Can the Integrated Motivational-Volitional Model of Suicidal Behaviour retrospectively differentiate between non-suicidal medically serious self-harmers, following hospital attendance, and those who attempt or die by suicide?

Oakes-Rogers, Sophie Alice (2022) Can the Integrated Motivational-Volitional Model of Suicidal Behaviour retrospectively differentiate between non-suicidal medically serious self-harmers, following hospital attendance, and those who attempt or die by suicide? Doctoral thesis, University of East Anglia.

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Abstract

Background
Self-harm and suicide are major public health issues, which are typically separated dichotomously, based on the presence or absence of suicidal intent, the frequency of self-harm and the severity of injuries sustained (American Psychiatric Association, 2013). However, literature suggests there are more discrete subgroups of self-harm that require further investigation. This has implications for theory and clinical practice. One such group is medically serious self-harm (MSSH), which has been defined as intentional self-harm, that is serious enough to require medical care within a general hospital (Breet & Bantjes, 2017).

Methods
The portfolio consisted of a systematic review and empirical paper. The systematic review explored the literature examining whether all instances of medically serious self-harm are attempts to end life, and the reasons for non-suicidal MSSH. The empirical paper explored whether motivational and volitional moderators from the Integrated-Volitional Model of Suicidal Behaviour (IMV, O’Connor & Kirkley, 2018), can retrospectively differentiate between those who enact hospital treated MSSH and those who attempt or die by suicide

Results
Eleven papers were identified and included in the systematic review. The systematic review found 49% of MSSH was enacted with suicidal intent, whilst 51% was not. Non-suicidal reasons fit within the dominant theory of non-suicidal self-injury, including coping with and regulating difficult internal emotional states, to stop or cope with intrapersonal conflict and to communicate to others to elicit a desired response. The empirical paper found The IMV model of suicidal behaviour differentiates between suicidal and non-suicidal hospital treated MSSH.

Conclusions
This thesis tentatively concludes that those who enact MSSH are not one homogenous group in that MSSH is underpinned by both suicidal and non-suicidal reasoning. Also, MSSH ought to be considered a separate subgroup of self-harm, given there are nuanced differences in the demographical profile of MSSH and the different psychological and social factors that contribute to non-suicidal MSSH, compared to suicidal behaviour. The findings align with overarching literature that cites there may be alternate, non-suicidal functions of MSSH and lends tentative support for the idea that contextualising MSSH purely within a suicidal framework is too simplistic.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Nov 2022 09:56
Last Modified:	09 Nov 2022 09:56
URI:	https://ueaeprints.uea.ac.uk/id/eprint/89725
DOI:

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