Doctor of Psychology (Clinical)
School of Psychology - Faculty of Health & Behavioural Sciences
Padoa, Carryn, Deliberate self-harm: a search for self or a cry for help?, DPsyc(Clin) thesis, School of Psychology, University of Wollongong, 2008. http://ro.uow.edu.au/theses/146
Objective: The aim of this study was to advance current research on the functions and expressions of self-injury and in particular to examine two motives of self-harm: (a) self-harm in response to threats to self (termed: search for self) and (b) self-harm as an act of communication to others (termed: a cry for help). Method: Study 1 investigated 45 participants attending accident and emergency departments following an episode of self-harm. All completed a structured interview and a repertory grid task. Interviews transcripts were classified: ‘cry for help’ (anaclitic) or ‘search for self’ (introjective). Self-harm characteristics were obtained using The Parasuicide History Interview which assesses for the number, method, intent, and medical severity of the self-harm event. Study 2 aimed to replicate study 1 using a clinical sample of 42 patients with Borderline Personality Disorder and comorbid Major Depressive Disorder. Results: Anaclitic typography represented significantly greater risk when compared to introjective psychopathology, despite the latter group exhibiting greater psychological constriction and more frequent episodes of self-harm. In addition, there appeared to be some important differences in the methods of self-harm chosen by the two groups, with anaclitic individuals utilising non-violent but potentially lethal methods compared to introjective individuals who utilised more violent and invasive methods of self-harm. Conclusion: Suicidal individuals who self-harm may be differentiated in terms of their motive, namely as a cry for help (anaclitic) or as a search for self (introjective). In this study, particular precautions and interventions are suggested following suicidal communications or behaviours by those individuals with anaclitic vulnerabilities, given their cry for help may be associated with more impulsive gestures that are unplanned and thus higher in medical lethality than introjective self-harmers, who engage in more frequent low-level attempts involving carefully planned actions.
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