Non suicidal self-injury: how adolescents understand and interpret their emotions and how their parents understand and interpret their adolescents’ emotion

Background: The dominant theories explaining non-suicidal self-injury (NSSI) focus on emotion regulation and stress reduction. International research confirms that the onset age for NSSI is between 12 and 15 years, with the behaviour largely hidden from clinical services. Research reveals that adolescents engaging in NSSI have greater difficulty with emotion regulation and exhibit elevated rates of internalising and externalising symptoms. A vital part of emotion regulation is emotion understanding. However research has yet to explore how adolescents engaging in NSSI or their parents understand emotion. Aim: The present study aimed to explore adolescent and parent understanding of their own emotion and their understanding of the emotions of others. Method: This was a qualitative study, using in-depth interviews with adolescents who engaged in NSSI (as defined by the Diagnostic and Statistical Manual - Fifth Edition) and their parents or main caregiver. Semi-structured interviews were used to explore adolescents and parents understanding of their own and others’ emotion. Data were audio recorded and transcribed verbatim. Findings: An Interpretative Phenomenological Analysis (IPA) revealed a number of superordinate and subordinate themes. The superordinate themes included ‘Emotional Wounds’ from past unresolved losses; ‘Barriers to Emotion Understanding’, related to the ways in which emotion understanding gets blocked; and ‘Communicating without Understanding’ related to how blocked understanding interferes within interpersonal communication. Conclusion: The findings are discussed in the context of current theory and implications for policy and practice. Limitations and strengths of the study are discussed and suggestions for future research are proposed.