Trauma Symptoms, Self-Compassion and Self Forgiveness among Individuals Engaged in Non-Suicidal Self Injury: A Multiple Case Study
##doi.readerDisplayName##:
https://doi.org/10.65166/b84gdn19关键词:
non-suicidal self-injury, trauma symptoms, self-compassion, self-forgiveness, mutliple case study, Filipino adolescents, young adults, psychological distress摘要
Non-suicidal self-injury (NSSI) is a growing concern among adolescents and young adults, yet limited research has examined how trauma-related distress is expressed and how self-compassion and self-forgiveness are experienced in this population within Filipino contexts. This multiple case study explored these experiences among four Filipino young adult females (aged 19–22) with a history of NSSI. Using Yin’s (2018) multiple case study approach, data were collected through semi-structured interviews and analyzed through thematic analysis with within-case and cross-case synthesis. Three cross-case themes emerged: (1) trauma symptoms expressed as psychological distress characterized by negative self-attitudes across affective, behavioral, and cognitive domains; (2) self-compassion as personal coping strategies combining adaptive practices (e.g., cognitive reframing, support-seeking, exercise, faith, journaling) and maladaptive patterns (e.g., self-doubt, diminished self-worth); and (3) self-forgiveness as personal responses to NSSI, ranging from denial and perceived unworthiness of forgiveness to acceptance, gratitude, and forgiveness of self and others. Family support, faith, and social connectedness emerged as protective influences. Findings indicate that experiences of distress, self-compassion, and self-forgiveness are developmentally and contextually shaped, underscoring the need for culturally attentive, personalized support. Based on the themes, an evidence-informed, culturally responsive intervention plan is proposed to address trauma-related distress, strengthen self-compassion skills, and support self-forgiveness processes among individuals engaged in NSSI.
##plugins.themes.default.displayStats.downloads##
参考
Agang-Ang, G., Quinto, L., Kim, Y., Eustaquio, J. C., De Vera, R. K., Crisologo, J., ... & Lavalle, D. K. (2025). Gender differences in nutrition, lifestyle, and distress among dormitory medical students: A cross-sectional study. International Journal of Health & Business Analytics, 1(1). https://doi.org/10.65166/xngg1k50
Alharbi, R., Varese, F., Husain, N., & Taylor, P. J. (2020). Posttraumatic stress symptomology and non-suicidal self-injury: The role of intrusion and arousal symptoms. Journal of Affective Disorders, 276, 920-926.
Algorani, E. B., & Gupta, V. (2023). Coping mechanisms. In StatPearls. StatPearls Publishing.
Andrei, L. E., Efrim-Budisteanu, M., Mihailescu, I., Buică, A. M., Moise, M., & Rad, F. (2024). Non-suicidal self-injury (NSSI) patterns in adolescents from a Romanian child psychiatry inpatient clinic. Children, 11(3), 297.
Atento, R. G. O., Quinto, L. F., Espelita, C. A. M., & San Juan, F. M. (2025). Narrative health analytics: Integrating empathy, data, and ethics in patient-centered healthcare. International Journal of Health and Business Analytics, 1(2), 1–33. https://doi.org/10.65166/yxgx8e59
Baetens, I., Decruy, C., Vatandoost, S., Vanderhaegen, B., & Kiekens, G. (2020). School-based prevention targeting non-suicidal self-injury: A pilot study. Frontiers in Psychiatry, 11, 437.
Bermido, C. M., Quinto, L. F., & Atento, R. G. O. (2025). A qualitative thematic review of contemporary challenges affecting health professions education: Implications for higher education leadership. International Journal of Health and Business Analytics, 1(2). https://doi.org/10.65166/yfm5w791
Bitarafan, M., Abasi, I., Fatemizadeh, M., Khorrami, M., & Aslezaker, M. (2023). The relationship between parental bonding and suicidal ideation: The mediating role of feelings of self-conscious affect (shame and guilt) and separation-individuation. Modern Care Journal, 20(3).
Bluth, K., Campo, R. A., Futch, W. S., & Gaylord, S. A. (2019). Age and gender differences in the associations of self-compassion and emotional well-being in a large adolescent sample. Journal of Youth and Adolescence, 48(3), 522-536.
Braehler, C., & Neff, K. D. (2020). Self-compassion in PTSD. In M. T. Tull & N. A. Kimbrel (Eds.), Emotion in posttraumatic stress disorder (pp. 367-396). Academic Press.
Bratt, A., & Fagerström, C. (2020). Self-compassion in old age: Confirmatory factor analysis of the 6-factor model and the internal consistency of the Self-Compassion Scale–Short Form. Aging & Mental Health, 24(4), 642-648.
