Hurting to Cope: Self-Injurious Behavior as an Escape from Self-Focus

Undergraduate Review Volume 6 Article 23 2010 Hurting to Cope: Self-Injurious Behavior as an Escape from Self-Focus Danielle Williams Follow this and additional works at: http://vc.bridgew.edu/undergrad_rev Part of the Psychology Commons Recommended Citation Williams, Danielle (2010). Hurting to Cope: Self-Injurious Behavior as an Escape from Self-Focus. Undergraduate Review, 6, 120-129. Available at: http://vc.bridgew.edu/undergrad_rev/vol6/iss1/23 This item is available as part of Virtual Commons, the open-access institutional repository of Bridgewater State University, Bridgewater, Massachusetts. Copyright © 2010 Danielle Williams Hurting to Cope: Self-Injurious Behavior as an Escape from Self-Focus DANIELLE WILLIAMS Danielle graduated from Bridgewater State College in January 2010, earning a Bachelor’s of Science in Psychology. Her research paper is a summary of her Honor’s thesis and has been presented at the Association for Psychological Science Conference. She would like to thank the psychology research lab at Bridgewater State College, the Adrian Tinsley Program, Joanne Michaud and, of course, her mentor Dr. Spievak. Danielle is pursuing graduate school in counseling psychology and plans to continue research. S elf-injurious behavior (SIB) is a prevalent problem in today’s society and is estimated to affect 4% of the general population (Darche, 1990; Nock & Prinstein, 2004). SIB has been described as a form of coping (Fliege et al., 2006) and a means of escaping negative feelings (Barrera, Violo & Graver, 2007; Nock & Prinstein, 2004), however it has not been examined within the framework of Baumeister’s escape-style-coping theory (Baumeister, 1991a; 1991b). In addition, although escape-style-coping theory has been linked with self-focused temperament (Spievak, 2003), SIB has not been examined in relation to chronic self-focus. It was hypothesized that those individuals who reported selfinjury would also be high in self-focus and report other related escape-style-coping behaviors. The results of two studies supported a positive correlation between selfinjury and self-focus and related escape-style-coping behaviors. Introduction Definitions of self-injurious behavior (SIB) vary slightly, but it is generally characterized as deliberate damage to body tissue without conscious suicidal intent. Prevalence rates of SIB may be as high as 4% in the general population, are as high as 21%-66% in clinical samples (Nock & Prinstein, 2004; Darche, 1990), and at least one self-injury incident was reported by 17% of college students in one recent study (Whitlock, Echenrode & Silverman, 2006). Although the definition specifies non-fatal injuries and self-injury is most often an isolated behavior that does not lead to suicide, there is a complex relationship between suicide and self-injury. For instance, one study found that 6.9% of a clinical sample that displayed self-harm behaviors later committed suicide (Hawton & Harriss, 2006). In another study, the authors found that about 1% of individuals who had received emergency care for SIB had committed suicide one year later (Howson, Yates & Hatcher, 2008). Indications that SIB may indeed suggest a risk for later suicidal behavior make further study even more important. The focus of the current research was to explicate the dispositional and situational vulnerabilities that predict SIB in the general population and investigate the often mentioned, but under researched function as a coping strategy. Until recently, research has been primarily descriptive and focused on special populations. For example, early research on SIB involved mostly mentally retarded, autistic (Barrera, Violo & Graver, 2007), and other disabled populations (Fliege, Kocalevent, Walter, Beck, Gratz & Gutierrez, 120 • THE UNDERGRADUATE REVIEW • 2010 BRIDGEWATER STATE COLLEGE 2006; Nock & Prinstein, 2004; Weierich & Nock, 2008). In addition, these studies generally employed case study methods (Barrera, Violo & Graver, 2007; Kress & Hoffman, 2008) or examined intervention techniques (Connors, 1996). The researchers often reported that SIB was more common when patients were under stress (Anderson & Ernst, 1994) and reexperiencing past traumas (Weierich & Nock, 2008). While not directly tested, one common supposition in the clinical literature is that SIB is used as a coping strategy. Nock & Prinstein’s (2004) research illustrated this concept through analyzing a comprehensive intake evaluation completed by 108 adolescents referred to a psychiatric inpatient unit for self-injurious thoughts or behaviors. Results revealed that participants reported engaging in SIB to cope with emotional difficulties. Other archival and survey studies have offered insight into possible dispositional and situational correlates and have documented common SIB behaviors. Fliege and colleagues (2006), who studied 361 mentally and behaviorally disordered adults, found that cutting was the most commonly reported form of SIB. In two studies (Nock, 2009; Weierich & Nock, 2008) researchers reported that individuals with a history of childhood abuse were more likely to engage in self-harm and in Weierich and Nock’s (2008) study of 84 sexually abused adolescents from psychiatric facilities, those who suffered from symptoms of posttraumatic stress disorder (PTSD) were more likely to engage in self-harm. Again, the work described above focused on special populations and the coping hypothesis was not directly tested in these studies, but the authors often suggested that the abuse survivors might have used SIB as a coping mechanism. To obtain a clearer picture of those who engage in SIB for coping purposes, it is important to examine how the research on coping and SIB might converge to predict the development of SIB as a learned coping strategy. Coping Style Much of the literature reviewed thus far has indicated a possibility that SIB serves as a coping mechanism. Additionally, in describing SIB, several authors have indirectly alluded to a style of coping that is closely aligned with mental or behavioral disengagement. This coping style is known as escape coping and is defined as emotion-focused efforts aimed at reducing the negative feelings associated with a stressful condition (Latack, 1986). Escape coping is effective in relieving negative feelings associated with anxiety, disappointment, dejection, and depression in the short term, but research concerning chronic escape-style-coping indicates long-term negative outcomes. Chronic escape-style-coping has been found in association with inferior physical and psychological health (Penley, Tomaka, & Wiebe, 2002; Rioli & Savick, 2003) including poor illness recovery outcomes (Lehto, Ojanen, Dyba, Aromaa & Kellokumpu-Lehtinen, 2006) and symptoms of workplace BRIDGEWATER STATE COLLEGE burnout and depersonalized manner (Rioli & Savick, 2003). Escape coping may be of interest in researching SIB because, when attentional resources are used to (...truncated)