The relationship between self-harm and alexithymia: a systematic review and meta-analysis
Article
Norman, H., Oskis, A., Marzano, L. and Coulson, M. 2020. The relationship between self-harm and alexithymia: a systematic review and meta-analysis. Scandinavian Journal of Psychology. 61 (6), pp. 855-876. https://doi.org/10.1111/sjop.12668
Type | Article |
---|---|
Title | The relationship between self-harm and alexithymia: a systematic review and meta-analysis |
Authors | Norman, H., Oskis, A., Marzano, L. and Coulson, M. |
Abstract | Self-harm, defined for the purpose of this review as any act of self-injury without explicit suicidal intent, is an increasing public health concern, with potential long-term implications for those who engage in it. Previous research has identified a correlational relationship between self-harm and alexithymia, an emotion processing deficit characterised by difficulties identifying and describing feelings, and an externally-orientated thinking style. Through a systematic search of the literature, the current review examines the association between alexithymia and self-harm. A meta-analysis based on 23 studies found a significant, positive relationship between self-harm and alexithymia, with a medium effect size (g = 0.57, 95% CI 0.45 to 0.71). All 23 studies used the Toronto Alexithymia Scale (TAS20) to measure alexithymia. The alexithymia subcomponents difficulty identifying feelings and difficulty describing feelings were significantly associated with self-harm, but there was no significant association between self-harm and externally-orientated thinking. The effect size of the relationship was significantly larger in adolescent samples compared with adult samples and in female compared with male samples. The definition of self-harm did not affect the effect size of the relationship between alexithymia and self-harm and the results are consistent with previous meta-analyses focused more narrowly on non-suicidal self-injury and, separately, suicidal behaviours. Heterogeneity between the included studies was high. The results support an affect regulation model of self-harm, in which self-harm is used to regulate an emotional experience that is poorly understood. |
Keywords | Self-harm; alexithymia; NSSI; emotion regulation; meta-analysis |
Research Group | Applied Health Psychology group |
Publisher | Wiley |
The Scandinavian Psychological Associations | |
Journal | Scandinavian Journal of Psychology |
ISSN | 0036-5564 |
Electronic | 1467-9450 |
Publication dates | |
Online | 24 Jul 2020 |
25 Nov 2020 | |
Publication process dates | |
Deposited | 24 Jun 2020 |
Accepted | 02 Jun 2020 |
Output status | Published |
Publisher's version | License File Access Level Open |
Accepted author manuscript | File Access Level Restricted |
Copyright Statement | © 2020 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd |
Digital Object Identifier (DOI) | https://doi.org/10.1111/sjop.12668 |
Web of Science identifier | WOS:000551515400001 |
Language | English |
https://repository.mdx.ac.uk/item/88zxq
Download files
67
total views14
total downloads3
views this month0
downloads this month
Export as
Related outputs
Digital mental health in schizophrenia and other severe mental illness: an international consensus on current challenges and potential solutions
Smith, K., Hardy, A., Vinnikova, A., Blease, C., Milligan, L., Hidalgo-Mazzei, D., Lambe, S., Marzano, L., Uhlhaas, P., Ostinelli, E., Anmella, G., Zangani, C., Aronica, R., Dwyer, B., Torous, J. and Cipriani, A. 2024. Digital mental health in schizophrenia and other severe mental illness: an international consensus on current challenges and potential solutions. JMIR Mental Health. 11, pp. 1-22. https://doi.org/10.2196/57155Characteristics and circumstances of rail suicides in England 2019-2021: a cluster analysis and autopsy study
Norman, H., Marzano, L., Fields, B., Brown, S., MacDonald Hart, S. and Kruger, I. 2024. Characteristics and circumstances of rail suicides in England 2019-2021: a cluster analysis and autopsy study . Journal of Affective Disorders. 354, pp. 397-407. https://doi.org/10.1016/j.jad.2024.03.020A police-led real-time surveillance system for suspected suicides in Great Britain
Marzano, L., Norman, H., Sohal, B., Hawton, K. and Mann, R. 2023. A police-led real-time surveillance system for suspected suicides in Great Britain. BMJ Mental Health. 26 (1). https://doi.org/10.1136/bmjment-2022-300643Linguistic profile automated characterisation in pluripotential clinical high-risk mental state (CHARMS) conditions: methodology of a multicentre observational study