Calhoun, C. D., Helms, S. W., Heilbron, N., Rudolph, K. D., Hastings, P. D., & Prinstein, M. J. (2019). Testing the interpersonal function of nonsuicidal self-injury: The moderating role of peer deviance. Journal of Consulting and Clinical Psychology, 87(8), 699-710.
Cebu, J. (2023). Emotional regulation and non-suicidal self-injury: A review. Philippine Journal of Psychology, 56(1), 45-62.
Chowdhury, M. R. (2024). Emotion regulation therapy: A comprehensive review. Journal of Clinical Psychology, 80(2), 215-230.
Cipriano, A., Cella, S., & Cotrufo, P. (2018). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, 1946.
Cleare, S., Gumley, A., & O'Connor, R. (2019). Self-compassion, self-forgiveness, suicidal ideation and self-harm: A systematic review. Clinical Psychology & Psychotherapy, 26(5), 511-530.
Coleman, S. E., Dunlop, B. J., Hartley, S., & Taylor, P. J. (2022). The relationship between rumination and NSSI: A systematic review and meta-analysis. British Journal of Clinical Psychology, 61(2), 405-443.
De Luca, L., Giletta, M., Menesini, E., & Prinstein, M. (2022). Reciprocal associations between peer problems and non-suicidal self-injury throughout adolescence. Journal of Child Psychology and Psychiatry, 63(12), 1486-1495.
Deng, Y., Zhang, Q., Zhang, J., Yan, J., Zhuang, W., Liu, X., ... & Wang, Y. (2023). Gender differences in non-suicidal self-injury among Chinese adolescents: A meta-analysis. Journal of Affective Disorders, 320, 123-131.
Drzał-Fiałkiewcz, E., Makarewicz, A., Walczak, M., Walczak, A., Futyma-Jędrzejewska, M., Kozak, G., & Karakuła-Juchnowicz, H. (2019). Self-harm—An overview of the tools used to assess non-suicidal self-harming behaviors. Current Problems of Psychiatry, 18(4), 342-359.
Ennis, C. R., Tock, J. L., Daurio, A. M., Raines, A. M., & Taylor, J. (2020). An initial investigation of the association between DSM-5 posttraumatic stress disorder symptoms and nonsuicidal self-injury functions. Psychological Trauma: Theory, Research, Practice, and Policy, 13(3), 345-353.
Erol, Y., & Inozu, M. (2024). An investigation of the mediating roles of emotion regulation difficulties, distress tolerance, self-compassion, and self-disgust in the association between childhood trauma and nonsuicidal self-injury. Archives of Suicide Research, 28(3), 815-829.
Faura-Garcia, J., Orue, I., & Calvete, E. (2020). Clinical assessment of non-suicidal self-injury: A systematic review of instruments. Clinical Psychology & Psychotherapy, 28(3), 539-554.
Fong, Z. H., Loh, W. N. C., Fong, Y. J., Neo, H. L. M., & Chee, T. T. (2022). Parenting behaviors, parenting styles, and non-suicidal self-injury in young people: A systematic review. Clinical Child Psychology and Psychiatry, 27(1), 61-81.
Fox, K. R., Ribeiro, J. D., Kleiman, E. M., Hooley, J. M., Nock, M. K., & Franklin, J. C. (2017). Affect intensity and reactivity in nonsuicidal self-injury. Journal of Affective Disorders, 216, 4-11.
Galicia, J. R., & Bautista, T. D. (2018). Prevalence of nonsuicidal self-injury and suicide attempt among young adult university students. Acta Medica Philippina, 52(1), 45-51.
Gilbert, P. (2017). Compassion as a social mentality: An evolutionary approach. In P. Gilbert (Ed.), Compassion: Concepts, research and applications (pp. 31-68). Routledge.
Grattan, R. E., Lara, N., Botello, R. M., Tryon, V. L., Maguire, A. M., Carter, C. S., & Niendam, T. A. (2019). A history of trauma is associated with aggression, depression, non-suicidal self-injury behavior, and suicide ideation in first-episode psychosis. Journal of Clinical Medicine, 8(7), 1082.
Griep, S. K., & MacKinnon, D. F. (2020). Does nonsuicidal self-injury predict later suicidal attempts? A review of studies. Archives of Suicide Research, 26(2), 428-446.
Gromatsky, M. A., Halverson, T. F., Dillon, K. H., Wilson, L. C., LoSavio, S. T., Walsh, S., ... & Kimbrel, N. A. (2022). The prevalence of nonsuicidal self-injury in military personnel: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 24(5), 2936-2952.
