Effective Factors in the Formation of Deliberate Self-Harm in Adolescence: Mental Health Professional’s Viewpoint

Objective: This study aimed to investigate the issues related to the formation and persistence of deliberate self-harm behavior in adolescents from Iranian mental health professionals' viewpoints. Method: The present qualitative study used a semi-structured interview to record the experiences of 9 mental health professionals with work experience in deliberate self-harm behavior in adolescence. Participants have been selected by the purposive sampling method. The Sterling content analysis method had used to analyze the text of the interviews. Results: The semantic units of the interview classified into 32 initial codes. The Sub-themes which had extracted are listed below: a rejection of new identities, repression, the disintegration of social identity, materialism, economic poverty, unresolved parental conflicts, lack of authority, the ambivalency between boundaries and freedom, shame and guilt, blame, fear of harm, liberation, self-care, escape mechanism and replacement, affect regulation, coping with self-disintegration and self-esteem, relationship conflicts with adults and peers, identity creation, identity disorder, boundless mental structure, lack of self-confidence and distorted self-perception. Four themes, traumatic society, vulnerable family, interpersonal impact and interpersonal effectiveness had categorized as subcategories of the transformational injuries. Conclusion: On the one hand, mental health specialists considered deliberate self-harm traumatic, on the other hand, they deem it for getting rid of negative emotions and controlling the internal and external world of adolescents. Further, they consider this behavior as a reaction to cultural conflicts, cultural materialism, and the disintegration of identity and role during adolescence in families not being capable to facilitate low-risk transformation for adolescents due to economic and psychological factors.