze and assess the relationship between the Tendency of Deliberate Self Harm and Parent and Peer Attachment among Young Adults.
Variables: The independent or predictor variable that was believed to affect the outcome through its active changes are parent and peer attachment. The variable to be predicted, the outcome is also known as the dependent variable. In our study, the tendency of deliberate self harm was the criterion variable.
Independent variable: Parent and Peer attachment.
Dependent variable: Self H
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