Guo, J., Wang, Y., Li, H., Feng, Y., Lu, J., Jiang, Y., & Zhao, X. (2024). Age of onset and clinical characteristics of non-suicidal self-injury in Chinese children and adolescents. Child and Adolescent Psychiatry and Mental Health, 18(1), 1-11.
Haregu, T., Chen, Q., Arafat, S. M. Y., Cherian, A., & Armstrong, G. (2023). Prevalence, correlates and common methods of non-suicidal self-injury in South Asia: A systematic review. BMJ Open, 13(11), e074776.
Hechanova, G. (2022). KATATAGAN: A Filipino resilience program for disasters and emergencies. Philippine Journal of Psychology, 55(1), 89-108.
Hong, W., Liu, R. D., Ding, Y., Oei, T. P., Fu, X., Jiang, R., & Jiang, S. (2020). Self-esteem moderates the effect of compromising thinking on forgiveness among Chinese early adolescents. Frontiers in Psychology, 11, 104.
Hooley, J. M., Fox, K. R., & Boccagno, C. (2020). Nonsuicidal self-injury: Diagnostic challenges and current perspectives. Neuropsychiatric Disease and Treatment, 16, 101-112.
Huang, C., Yuan, Q., Ge, M., Sheng, X., Yang, M., Shi, S., ... & Zhou, X. (2022). Childhood trauma and non-suicidal self-injury among Chinese adolescents: The mediating role of psychological sub-health. Frontiers in Psychiatry, 13, 798369.
Igmen, J. D. (2024). The path of intra- and interpersonal factors to nonsuicidal self-injury (NSSI) through emotional distress with emotion regulation as a buffer: A moderated-mediation study [Doctoral dissertation, De La Salle University]. Animo Repository.
Jovanović, V. (2022). Internalizing behaviors in adolescence: The unique contribution of life satisfaction beyond positive and negative affect. Personality and Individual Differences, 192, 111593.
Kachadourian, L. K., Nichter, B., Herzog, S., Norman, S. B., Sullivan, T., & Pietrzak, R. H. (2022). Non-suicidal self-injury in US military veterans: Results from the National Health and Resilience in Veterans Study. Clinical Psychology & Psychotherapy, 29(3), 941-949.
Kazgan Kılıçaslan, A., Yıldız, S., Kurt, O., & Atmaca, M. (2022). Comparison of non-suicidal self-injury and suicide attempts in relation to anger rumination. Alpha Psychiatry, 23(2), 82-88.
Kentopp, S. D., Conner, B. T., Fetterling, T. J., Delgadillo, A. A., & Rebecca, R. A. (2021). Sensation seeking and nonsuicidal self-injurious behavior among adolescent psychiatric patients. Clinical Child Psychology and Psychiatry, 26(2), 430-442.
Kılıç, A., Hudson, J., McCracken, L., Ruparelia, R., Fawson, S., & Hughes, L. D. (2020). A systematic review of the effectiveness of self-compassion-related interventions for individuals with chronic physical health conditions. Behavior Therapy, 52(3), 607-625.
Konaszewski, K., & Surzykiewicz, J. (2023). Forgiveness and mental health in adolescents: A systematic review. Journal of Moral Education, 52(2), 189-208.
Kottman, T. (2019). Non-suicidal self-injury in children and adolescents. Journal of Mental Health Counseling, 41(3), 215-228.
Kravchuk, S. (2022). Self-forgiveness and psychological well-being: A correlational study. Psychology Research, 12(4), 201-215.
Lei, H., Yang, Y., Zhu, T., Zhang, X., & Dang, J. (2024). Network analysis of the relationship between non-suicidal self-injury, depression, and childhood trauma in adolescents. BMC Psychology, 12(1), 234.
Leonard, J. (2020). What is trauma? Definition, symptoms, and causes. Medical News Today. https://www.medicalnewstoday.com/articles/trauma
Lewis, S. P., & Hasking, P. A. (2021). Self-injury recovery: A person-centered framework. Journal of Clinical Psychology, 77(4), 884-895.
Liu, J., Li, J. T., Zhou, M., Liu, H. F., Fan, Y. Y., Mi, S., & Tang, Y. L. (2023). Non-suicidal self-injury in adolescents with mood disorders and the roles of self-compassion and emotional regulation. Frontiers in Psychiatry, 14, 1214192.
Lurigio, A. J., Nesi, D., & Meyers, S. M. (2023). Nonsuicidal self injury among young adults and adolescents: Historical, cultural and clinical understandings. Social Work in Mental Health, 22(1), 122-148.
