Mallindine, Clare; (2002) To what degree does social rank theory help us to understand self-injurious behaviour amongst patients in a high security setting? Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

The aim of this study was to investigate the relationship between perceived social rank and self-injurious behaviour amongst patients in a high security hospital. The study also examined differences between individuals who engaged in a least one instance of self-injurious behaviour during a 5-year period (N=21) and those who had never self-injured (N=15). Participants were asked to complete self-report questionnaires designed to measure feelings relating to social put-down, general levels of shame and depression, level and quality of self-capacities (e.g. relatedness, identity and affect regulation), and autobiographical memory. It was found that males who self-injured were significantly more likely to have a history of substance abuse than those who did not self-injure. Males participants who self-harmed reported experiencing greater difficulties in the areas of self capacities; were more sensitive to social put-downs and produced significantly more memories which were over-general, than those who had never engaged in self-injury. The female participants (N=13) who displayed greatest over-general recall had the fewest episodes of self-injury in the last 5 years. This suggests that for some individuals at least, over-general memory may have an adaptive function in helping to protect individuals from the build-up of the kinds of thoughts, memories, and feelings which may lead to self-harm. Finally, while there was no significant difference between males who self-injured and those who did not in relation to their 'general' perception of social rank, as predicted, both men and women reported experiencing a dramatic fall in their perceived social rank just prior to self-injurious behaviour. Immediately following the act of self-injury, the female's perception of social rank returned to within the 'normal' range relative to their own base-rate. While men also reported that their perception of social rank increased following the act of self-injury, it appears to take longer before there is a return to 'normal' levels relative to their own base-rate. The study highlighted several variables of clinical interest within this client group which seem to discriminate self-harmers from those who do not. The findings provide preliminary evidence for the development of interventions directed at addressing self-injuring individual's perceived social status, difficulties in the area of self-capacities (relatedness, identity and emotion regulation), and autobiographical recall.

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