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Self-harm : an investigation into disclosure, help-seeking, and implicit and explicit attitudes
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Olin, Sarah Louisa (2021) Self-harm : an investigation into disclosure, help-seeking, and implicit and explicit attitudes. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3861732
Abstract
Self-harm is defined as bodily harm caused intentionally by an individual without suicidal intent. Self-harm poses a significant threat to public health, with estimated lifetime prevalence rates between 13.3% and 19.6% among university students (Benjet et al., 2019; Sivertsen et al., 2019). Prior research has found that people who self-harm are 49 times more likely to die by suicide than the general population (Hawton et al., 2015), while most individuals who self-harm do not seek help, especially not from medical professionals (Fortune et al., 2008). A key concern when deciding whether to seek help is perceived stigma (Nearchou et al., 2018), although research has found discrepancies between experiences and measured attitudes: experienced responses can vary widely between gentle and hostile (MacDonald et al., 2020) while attitude research suggests tolerant attitudes towards people who self-harm (e.g., Gagnon & Hasking, 2012; Nielsen & Townsend; 2018). This discrepancy can be explained by how attitudes are measured. Attitudes can be measured either explicitly or implicitly, with explicit measures being more susceptible to biases and implicit measures being thought to measure underlying attitudes (Friese, Hofmann & Schmitt, 2008).
The current thesis explored the experiences of disclosure and help-seeking of students with a history of self-harm using a semi-structured interview, analysed using reflexive thematic analysis as outlined by Braun and Clarke (2006; 2021). Interviews with 19 students produced three main themes: peers who self-harm, choice, and responses. Peers who self-harm involved reciprocal disclosure, shared experience and understanding, and self-other comparison. Choice consisted of three levels, namely being found out, compelled disclosure, and seeking support. The responses theme included immediate and long-term responses, indirect responses, and self-directed responses. Interviewees perceived public stigma towards self-harm, with experiences of indirect stigma and impulsive, immediate responses suggesting negative underlying attitudes of some respondents. However, improved responses over time could be explained by either improved understanding or more measured responses. The remainder of the thesis aimed to investigate explicit and implicit attitudes towards people who self-harm.
The three quantitative chapters of the thesis used Go/No-Go Association Tasks (GNAT; Nosek & Banaji, 2001) to implicitly measure attitudes, alongside a self-harm adaptation of the Depression Stigma Scale (DSS; Griffiths et al., 2008) and attribute ratings to measure explicit attitudes towards people who self-harm. There were a total of 84 participants in Chapter 4, 101 in Chapter 5, and 115 in Chapter 6. Participants of all three quantitative studies demonstrated tolerant explicit attitudes towards people who self-harm. However, implicit measures showed largely negative associations with people who self-harm when pairing self-harm with ‘Bad Person’, ‘Dangerous’ and ‘Blameworthy’. These findings suggested negative underlying attitudes towards people who self-harm. However, in the final study, self-harming behaviours, not people who self-harm, were associated with ‘Dangerous’ attributes. This finding is discussed with regards to ambiguity within the measure, such that the GNAT could have been interpreted as danger to the self or others, along with the possibility that the learning procedure implemented was not sufficient to establish a mental association between non-word names and self-harm.
The conclusion of this thesis discussed the practical and theoretical implications of the research conducted within. It was concluded that the current research supports a distinction between affective and cognitive components of attitude, and has supplied potential methods to implicitly measure attitudes towards a social group rather than the qualities which make them ‘other’. The studies within this thesis found high rates of historic selfharm, highlighting the importance of investigating self-harm among the student population. By implicitly measuring attitudes among this population, the present research can explain discrepancies between help-seeking experiences and explicit attitudes. Limitations and proposed future directions are discussed.
Item Type: | Thesis (PhD) | ||||
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Subjects: | B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HM Sociology H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services |
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Library of Congress Subject Headings (LCSH): | Self-mutilation, Self-mutilation in adolescence, Self-mutilation -- Psychological aspects, Self-mutilation -- Treatment, Health attitudes, Attitude (Psychology) | ||||
Official Date: | December 2021 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Department of Psychology | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Fox, Claudine ; MacCallum, Fiona ; Watson, Derrick G. | ||||
Sponsors: | Economic and Social Research Council (Great Britain) | ||||
Format of File: | |||||
Extent: | 180 pages : illustrations | ||||
Language: | eng |
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