Malko, A., Duenser, A., Kangas, M., Molla-Allod, D., & Paris, C. (2023). Social media language of non-suicidal self-injury: A scoping review. Clinical Psychology Review, 99, 102233.
Mancinelli, E., Ruocco, E., Napolitano, S., & Salcuni, S. (2022). A network analysis on self-harming and problematic smartphone use—The role of self-control, internalizing and externalizing problems in a sample of self-harming adolescents. Comprehensive Psychiatry, 112, 152285.
Masana, L., Reyes, M., & Delariarte, C. (2020). Unraveling non-suicidal self-injury: Understanding the behavioral dynamics of Filipino adolescents at risk of deliberate self-harm. North American Journal of Psychology, 22(2), 331-354.
Miles, M. B., Huberman, A. M., & Saldaña, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). SAGE Publications.
Mills, J., Wand, T., & Fraser, J. A. (2018). Exploring the meaning and practice of self-care among palliative care nurses and doctors: A mixed-methods study. International Journal of Nursing Studies, 78, 108-116.
Min, J., Lopez, S. V., Dunn, D. S., Leffingwell, T. R., & Mullins-Sweatt, S. N. (2021). Understanding perceptions of nonsuicidal self-injury: Descriptive and injunctive norms. Psychiatric Quarterly, 92(4), 1657-1671.
Molinero, C., Bonete, S., Crespí, P., Ramos, S., & González De Abreu, A. (2024). Effectiveness of forgiveness training programs in university contexts: A systematic review and meta-analysis. Cogent Education, 11(1), 2378242.
Moloney, F., Amini, J., Sinyor, M., Schaffer, A., Lanctôt, K. L., & Mitchell, R. H. B. (2024). Sex differences in the global prevalence of nonsuicidal self-injury in adolescents: A meta-analysis. JAMA Network Open, 7(6), e2415436.
Muehlenkamp, J. J., Xhunga, N., & Brausch, A. M. (2019). Self-injury age of onset: A risk factor for NSSI severity and suicidal behavior. Archives of Suicide Research, 23(4), 551-563.
Muehlenkamp, J. J., Brausch, A. M., & Littlefield, A. K. (2023). Concurrent and prospective effects of non-suicidal self-injury on suicide ideation and behavior. Journal of Affective Disorders, 320, 132-139.
Nagy, L. M., Shanhan, M., & Baer, R. A. (2021). An experimental investigation of the effects of self-compassion and self-criticism on reactions to a laboratory-based stressor. Mindfulness, 12(5), 1189-1200.
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85-101.
Neff, K. D., & Vonk, R. (2009). Self-compassion versus global self-esteem: Two different ways of relating to oneself. Journal of Personality, 77(1), 23-50.
Ozcan, O., Hoelterhoff, M., & Wylie, E. (2021). Faith and spirituality as psychological coping mechanism among female aid workers: A qualitative study. International Journal of Humanitarian Action, 6(1), 15.
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y
Per, M., Simundic, A., Argento, A., Khoury, B., & Heath, N. (2022). Examining the protective role of self-compassion in the relationship between adverse childhood experiences and non-suicidal self-injury. Child Abuse & Neglect, 131, 105764.
Phuoc, L. H., & Nguyen, T. T. (2020). Self-compassion and well-being among Vietnamese adolescents: The role of living with parents. Asian Journal of Social Psychology, 23(4), 412-422.
Piccirillo, M. L., Burke, T. A., Moore-Berg, S. L., Alloy, L. B., & Heimberg, R. G. (2020). Self-stigma toward nonsuicidal self-injury: An examination of implicit and explicit attitudes. *Suicide and Life-Threatening Behavior, 50*(5), 1007-1024.
Pierro, A., Pica, G., Giannini, A. M., Higgins, E., & Kruglanski, W. (2018). Self-forgiveness and its relationship with well-being. Current Psychology, 37(3), 567-578.
Rahmandani, A., Kahija, Y., & Salma, S. (2019). Forgiveness meditation as an effort in improving mental health among college students. Indian Journal of Public Health Research & Development, 10(6), 795-800.
Reyes, M. E., Davis, R. D., David, A. J., Delos Santos, J. L., & Villarosa, M. T. (2019). Childhood adversity and non-suicidal self-injury among Filipino adolescents. Philippine Journal of Psychology, 52(2), 123-145.
Rosenrot, S. (2019). Self-forgiveness and non-suicidal self-injury. Journal of Clinical Psychology, 75(8), 1432-1445.
