Stigma and nonsuicidal self-injury: Application of a conceptual framework.

Abstract

Nonsuicidal self-injury (NSSI) is a stigmatized behavior that involves intentionally damaging one’s own body, usually by cutting or burning the skin. Despite evidence that NSSI is stigmatized, the processes underlying NSSI stigma and associated outcomes are poorly understood. Given associations between NSSI and mental illness, NSSI may incur mental illness–related stigma. Additionally, NSSI is self-inflicted, which violates societal expectations of self-preservation, resulting in stigmatization. Finally, NSSI leaves physical marks in the form of wounds and scars that are subject to stigmatization. These behavioral and physical aspects of NSSI mean that a mental illness stigma lens may not holistically capture the experience and process of NSSI stigma. Understanding the manifestation and experience of NSSI stigma is a critical step toward stigma reduction. Given the incipient nature of research in this area, we have a unique opportunity to provide a theoretically grounded foundation to stimulate future work. In this article, we draw on theoretical perspectives to demonstrate the complexity of NSSI stigma and identify possible constructs that may underlie the development and experience of NSSI stigma. We then provide a theoretically and empirically informed framework to guide future work in this area.

Self‐injury recovery: A person‐centered framework

“…A common concern for many individuals who have self‐injured is the aspect of disclosure (Rosenrot & Lewis, 2018). Understandably, given the significant shame and stigma associated with NSSI (e.g., Long, 2018; Staniland et al, 2020), many individuals are reluctant to share their experiences (Rosenrot & Lewis, 2018). Yet, for many people, disclosing NSSI may be a critical part of the recovery experience (Lewis & Hasking, 2020).…”

Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources

“…Previous research has also highlighted that some medical health professionals hold negative and stigmatising attitudes towards people who self-injure (Karman et al, 2015;Saunders et al, 2012). These attitudes may be exacerbated during the increased stress and demands on resources created by COVID-19, perhaps impacting subsequent helpseeking behaviour beyond the current pandemic (Staniland et al, 2020).…”

“…The loss of support provided by schools is even more harmful for youth at risk of, or engaging in, NSSI. Coupled with the stigma associated with NSSI (Burke et al, 2019;Lloyd et al, 2018;Staniland et al, 2020) and the hesitation among youth to disclose their self-injury (Rosenrot & Lewis, 2018), the loss of school support presents an added layer of challenges to receiving services. The protective factor that school mental health professionals play in offering accessible, face-toface support and mitigating negative outcomes of youth who engage in NSSI (Hasking et al, 2016) has been interrupted.…”

Understanding Self-Injury: A Person-Centered Approach

“…Accordingly, this Open Forum offers a framework to be used in clinical work to yield better outcomes for both individuals who self-injure and health care workers who care for them. We do not offer a treatment guide but rather a new way to think about self-injury that is commensurate with recent movements in the field to adopt a person-centered approach when working with people who self-injure (3,10,11). Because many individuals who engage in self-injury experience a sense of being stigmatized and misunderstood (9,11), this framework is intended for use with all individuals who selfinjure.…”