Year

2022

Degree Name

Doctor of Psychology (Clinical Psychology)

Department

School of Psychology

Abstract

Self-harm is a global youth mental health priority, identified as one of the top 25 causes of mortality in children and adolescents internationally (Global Burden of Disease Pediatrics Collaboration, 2016). Several variables are identified as potentially influencing responses to self-harm, including beliefs about the functions of self-harm behaviour, attitudes and knowledge regarding self-harm, and self-appraisals of gatekeeper attributes. This thesis explored the factors that influence responses to selfharm behaviour by potential gatekeepers and peers. It explored the relationship between these variables and helping and discriminatory responses utilising an adaptation of the attribution model of public stigma (Corrigan et al., 2003), comprised of stigmatising cognitive, emotional, and behavioural responses to self-harm. The thesis also sought to address a number of methodological limitations apparent in the broader self-harm literature. Study 1 investigated the perceived functions of self-harm reported by potential gatekeepers and examined how these compare to the self-reported functions of self-harm in young people. Data for this study was obtained from three sources. First, postgraduate trainee teachers (N =111, also participants in Study 2) and postgraduate school counselling students (N = 37). Second, undergraduate psychology students (N =238, also participants in Study 3). These groups were compared to archival data from a clinical reference group of 281 young people attending treatment at a suicide prevention program (Rankin, 2016). Participants completed a survey regarding their beliefs about young people who self-harm, including the Inventory of Statements about Self-Harm (Klonsky & Glenn, 2009). Participants endorsed all functions of self-harm at higher rates than the comparison clinical reference group. They also endorsed interpersonal functions to a greater extent than the clinical reference group. Study 2 investigated the perceptions and responses to the self-harm behaviour of young people amongst 97 trainee teachers (aged 20–51 years). Participants were randomised to receive one of two vignettes depicting self-harm that was either hidden or displayed by a young person. The vignettes aimed to infer either an interpersonal (displayed) or intrapersonal (hidden) motivation. Participants completed self-report measures assessing stigmatising cognitive, emotional, and behavioural responses to self-harm. Self-appraised gatekeeper attributes and staff attitudes towards self-harm were also assessed. Results suggest that perceived motivation for self-harm influences participants’ stigmatising responses to self-harm. Additionally, participants’ gatekeeper attributes and their staff-related attitudes towards self-harm appear to influence their cognitive, emotional, and behavioural responses to self-harm, dependent on what they perceive the motivation to be. Study 3 examined the relationship between pre-existing beliefs regarding the functions of self-harm and helping/discriminatory responses in the undergraduate sample (N = 237). Helping and discriminatory responses to self-harm were compared with an existing psychophysical measure that generated thresholds for helping intentions based on the frequency of self-harm behaviours (scratches) presented (Turner et al., 2021). Participants were randomised to receive one of three vignettes depicting self-harm as either hidden or displayed with a third control condition where no information about the self-harm was provided (control). Participants completed questionnaires assessing responses towards the vignette, help-seeking attitudes, beliefs about the functions of self-harm, and engaged in a computer-based task assessing helping-intentions for self-harm. Results indicated that stronger endorsement of interpersonal functions were related to more discriminatory responses to self-harm (e.g., blame, anger, coercion, and reduced helping). Conversely, stronger endorsement of intrapersonal functions were related to less discriminatory responses. Participants’ responses to self-harm were consistent with the attribution model of stigma (Corrigan et al., 2003), and components of a parallel ‘danger-appraisal’ hypothesis wherein discriminatory responses related to perceptions of dangerousness are mediated by fear, rather than personal responsibility beliefs. There were no significant differences in either helping thresholds or helping/discriminatory responses between vignette conditions. Participants’ thresholds were not significantly correlated with other measures of help-seeking attitudes or helping/discriminatory responses. These results suggest that beliefs regarding the functions of self-harm account for significant variance in helping and discriminatory responses to self-harm. Future research regarding gatekeeper interventions for self-harm behaviour in schools should take into consideration relevant beliefs regarding the motivations of self-harm behaviour. These findings also highlight an opportunity to develop attributional approaches to understanding stigma in contexts that deviate from typical peer-to-peer relationships.

Comments

Thesis by publication

FoR codes (2008)

111714 Mental Health

FoR codes (2020)

520199 Applied and developmental psychology not elsewhere classified

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.