Stigma towards individuals who self harm: impact of gender and disclosure
| Published date | 17 December 2018 |
| DOI | https://doi.org/10.1108/JPMH-02-2018-0016 |
| Date | 17 December 2018 |
| Pages | 184-194 |
| Author | Brendan Lloyd,Alexandra Blazely,Lisa Phillips |
| Subject Matter | Health & social care,Mental health,Public mental health |
Stigma towards individuals who self harm:
impact of gender and disclosure
Brendan Lloyd, Alexandra Blazely and Lisa Phillips
Abstract
Purpose –Non-suicidal self-injury (NSSI) is reasonably common, particularly among young people with
prevalence rates of up to 25 per cent reported. Many factors contribute towards NSSI, including depression,
anxiety and history of abuse and NSSI is a risk factor for suicide. Many people who engage in NSSI do not
seek help, potentially due to concern about sigmatising attitudes. The purpose of this paper is to investigate
the impact of gender and disclosure on stigmatising attitudes towards individuals who engage in NSSI.
Design/methodology/approach –Participants were 384 first-year university students (77.4 per cent
female; mean age 19.50 years (SD ¼3.53)) who completed measures of stigmatising attitudes in response to
vignettes featuring individuals who engaged in self-harming behaviour. Vignettes varied in the gender of the
individual as well as whether the NSSI was disclosed or not.
Findings –The results support the attribution model of public discrimination in relation to NSSI stigma.
Perceptions of higher personal responsibility for NSSI behaviour and higher levels of danger and manipulation
were positively associated with stigmatizing attitudes and behaviours. Male research participants reported
significantly higher levels of stigmatizing attitudes and behaviours than females.
Social implications –The level of stigmatising attitudes towards individuals who engage in NSSI is
significant and may impact on help-seeking behaviour.
Originality/value –Between 10 and 25 per cent of adolescents engage in some form of NSSI, but only a
minority seek help to address this behaviour. This study suggests that attitudes by peers may influence
help-seeking. Further research is required outside of tertiary education settings.
Keywords Non-suicidal self injury, Gender, Stigma
Paper type Research paper
Non-suicidal self-injury (NSSI) refers to the intentional and direct injuring of one’s body without
suicidal intent (American Psychiatric Association, 2013). The most common form of self-injury is
skin-cutting, on the wrists, forearm or neck, hitting and burning (Bresin and Schoenleber, 2015).
While a recent meta-analysis suggests females are about 1.5 times more likely to engage in NSSI
than males, that gender ratio is commonly thought to be influenced by the fact that males are less
likely to seek help (Bresin and Schoenleber, 2015). Gender differences in frequency of self-harm
episodes, wound care, function, method and emotional states preceding and following a
self-harm episode are recognised (Andover et al., 2010; Claes et al., 2007).
NSSI is most common during adolescence, with international lifetime prevalence rates in
individuals aged 10–19 between 10 and 25 per cent commonly being observed (Muehlenkamp
et al., 2012). Given these high rates, some researchers have called for NSSI to be a stand-alone
diagnostic entity (Posporelis et al., 2015).
Whilst most often associated with borderline personality disorder (BPD), research has also linked
NSSI with eating disorders (García-Nieto et al., 2015), depression, anxiety (Ross and Lee Heath,
2003) and history of abuse (Yates et al., 2008). NSSI has also been observed in non-clinical
samples (Klonsky et al., 2003).
Individuals may engage in NSSI to avoid psychological pain, to express psychological distress or
to refocus one’s attention away from negative stimuli (Klonsky, 2007). Alternatively individuals
who engage in NSSI may intentionally induce physical pain to allow themselves to focus on a
Received 23 February 2018
Revised 14 September 2018
Accepted 15 September 2018
Brendan Lloyd and
Alexandra Blazely are both
based at the School of
Psychological Sciences,
University of Melbourne,
Carlton, Australia.
Lisa Phillips is Professor at the
School of Psychological
Sciences, University of
Melbourne, Carlton, Australia.
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JOURNAL OF PUBLIC MENTAL HEALTH
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VOL. 17 NO. 4 2018, pp. 184-194, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-02-2018-0016
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