Perceptions of family functioning in adolescents who self‐harm

Abstract

This study compares the self-reported family functioning of 21 adolescents presenting at four UK medical wards with self-harming behaviour with those obtained from a sample of adolescents drawn from the local community. Adolescents hospitalized for self-harm reported that their families were more dysfunctional than healthy controls on the family perceptions scale. However, this difference was not observed when covariates such as emotional and behavioural distress were controlled for. Poor levels of agreement between adolescents and adult family members in relation to family perceptions were also observed. The findings suggest that adolescents who engage in significant self-harm perceive impairments in their family functioning. These reported impairments may be the result of concurrent emotional and behavioural distress or some form of interaction between family functioning and distress. A comprehensive family assessment to detect absolute changes and disparities in perceived family functioning may therefore help guide family interventions in this context. Practitioner points• Adolescents who are hospitalized for self-harm report significant impairments in family functioning compared with healthy controls. • Adolescent and adult family members appear to disagree on the degree of impaired family functioning. • A comprehensive family assessment may therefore help guide family interventions in hospitalized adolescents.

The Relationship Between Nonsuicidal Self‐Injury and Family Functioning: Adolescent and Parent Perspectives

“…Among dyads where the adolescent is experiencing mental illness, such as major depressive disorder, adolescents typically report poorer family functioning than their parents (e.g., Tamplin, Goodyer, & Herbert, ). Recently, Palmer, Welsh, and Tiffin () extending this finding to NSSI, reporting that the sampled adolescents who presented to a medical ward in England for an episode of self‐injury reported significantly poorer family functioning than their parents. Palmer et al.…”

“…Palmer et al. 's () findings indicate that parents may not be aware how poorly the family unit is perceived by their adolescent with a history of self‐injury. However, this study treated parent and adolescent reports as independent which is inappropriate given the intrafamilial correlations of reported family functioning.…”

Family and School Contexts as Predictors of Suicidal Behavior among Adolescents: The Role of Depression and Anxiety

“…Family function has been defined as the interactions between-and reactions to-family members [11], and such interactions being dysfunctional has been related to mental health disturbances and higher rates of suicidal behavior during adolescence [6,9,10]. In line with this, it has been demonstrated that adolescents who self-harm perceive significant impairments in family function [12]. Several mechanisms have been proposed to explain the relationship between family dysfunction and suicidal behavior in adolescents.…”

Understanding Adolescents’ Experiences of Self-Harm: Secondary Analysis of Family Therapy Sessions from the SHIFT Trial

“…Questionnaires have often been used in research, arm, predominantly to assess prevalence and identify reasons given for self-harm (Nock & Prinstein, 2004;Lloyd-Richardson, Perrine, Dierker and Kelley, 2007;Palmer, Welsh & Tiffin, 2016). One difficulty with the use of questionnaires to understand the reasons why people self-harm is that the very use of the measure limits the choices for the respondent.…”