Abstract
Deliberate self-harm (DSH) is a significant global health concern among university students. Investigating the interplay between coping styles, social support, and DSH is crucial for understanding and predicting DSH in this population. The aims to clarify the complex association among DSH, coping styles, and social support and to quantify the predictive power of coping styles and social support. A cross-sectional, correlational design was used to collect self-reported data from 905 university students in Jordan. The study found that 63.4% of university students engaged in DSH, with varying degrees of severity. Coping styles revealed a predominant reliance on religious and planning coping styles. Social support scores exhibited considerable variability among items, with family support being the highest. Coping styles and social support were found to significantly predict DSH. In conjunction, fostering a culture of open communication and reducing stigma surrounding mental health issues is imperative. This can be achieved through campus-wide awareness campaigns, promoting peer support networks, and engaging in ongoing dialogue to create a nurturing environment for student well-being. These findings contribute to the understanding of DSH among university students and offer opportunities for targeted interventions such as workshops on problem-solving, stress management, and faculty training to enhance student mental health in universities and support strategies to enhance well-being.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abuhamdah, S. M., Naser, A. Y., Abdelwahab, G. M., & AlQatawneh, A. (2021). The prevalence of mental distress and social support among university students in Jordan: A cross-sectional study. International Journal of Environmental Research and Public Health, 18(21), 11622. https://doi.org/10.3390/ijerph182111622
Aggarwal, S., Patton, G., Reavley, N., Sreenivasan, S. A., & Berk, M. (2017). Youth self-harm in low-and middle-income countries: Systematic review of the risk and protective factors. International Journal of Social Psychiatry, 63(4), 359–375. https://doi.org/10.1177/00207640177001
Al-Bitar, Z. B., Sonbol, H. N., Al-Omari, I. K., Badran, S. A., Naini, F. B., Al-Omiri, M. K., & Hamdan, A. M. (2022). Self-harm, dentofacial features, and bullying. American Journal of Orthodontics and Dentofacial Orthopedics, 162(1), 80–92. https://doi.org/10.1016/j.ajodo.2021.02.025
Alghamdi, M. (2020). Cross-cultural validation and psychometric properties of the Arabic Brief COPE in Saudi population. Medical Journal of Malaysia, 75(5), 502–509.
Al-Shannaq, Y., & Aldalaykeh, M. (2021). Suicide literacy, suicide stigma, and psychological help seeking attitudes among Arab youth. Current Psychology, 1–13. https://doi.org/10.1007/s12144-021-02007-9.
Beutler, L. E., Harwood, T. M., Kimpara, S., Verdirame, D., & Blau, K. (2011). Coping style. Journal of Clinical Psychology, 67(2), 176–183. https://doi.org/10.1002/jclp.20752
Burns, J., & Birrell, E. (2014). Enhancing early engagement with mental health services by young people. Psychology Research and Behavior Management, 303–312. https://doi.org/10.2147/PRBM.S49151.
Canty-Mitchell, J., & Zimet, G. D. (2000). Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. American Journal of Community Psychology, 28(3), 391–400. https://doi.org/10.1023/A:1005109522457
Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6
Cherkil, S., Gardens, S. J., & Soman, D. K. (2013). Coping styles and its association with sources of stress in undergraduate medical students. Indian Journal of Psychological Medicine, 35(4), 389–393.
Cooper, J., Kapur, N., Webb, R., Lawlor, M., Guthrie, E., Mackway-Jones, K., & Appleby, L. (2005). Suicide after deliberate self-harm: A 4-year cohort study. American Journal of Psychiatry, 162(2), 297–303. https://doi.org/10.1176/appi.ajp.162.2.297
Dabbas, M., Oais, R., Abu-Ghanomee, K., & Aburish, K. (2008). Causes of deliberate self-harm among patients attending the accident and emergency department at King Hussein Medical Center. JRMS, 15(1), 35–39.
Demuthova, S., & Demuth, A. (2019). The prevalence and most frequent forms of self-harm in adolescents. In International Conference on Research in Psychology 39–51.
