A Thematic Analysis Psychosocial And Cultural Determinants Of Intentional Indirect Self-Harm Among Adolescents: A Qualitative Approach

Abstract

Intentional Indirect Self-Harm (IISH) is an emerging but under-researched concern in adolescent mental health, particularly in South Asian contexts like Pakistan. Unlike direct self-injury, IISH involves covert, harmful behaviors such as substance abuse, disordered eating, and emotional withdrawal.[1] This qualitative study investigates the Psychosocial and cultural factors contributing to IISH among 69 adolescents (ages 12–18) from Islamabad and Rawalpindi, using an ethnographic approach. Thematic analysis of semi-structured interviews revealed key psychological themes: stress, depression, anxiety, anger, and emotional instability, rooted in family pressure, academic burden, and cultural constraints. Findings highlight how adolescents internalize distress and engage in self-harming behaviors as maladaptive coping strategies, often unrecognized by themselves or others. The study emphasizes the need for culturally sensitive mental health interventions, early screening, and school-based support systems. It contributes to the literature by contextualizing IISH within Pakistani socio-cultural norms, offering insights for educators, clinicians, and policymakers aiming to address adolescent psychological well-being.