Date of Award
Psychology, Compulsive, Deliberate self-harm, Impulsive
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Although non-suicidal deliberate self-harm (DSH) is often characterized as impulsive in the literature, the impulsive and compulsive features of DSH have not been adequately investigated. This study used qualitative and quantitative methods to examine the impulsive and compulsive features of DSH in two samples: clinicians describing the prototypical DSH client (N = 115) and undergraduates self-reporting on DSH experiences (N = 96). Of 3460 undergraduates, 12.14% endorsed a history of multiple DSH episodes. Both samples endorsed predominantly multiple methods including self-cutting, scratching, burning, and hitting. According to Simeon and Favazza's (2001) hypothetical model, these would be classified as "impulsive" DSH (98.25% in clinician sample, 94.79% in undergraduate sample). It was predicted that clinicians would describe DSH as more impulsive than compulsive, consistent with this model. In contrast, it was predicted that undergraduates would describe more compulsivity than impulsivity in association with DSH. Items generated to reflect impulsive and compulsive features of DSH were evaluated using expert ratings of these items and established measures of impulsivity and compulsivity. Analyses within and between the two samples revealed: (1) a set of items designed to reflect impulsive and compulsive features of DSH can be reduced to components relating to these two constructs in both samples; (2) impulsivity and compulsivity as reflected in these items show a negative correlation (r = -.42, p < .01); (3) clinicians described more compulsive than impulsive features in association with the prototypical DSH client's DSH; (4) undergraduates described more compulsive than impulsive features in association with DSH; (5) in undergraduates, general impulsivity and compulsivity positively predicted the number of methods of DSH, while DSH specific compulsive features were positive predictors of number of methods, frequency, and frequency per year. Impulsive/urge-driven features positively predicted number of methods and negatively predicted severity. Qualitative data offered insights into the complex relationship between impulsivity and compulsivity. These findings suggest that it is inaccurate to qualify these forms of DSH as "impulsive" in clinical and non-clinical settings, and that compulsivity (particularly specifically as it relates to DSH) may play a unique and important role in DSH. Suggestions for future research are discussed.
Bertrim, Sarah, "The experience of deliberate self -harm: Impulsive and compulsive features" (2008). Electronic Theses and Dissertations. 8194.