Non-suicidal reasons for self-harm: A systematic review of self-reported accounts

J Affect Disord. 2016 Feb:191:109-17. doi: 10.1016/j.jad.2015.11.043. Epub 2015 Nov 28.


Background: Self-harm is a major public health problem yet current healthcare provision is widely regarded as inadequate. One of the barriers to effective healthcare is the lack of a clear understanding of the functions self-harm may serve for the individual. The aim of this review is to identify first-hand accounts of the reasons for self-harm from the individual's perspective.

Method: A systematic review of the literature reporting first-hand accounts of the reasons for self-harm other than intent to die. A thematic analysis and 'best fit' framework synthesis was undertaken to classify the responses.

Results: The most widely researched non-suicidal reasons for self-harm were dealing with distress and exerting interpersonal influence. However, many first-hand accounts included reasons such as self-validation, and self-harm to achieve a personal sense of mastery, which suggests individuals thought there were positive or adaptive functions of the act not based only on its social effects.

Limitations: Associations with different sub-population characteristics or with the method of harm were not available from most studies included in the analysis.

Conclusions: Our review identified a number of themes that are relatively neglected in discussions about self-harm, which we summarised as self-harm as a positiveexperience and defining the self. These self-reported "positive" reasons may be important in understanding and responding especially to repeated acts of self-harm.

Keywords: Function; Non suicidal; Self-harm; Systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Intention*
  • Interpersonal Relations*
  • Self Report
  • Self-Injurious Behavior / psychology*
  • Stress, Psychological / psychology*