Using implementation intentions to reduce self-harm

Paterson, Abigail

Thesis

Using implementation intentions to reduce self-harm

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Creator

Paterson, Abigail

Rights statement

Strathclyde Thesis Copyright

Awarding institution

University of Strathclyde

Date of award

2024

Thesis identifier

T16855

Person Identifier (Local)

201853404

Qualification Level

Doctoral (Postgraduate)

Qualification Name

Doctor of Philosophy (PhD)

Department, School or Faculty

Department of Psychological Sciences and Health

Abstract

Implementation intentions (IMPs) are IF-THEN plans that require people to specify critical situations (e.g., situations that tempt a behaviour, such as self-harm) and link those situations with goal-directed responses (e.g., coping strategies). This research tested the effectiveness of an intervention technique (a volitional help sheet) designed to encourage the formation of IMPs to avoid self-harm thoughts and behaviour in the wider community. Chapter 1 discusses the prevalence and detrimental impact of self-harm behaviour and thoughts, and existing interventions. Chapter 2 introduces the concept of IMPs and reviews evidence suggesting that IMP interventions are likely to reduce self-harm. Potential motivational, volitional, and cognitive moderators of IMPs are also considered. Following a consideration of key methodological issues relating to the design of the present research (chapter 3), study 1 is presented in chapter 4. Study 1 showed that an IMP intervention reduced self-harm behaviour in the critical situations specified in participants’ plans. In line with expectations, this effect was observed only when individuals were motivated to reduce self-harm and experienced high levels of self-harm and suicide-related mental imagery. No effects were observed on other measured outcomes: self-harm in unspecified critical situations, suicidality, anxiety, and depression. Exposure to self-harm by friends and family did not moderate the effects of the intervention on any outcome measure. Study 2 (chapter 5) showed that the IMP intervention reduced self-harm thoughts in the participants’ specified critical situations. Consistent with study 1, this effect was observed only when individuals were motivated to stop thinking about self-harm. No effects of the intervention were largely observed on other outcome measures. Cognitive abilities (attention, and prospective and retrospective memory) did not moderate the effects of the intervention on self-harm thoughts, suicidality, anxiety or depression. However, there was evidence that they moderated the effects of the intervention on self-harm behaviour. Chapter 6 presents a pilot study for a clinical trial to test the effects of IMPs, and the moderators investigated in this thesis, on patients admitted to hospital for self-harm. A reflection on the pilot’s methods and results is presented with a view to a future, full-scale clinical trial. The overall findings across the three studies are discussed in chapter 7. Implications for practice and future research are presented.

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