Deliberate self-harm among adolescents in South African children’s homes

Abstract

The current study is motivated by the relative lack of research on the contagion of deliberate self-harm, research on self-harm among adolescents in children's homes, as well as South African research on self-harm. In this study, I explore three aspects concerning deliberate self-harm in the South African context: The perceptions of adolescents in children's homes concerning the possible contagion of self-harm; the frequency, methods, duration and severity of self-harm among adolescents in children's homes; and lastly, the motivations of adolescent self-harm in children's homes. I make use of both quantitative measures, being the Deliberate Self-Harm Inventory (DSHI) developed by Gratz (2001) and the Functional Assessment of Self-Mutilation (FASM) developed by Lloyd (1997), and qualitative measures, being the logbooks completed by participants and three semi-structured interviews conducted, to address these questions. The current study uses both the functional approach to deliberate self-harm, that classifies self-harm according to the four functions that produce and maintain such behaviour, and the environmental model that emphasises the situational influences on the contagion of deliberate self-harm. The findings of the study indicate that 10 of the 12 adolescent participants have experienced either the acquisition or episodes of co-occurrence of self-harm through contagion, both outside the children's homes and within the children's homes. The contagion of self-harm is influenced by the desensitisation and growing prevalence of self-harm, frequent observations of self-harm, close personal relationships between individuals who selfharm, and the influence of the visual media. With regard to the findings of the DSHI, the methods most commonly employed for self-harm in the study include cutting, carving words into the skin, as well as the breaking of bones; the majority of the methods had been employed by the participants within the last year; and the emotions present immediately prior to the episode of self-harm include anger, depression, sadness, frustration, anxiety and disappointment. Findings from the FASM indicate that the motivation for the majority of the adolescent participants' self-harm is 'to stop bad feelings'. Furthermore, the findings of the study indicate that psychological intervention may be available to adolescents in several situations; that the personal histories of the adolescent participants include experiences of physical, emotional and sexual abuse, parental unavailability, the observation of parental alcoholism, as well as the experience of human trafficking; and suicide attempts have been made by the participants following instances of perceived ineffectiveness of self-harm. From the findings, it is evident that the contagion of self-harm is no longer a hypothetical phenomenon. Further implications of the study include the need for continued research on the methods reported by South African individuals who engage in self-harm that are not as prevalent in other research; and the influence of the study on the development and implementation of interventions to address self-harm in children's homes. Copyright