Magnani, L., Carmisciano, L., dell’Orletta, F., Bettinardi, O., Chiesa, S., Imbesi, M., Limonta, G., Montagna, E., Turone, I., Martinasso, D., Aguglia, A., Serafini, G., Amore, M., Costanza, A., Sibilla, F., Calcagno, P., Patti, S., Molino, G., Escelsior, A., Trabucco, A., Marzano, L., Brunato, D., Ravelli, A., Cappucciati, M., Fiocchi, R., Guerzoni, G., Maravita, D., Macchetti, F., Mori, E., Paglia, C., Roscigno, F. and Saginario, A. 2023. Linguistic profile automated characterisation in pluripotential clinical high-risk mental state (CHARMS) conditions: methodology of a multicentre observational study. BMJ Open. 13. https://doi.org/10.1136/bmjopen-2022-066642Factors prompting and deterring suicides on the roads
Norman, H., Marzano, L., Winter, R., Ioana, C., Mackenzie, J. and Marsh, I. 2023. Factors prompting and deterring suicides on the roads. BJPsych Open. 9 (3). https://doi.org/10.1192/bjo.2023.52Media coverage and speculation about the impact of the COVID-19 pandemic on suicide: a content analysis of UK news
Marzano, L., Hawley, M., Fraser, L., Lainez, Y., Marsh, J. and Hawton, K. 2023. Media coverage and speculation about the impact of the COVID-19 pandemic on suicide: a content analysis of UK news. BMJ Open. 13 (2). https://doi.org/10.1136/bmjopen-2022-065456Quality traceability for user-centric context-aware systems in intelligent environments
Sakanga, N., Augusto, J., Brodie, L. and Marzano, L. 2022. Quality traceability for user-centric context-aware systems in intelligent environments. Work-07: Digital Innovation for people well-being: Healthcare and Agriculture perspectives . Yokohama, Japan 07 Nov 2022 IEEE. https://doi.org/10.1109/WF-IoT54382.2022.10152209"My heart and my brain is what's bleeding, these are just cuts." An interpretative phenomenological analysis of young women's experiences of self-harm
Norman, H., Marzano, L., Oskis, A. and Coulson, M. 2022. "My heart and my brain is what's bleeding, these are just cuts." An interpretative phenomenological analysis of young women's experiences of self-harm. Frontiers in Psychiatry. 13, pp. 1-7. https://doi.org/10.3389/fpsyt.2022.914109Parenting adolescent daughters: differential effects of maternal attachment insecurity and proximity-seeking
Oskis, A., Thorn, L. and Clow, A. 2022. Parenting adolescent daughters: differential effects of maternal attachment insecurity and proximity-seeking. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 24 (1), pp. 69-86. https://doi.org/10.3280/MAL2022-001005Have news reports on suicide and attempted suicide during the COVID-19 pandemic adhered to guidance on safer reporting? A UK-wide content analysis study
Marzano, L., Hawley, M., Fraser, L., Harris-Skillma, E., Lainez, Y. and Hawton, K. 2022. Have news reports on suicide and attempted suicide during the COVID-19 pandemic adhered to guidance on safer reporting? A UK-wide content analysis study. Crisis: The Journal of Crisis Intervention and Suicide Prevention. https://doi.org/10.1027/0227-5910/a000856Intervening to prevent suicide at railway locations: findings from a qualitative study with front-line staff and rail commuters
Katsampa, D., Mackenzie, J., Crivatu, I. and Marzano, L. 2022. Intervening to prevent suicide at railway locations: findings from a qualitative study with front-line staff and rail commuters. BJPsych Open. 8 (2), pp. 1-7. https://doi.org/10.1192/bjo.2022.27Representing suicide: giving voice to a desire to die?
Marsh, I., Winter, R. and Marzano, L. 2022. Representing suicide: giving voice to a desire to die? Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. 26 (1), pp. 10-26. https://doi.org/10.1177/13634593211046843![](/~18/aqs/default-thumbnail.png)
"Hard to say, hard to understand, hard to live": possible associations between neurologic language impairments and suicide risk
Costanza, A., Amerio, A., Aguglia, A., Magnani, L., Serafini, G., Amore, M., Merli, R., Ambrosetti, J., Bondolfi, G., Marzano, L. and Berardelli, I. 2021. "Hard to say, hard to understand, hard to live": possible associations between neurologic language impairments and suicide risk. Brain Sciences. 11 (12). https://doi.org/10.3390/brainsci11121594"I can’t describe it and they can’t see the rain." an interpretative phenomenological analysis of the experience of self-harm in young adults who report difficulties identifying and describing their feelings
Norman, H., Marzano, L., Oskis, A. and Coulson, M. 2023. "I can’t describe it and they can’t see the rain." an interpretative phenomenological analysis of the experience of self-harm in young adults who report difficulties identifying and describing their feelings. Current Psychology. 42 (12), pp. 10151-10162. https://doi.org/10.1007/s12144-021-02273-7MasterChef: a Master class in fight, flight, or flambé?
