Risk and protective factors of deliberate self-harm among individuals with substance use disorder: A qualitative study in Pakistan.

OBJECTIVES

This study aimed "To identify the factors which increase the vulnerability of self-harm behavior among individuals with substance use and factors which buffer that risk".

METHODS

The present qualitative study was hosted by National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan. It took seven months, from October 2021 to April 2022 to conduct the study. Face-to-face in-depth interviews were conducted in rehabilitation centers of two different cities. The sample of the study included ( = 26) participants, 21 individuals with substance use disorder (with/without deliberate self-harm), and five experts (experienced in dealing with the target population). All the interviews were recorded and transcribed for reflexive thematic analysis. A brief survey was also used to get information about demographics and self-harm behaviors.

RESULTS

The analysis helped to develop nine themes (six risk factors & three protective factors), including separate subthemes for each. The themes were named as a spectrum of adverse experiences, maladaptive personality traits, poor methods of dealing with stressors, chaotic emotions and thoughts about self, internalizing and externalizing problems, and self-harm-related specific factors. Additionally, themes generated for the protective factors were supportive social ties, adaptive coping strategies, and promoting personal resources.

CONCLUSION

Specific familial, social, and personal factors increase the likelihood of self-harm by causing negative self-evaluation, poor coping skills and psychological distress. This vulnerability ends with self-harm, when combined with conducive environmental situations for the risky behavior. However, the risk can be decreased by providing social and emotional support and encouraging positive mental attitudes.