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Table 5 Reported Reasons for Self-harm (by year of publication)

From: Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review

Reported Reasons (n [%])Study quality
Intrapersonal Reasons aInterpersonal Reasons b
Sefa-Dedeh & Canetto
(1992) [22]
Attempted suicideGeneral Hospital.
Qualitative clinical case study of clinical records.
(Two cases: Only Case A included in review).
▪ Die
▪ Validate self
▪ Get revenge against parents
▪ Make parents feel guilty;
▪ Obtain empathy and understanding from family.
▪ Regain control over social relationships and resources.
Wassenaar et al.
(1998) [23]
South Africa
Attempted suicideGeneral Hospital.
Qualitative clinical case study of clinical records.
(Three cases: Only Case 2 included in review).
To dieTo resolve conflict with parents.4/5
Mhlongo & Peltzer
(1999) [88]
South Africa
ParasuicideGeneral hospital.
Patients’ records and interviews with patients presenting with self-harm.
(n = 100)
To die (27 [27%])To demonstrate, usually, against family conflicts and abuse (58 [58%])3/5
Beekrum et al.
(2011) [24]
South Africa
Non-fatal suicidal behaviourGeneral hospital.
Qualitative case study.
(n = 10)
To: c
▪ Stop feelings of hopelessness and despair.
▪ Get rid of negative thoughts.
To: c
▪ Let others (e.g., boyfriend, or parent) change their behaviour or attitudes.
▪ Communicate distress related to conflict with parents, parental conflict, high parental expectations, and peer-cultural conflict.
▪ Get parents/family to understand their problems.
(2011) [29]
South Africa
Deliberate self-harmChildren’s homes.
Mixed methods approach.
(n = 12)
▪ Stop bad feelings (8 [66.6%])
▪ Feel relaxed (7 [58.3%])
▪ Feel something, even if it was pain (7 [58.3%])
▪ Punish self (5 [41.6%])
▪ Relieve feeling ‘numb’/empty (5 [41.6%])
▪ Get control of a situation (5 [41.6%])
▪ Receive more attention from guardians /caregivers/ friends (2 [16.6%])
▪ Get guardians/caregivers to understand you (2 [16.6%])
▪ Get help (1 [8.3%])
van Rooyen
(2013) [50]
South Africa
Deliberate self-harmUniversity.
Cross-sectional survey of students.
(n = 603)
To: c
▪ Stop bad feeling
▪ Relieve feeling numb or empty
▪ Punish yourself
▪ Feel relaxed
▪ Get control of a situation
▪ Feel part of a group
▪ Be like someone you respect
▪ Avoid having to do something unpleasant you don’t want to do
To: c
▪ Let others know how desperate you were
▪ Try to get a reaction from someone, even if it’s a negative reaction
▪ Receive more attention from your parents or friends
▪ Get your parents to understand or notice you
▪ Get other people to act differently or change
▪ Avoid school, work, or other activities
▪ Avoid being with people
Meissner & Bantjes (2017) [27]
South Africa
Attempted suicideUniversity.
One-to-one semi-structured qualitative interviews with students with histories of attempted suicide.
(n = 4)
To: c
▪ Escape feeling trapped
▪ Avoid suicide
▪ Distract from painful memories
▪ Die
To: c
▪ Make emotional pain visible to others
▪ Disconnect from others
(2018) [26]
South Africa
Non-Fatal Suicidal BehaviourGeneral hospital.
Qualitative case study approach: One-to-one semi-structured interviews with clinical sample of adolescents.
(n = 10)
To: c
▪ Escape unbearable thoughts
▪ End sense of meaninglessness
▪ Die
To: c
▪ Escape a painful/unbearable situation
▪ Make parents change their mind/behaviour.
  1. a Intrapersonal reasons (i.e., reasons intended to change one’s state or circumstances): reasons or motives relate to desired changes in one’s personal or internal state, including changes in sensations, emotional states or thoughts
  2. b Interpersonal reasons (i.e., reasons intended to change the state or circumstances of significant others): include desired changes within one’s social environment, such as communicating distress to someone, or to influence the behaviour of others or to punish others
  3. c Frequency distribution of reasons not reported