title: Non-suicidal reasons for self-harm: A systematic review of self-reported accounts.
abstract: BACKGROUND
  Self-harm is a major public health problem yet current healthcare provision is widely regarded as inadequate. One of the barriers to effective healthcare is the lack of a clear understanding of the functions self-harm may serve for the individual. The aim of this review is to identify first-hand accounts of the reasons for self-harm from the individual's perspective.
  
  
  METHODS
  A systematic review of the literature reporting first-hand accounts of the reasons for self-harm other than intent to die. A thematic analysis and 'best fit' framework synthesis was undertaken to classify the responses.
  
  
  RESULTS
  The most widely researched non-suicidal reasons for self-harm were dealing with distress and exerting interpersonal influence. However, many first-hand accounts included reasons such as self-validation, and self-harm to achieve a personal sense of mastery, which suggests individuals thought there were positive or adaptive functions of the act not based only on its social effects.
  
  
  CONCLUSIONS
  Associations with different sub-population characteristics or with the method of harm were not available from most studies included in the analysis.
  
  
  CONCLUSIONS
  Our review identified a number of themes that are relatively neglected in discussions about self-harm, which we summarised as self-harm as a positiveexperience and defining the self. These self-reported "positive" reasons may be important in understanding and responding especially to repeated acts of self-harm.
authors.affiliation: Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Rd, LS2 9LJ Leeds, United Kingdom.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Edmondson
authors.affiliation: Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Rd, LS2 9LJ Leeds, United Kingdom.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Brennan
authors.affiliation: Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Rd, LS2 9LJ Leeds, United Kingdom. Electronic address: A.O.House@leeds.ac.uk.
authors.forename: Allan O
authors.initials: AO
authors.lastname: House
mesh_terms: D006801:Humans; D033182:Intention; D007398:Interpersonal Relations; D057566:Self Report; D016728:Self-Injurious Behavior / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: Function; Non suicidal; Self-harm; Systematic review