August 2011
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The Development of Self-Injury as a Multi-Functional Behaviour
ABSTRACT In order to advance our understanding of self-injury this longitudinal study investigated the experiences of 25 adults who had used or were using self-injury. This was achieved by obtaining verbal narrative accounts of their experiences of using self-injury from its onset during childhood or early adolescence, throughout adolescence and into adulthood. These verbatim accounts formed a corpus of data which was analysed using a grounded theory method. This process established seven robust categories associated with the use of self-injury consisting of behavioural, cognitive, emotional, social, occupational, communication and physiological experiences. By thoroughly examining these categories the development of self-injury as a versatile multi-functional behaviour emerged which was governed by the individuals‟ needs. Evidence for these multiple uses stemmed from the similarities that developed in the individuals‟ use of self-injury over time. Highlighting these multiple functions it was established that improved social, communication and occupational conditions were crucial aspects in the participants‟ reduction in using self-injury. The contribution this research has made towards developing our understanding of self-injury was addressed, particularly in relation to its use by the non-clinically defined members of the general public who took part, and in the context of advancing relevant nursing research and practice. Several critical aspects of the methodology were identified, in particular the restrictive generalisation of the findings to others who self-injure, and the use of retrospective accounts were discussed and directives were outlined to improve these aspects in future research. Proposals were made for further research to clarify and investigate the multiple functions of self-injury and to increase our understanding of the continuing use of covert self-injury during adulthood. Additionally, the relevance of the findings to nursing practice, principally in relation to adequately assessing the use of self-injury was discussed.
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