The people behind the pain : a review of social relationships and the motivations behind adolescent deliberate self-harm

Abstract

This review explored the social relationships and motivations of adolescents who engage in deliberate self-harm (DSH) behaviour for nonclinical reasons, focusing on the family, peer networks, social support, and online relationships. DSH has mostly been viewed as a clinical problem and linked to medical conditions, such as depression or borderline personality disorder. However, adolescents who may self-harm for various other nonclinical reasons have rarely been acknowledged. This review examined studies of nonclinical samples of adolescents aged 12-19 to gather evidence of how factors in adolescents’ social relationships can precipitate adolescent DSH behaviour. Family intactness and cohesion, social support within the family appear to serve as protective factors for the adolescent. Peer influence effects on DSH remain significant too, and it has been proposed that adolescent DSH behaviour can be influenced through social reinforcement processes. Some significance regarding the relationship between DSH and virtual relationships has also been found, though not much research has been done in this area. On the basis of these analyses, a possible intervention model was proposed, one that can be used to identify social motivations for DSH though further research should be conducted to test its validity and reliability. Practical implications for community efforts to help DSH-adolescents are briefly discussed. Future research should also focus on how social relationships in the virtual world can impact adolescent DSH behaviour.