Oskis, A. 2021. MasterChef: a Master class in fight, flight, or flambé? Gastronomica. 21 (1), pp. 58-64. https://doi.org/10.1525/gfc.2021.21.1.58The relationship between alexithymia and self-harm: the mediating role of mindfulness
Norman, H., Marzano, L., Oskis, A. and Coulson, M. 2021. The relationship between alexithymia and self-harm: the mediating role of mindfulness. Current Psychology. https://doi.org/10.1007/s12144-021-01553-6Reporting on suicidal behaviour and COVID-19—need for caution
Hawton, K., Marzano, L., Fraser, L., Hawley, M., Harris-Skillma, E. and Lainez, Y. 2021. Reporting on suicidal behaviour and COVID-19—need for caution. The Lancet Psychiatry. 8 (1), pp. 15-17. https://doi.org/10.1016/S2215-0366(20)30484-3The child attachment style interview (Child-ASI) and depression: preliminary findings
Bifulco, A., Jacobs, C., Oskis, A., Bunn, A. and Spence, R. 2021. The child attachment style interview (Child-ASI) and depression: preliminary findings. Educational and Child Psychology. 38 (1), pp. 62-74.Suicidal behavior in individuals accused or convicted of child sex abuse or indecent image offenses: systematic review of prevalence and risk factors
Key, R., Underwood, A., Farnham, F., Marzano, L. and Hawton, K. 2021. Suicidal behavior in individuals accused or convicted of child sex abuse or indecent image offenses: systematic review of prevalence and risk factors. Suicide and Life-Threatening Behavior. 51 (4), pp. 715-728. https://doi.org/10.1111/sltb.12749Patterns and motivations for method choices in suicidal thoughts and behaviour: qualitative content analysis of a large online survey
Marzano, L., Katsampa, D., Mackenzie, J., Kruger, A., El-Gharbawi, N., Ffolkes-St-Helene, D., Mohiddin, H. and Fields, B. 2021. Patterns and motivations for method choices in suicidal thoughts and behaviour: qualitative content analysis of a large online survey. BJPsych Open. 7 (2), pp. 1-6. https://doi.org/10.1192/bjo.2021.15First-person accounts of the processes and planning involved in a suicide attempt on the railway
Marsh, I., Marzano, L., Mosse, D. and Mackenzie, J. 2021. First-person accounts of the processes and planning involved in a suicide attempt on the railway. BJPsych Open. 7 (1). https://doi.org/10.1192/bjo.2020.173Exposure to and experience of self-harm and self-harm related content: an exploratory network analysis
Kirtley, O., Hussey, I. and Marzano, L. 2021. Exposure to and experience of self-harm and self-harm related content: an exploratory network analysis. Psychiatry Research. 295, pp. 1-8. https://doi.org/10.1016/j.psychres.2020.113572Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences
Lascelles, K., Marzano, L., Brand, F., Trueman, H., McShane, R. and Hawton, K. 2021. Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences. BJPsych Open. 7 (1), pp. 1-8. https://doi.org/10.1192/bjo.2020.132Overwhelmed and powerless: staff perspectives on mother - infant separations in English prisons
Powell, C., Ciclitira, K. and Marzano, L. 2020. Overwhelmed and powerless: staff perspectives on mother - infant separations in English prisons. Journal of Criminal Psychology. 10 (4), pp. 311-328. https://doi.org/10.1108/JCP-04-2020-0017Covid-19: the last call for telepsychiatry
Amerio, A., Odone, A., Marzano, L., Costanza, A., Aguglia, A., Serafini, G., Signorelli, C., Ghaemi, S. and Amore, M. 2020. Covid-19: the last call for telepsychiatry. Acta biomedica: Atenei Parmensis. 91 (3). https://doi.org/10.23750/abm.v91i3.10337Associations between adult attachment and vision-related quality of life in visually impaired individuals
Ctori, I., Ahmad, S., Subramanian, A. and Oskis, A. 2020. Associations between adult attachment and vision-related quality of life in visually impaired individuals. Psychology, Health & Medicine. https://doi.org/10.1080/13548506.2020.1778749Assessing parenting in potentially abusive parents: a qualitative evaluation of practitioner responses to the parenting role interview
Barry, R., Edwards, S., Oskis, A. and Carraro, E. 2019. Assessing parenting in potentially abusive parents: a qualitative evaluation of practitioner responses to the parenting role interview. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 21 (3), pp. 39-53. https://doi.org/10.3280/MAL2019-003004Caregiving and care seeking as predictors of depression in girls: a pilot study of parenting in mother-daughter dyads
Oskis, A., Thorn, L. and Clow, A. 2019. Caregiving and care seeking as predictors of depression in girls: a pilot study of parenting in mother-daughter dyads. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 21 (3), pp. 11-21. https://doi.org/10.3280/MAL2019-003002![](/~18/aqs/default-thumbnail.png)