Schafer, S. K., Kunzler, A. M., Kalisch, R., Tüscher, O., & Lieb, K. (2024). Digital resilience interventions: A systematic review and meta-analysis. Clinical Psychology Review, 108, 102378.
Schreiner, M. W., Mueller, B. A., Klimes-Dougan, B., Begnel, E. D., Fiecas, M., Hill, D., ... & Cullen, K. R. (2020). White matter microstructure in adolescents and young adults with non-suicidal self-injury. Frontiers in Psychiatry, 10, 1019.
Sedighimornani, N., Rimes, K. A., & Verplanken, B. (2019). Exploring the relationships between mindfulness, self-compassion, and shame. SAGE Open, 9(3), 1-12.
Sen, H. E., Colucci, L., & Browne, D. T. (2022). Keeping the faith: Religion, positive coping, and mental health of caregivers during COVID-19. Frontiers in Psychology, 12, 805019.
Smith, P., Dalgleish, T., & Meiser-Stedman, R. (2019). Practitioner review: Posttraumatic stress disorder and its treatment in children and adolescents. Journal of Child Psychology and Psychiatry, 60(5), 500-510.
Swami, V., Andersen, J., & Furnham, A. (2021). Self-compassion in psychology: A bibliometric analysis. Current Psychology, 40(8), 3815-3826.
Swannel, S., Martin, G., & Page, A. (2014). The prevalence of non-suicidal self-injury across the lifespan. Journal of Affective Disorders, 168, 1-7.
Toplu-Demirtas, E., Kemer, G., Pope, A. L., & Moe, J. L. (2018). Self-compassion, romantic relationship satisfaction, and relationship attachment. The Family Journal, 26(3), 291-300.
Ty, D. S., Rivas, M. A., Regalado, M. R., & Arranz-Lim, F. (2019). Demographic and clinical correlates of non-suicidal self-injury among Filipino pediatric patients. Philippine Journal of Pediatrics, 68(1), 23-31.
Ty, D. S., Rivas, M. A., Regalado, M. R., & Arranz-Lim, F. (2024). Non-suicidal self-injury in Filipino pediatric patients: A cross-sectional study. Asian Journal of Psychiatry, 91, 103845.
Vibhakar, V., Allen, L. R., Gee, B., & Meiser-Stedman, R. (2019). A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma. Journal of Affective Disorders, 255, 77-89.
Whitlock, J., & Purington, A. (2013). The Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Cornell Research Program on Self-Injury and Recovery.
Woodyatt, L., Worthington, E. L., Jr., Wenzel, M., & Griffin, B. J. (2019). Handbook of the psychology of self-forgiveness. Springer.
Wu, J., Liu, S., Luo, J., Li, X., & You, J. (2022). The effects of childhood abuse, depression, and self-compassion on adolescent nonsuicidal self-injury: A moderated mediation model. Child Abuse & Neglect, 136, 105993.
Wulandari, I., & Megawati, F. E. (2020). The role of forgiveness on psychological well-being on adolescents: A review. Advances in Social Science, Education and Humanities Research, 395, 112-118.
Yang, J., Chen, Y., Yao, G., Wang, Z., Fu, X., Tian, Y., & Li, Y. (2022). Key factors selection on adolescents with non-suicidal self-injury: A support vector machine based approach. Frontiers in Public Health, 10, 1049069.
Yang, L., Jia, F., Lu, X., & Jia, C. (2023). Childhood maltreatment and non-suicidal self-injury in adolescents: A meta-analysis. Child Abuse & Neglect, 135, 105982.
Yarnell, L. M., Neff, K. D., Davidson, O. A., & Mullarkey, M. (2015). Gender differences in self-compassion: Examining the role of gender role orientation. Mindfulness, 10(6), 1136-1152.
Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). SAGE Publications.
Yu, C., Cai, Y., & Pan, M. (2024). Correlation analysis of non-suicidal self-injury behavior with childhood abuse, peer victimization, and psychological resilience in adolescents with depression. Actas Españolas de Psiquiatría, 52(3), 289-300.
Zare, E., Kaveh, M. H., Karimi, M., Nazari, M., & Seif, M. (2023). The effect of a social cognitive theory-based educational intervention on nonsuicidal self-injury prevention in high school students: A randomized educational intervention trial. Journal of Adolescence, 95(5), 1005-1016.
##submission.downloads##
已出版
期次
栏目
##submission.license##
##submission.copyrightStatement##
##submission.license.cc.by-nc-sa4.footer##This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright of their articles but grant the International Journal of Health & Business Analytics (IJHBA) the right of first publication.
