Deliberate self-harm as an addictive behaviour : a systematic analysis

This thesis focuses on two prominent theories of addiction and the predictions that they make when applied to DSH. Results from the second study indicated that those who self-harm endorse many criteria of clinical dependence and behavioural addiction. The results also suggested that theories of addiction may go some way towards enhancing our understanding of the mechanisms that maintain DSH. Reported pain was significantly higher for early self-harming episodes compared to later episodes and accidental episodes and accidental episodes of injury. Longer lasting tension effects were reported for later episodes. Episodes of DSH also regulated the intensity of happiness, anger and sadness. This supports predictions made by the Opponent Process theory (OPT) of addiction. However, OPT could not account for all of the results. Emotional regulation was not more pronounced in later episodes, neither were injuries more severe. Further testing of this theory was therefore necessary. The third study considered the valence of cues associated with self-harm, using implicit and explicit measures. The findings indicate that the valence of the cues was not aiding the maintenance of the behaviour, i.e. that motivation to maintain self-harming persisted regardless of the attribution of the cues, refuting predictions made by OPT. The final set of studies used an implicit task to test predictions made by another addiction theory (the Incentive Sensitisation Theory; Robinson & Berridge, 1993). An attentional bias toward words associated with self-harm and personalised self-harm picture stimuli was demonstrated by those currently self-harming but not by those who had never self-harmed, supporting predictions made by the theory; however abstainers also demonstrated a lack of attentional vigilance to self-harm cues, refuting predictions made by IST.