Department of Statistics - Jordan. (2012). Population. Department of Statistics - Jordan. https://dosweb.dos.gov.jo/ar/population/population-2/
Doukas, N., & Ahmed, S. (2016). Substance Use among Muslims Residing in the United States: A Literature Review. Journal of Alcohol Drug Dependence Substance Abuse 2(006). DOI: https://doi.org/10.24966/ADSD-9594/100006
Dozois, D. J., Martin, R. A., & Bieling, P. J. (2009). Early maladaptive schemas and adaptive/maladaptive styles of humor. Cognitive Therapy and Research, 33, 585–596. https://doi.org/10.1007/s10608-008-9223-9
Freire, C., Ferradás, M. D. M., Valle, A., Núñez, J. C., & Vallejo, G. (2016). Profiles of psychological well-being and coping strategies among university students. Frontiers in Psychology, 7, 1554. https://doi.org/10.3389/fpsyg.2016.01554
Freire, C., Ferradás, M. D. M., Regueiro, B., Rodríguez, S., Valle, A., & Núñez, J. C. (2020). Coping strategies and self-efficacy in university students: A person-centered approach. Frontiers in Psychology, 11, 841. https://doi.org/10.3389/fpsyg.2020.00841
Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76(2), 238–250. https://doi.org/10.1037/0002-9432.76.2.238
Graves, B. S., Hall, M. E., Dias-Karch, C., Haischer, M. H., & Apter, C. (2021). Gender differences in perceived stress and coping among college students. PLoS ONE, 16(8), e0255634. https://doi.org/10.1371/journal.pone.0255634
Gregory, P., Stevenson, F., King, M., Osborn, D., & Pitman, A. (2020). The experiences of people bereaved by suicide regarding the press reporting of the death: Qualitative study. BMC Public Health, 20, 1–14. https://doi.org/10.1186/s12889-020-8211-1
Griffin, K., Twynstra, J., Gilliland, J. A., & Seabrook, J. A. (2023). Correlates of self-harm in university students: A cross-sectional study. Journal of American College Health, 71(3), 959–966. https://doi.org/10.1080/07448481.2021.1909049
Hallab, L., & Covic, T. (2010). Deliberate self-harm: The interplay between attachment and stress. Behaviour Change, 27(2), 93–103. https://doi.org/10.1375/bech.27.2.93
Hamaideh, S. H. (2011). Stressors and reactions to stressors among university students. International Journal of Social Psychiatry, 57(1), 69–80. https://doi.org/10.1177/0020764009348442
Hamaideh, S., Al-Magaireh, D., Abu-Farsakh, B., & Al-Omari, H. (2014). Quality of life, social support, and severity of psychiatric symptoms in Jordanian patients with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 21(5), 455–465. https://doi.org/10.1111/jpm.12112
Hamdan-Mansour, A. M., & Dawani, H. A. (2008). Social support and stress among university students in Jordan. International Journal of Mental Health and Addiction, 6, 442–450. https://doi.org/10.1007/s11469-007-9112-6
Hamdan-Mansour, A. M., Alzayyat, A. A., Hamaideh, S. H., Rafaiah, M. Q. B., Al Jammal, O. L., & Hamdan-Mansour, L. A. (2021). Predictors of deliberate self-harm among university students. International Journal of Mental Health and Addiction, 1–13. https://doi.org/10.1007/s11469-021-00561-8.
Hanania, J. W., Heath, N. L., Emery, A. A., Toste, J. R., & Daoud, F. A. (2015). Non-suicidal self-injury among adolescents in Amman. Jordan. Archives of Suicide Research, 19(2), 260–274. https://doi.org/10.1080/13811118.2014.915778
Harriss, L., & Hawton, K. (2011). Deliberate self-harm in rural and urban regions: A comparative study of prevalence and patient characteristics. Social Science & Medicine, 73(2), 274–281. https://doi.org/10.1016/j.socscimed.2011.05.011
Haw, C., & Hawton, K. (2008). Life problems and deliberate self-harm: Associations with gender, age, suicidal intent and psychiatric and personality disorder. Journal of Affective Disorders, 109(1–2), 139–148. https://doi.org/10.1016/j.jad.2007.12.224
Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., & Stewart, A. (2003). Deliberate self-harm in adolescents: A study of characteristics and trends in Oxford, 1990–2000. Journal of Child Psychology and Psychiatry, 44(8), 1191–1198. https://doi.org/10.1111/1469-7610.00200
Hawton, K., Bergen, H., Kapur, N., Cooper, J., Steeg, S., Ness, J., & Waters, K. (2012a). Repetition of self-harm and suicide following self-harm in children and adolescents: Findings from the Multicentre Study of Self-harm in England. Journal of Child Psychology and Psychiatry, 53(12), 1212–1219. https://doi.org/10.1111/j.1469-7610.2012.02559.x
Hawton, K., Saunders, K. E., & O’Connor, R. C. (2012b). Self-harm and suicide in adolescents. The Lancet, 379(9834), 2373–2382. https://doi.org/10.1016/S0140-6736(12)60322-5
Hawton, K., Bergen, H., Cooper, J., Turnbull, P., Waters, K., Ness, J., & Kapur, N. (2015). Suicide following self-harm: Findings from the multicentre study of self-harm in England, 2000–2012. Journal of Affective Disorders, 175, 147–151. https://doi.org/10.1016/j.jad.2014.12.062
Hawton, K., Bergen, H., Casey, D., Simkin, S., Palmer, B., Cooper, J., ... & Owens, D. (2007). Self-harm in England: A tale of three cities: Multicentre study of self-harm. Social Psychiatry and Psychiatric Epidemiology, 42, 513–521. https://doi.org/10.1007/s00127-007-0199-7.
Jannah, S. R., Yuliadi, I., & Scarvanovi, B. W. (2022). The mediating effect of self-criticism on college students’ emotion dysregulation and intention to self-harm. Psikohumaniora: Jurnal Penelitian Psikologi, 7(1), 65–76. https://doi.org/10.21580/pjpp.v7i1.10813
Jordanian Ministry of Higher Education. (2023). Higher Education in Jordan. Jordanian Ministry of Higher Education. https://mohe.gov.jo/En/Pages/Higher_Education_in_Jordan
Kasi, P. M., Naqvi, H. A., Afghan, A. K., Khawar, T., Khan, F. H., Khan, U. Z., ... & Khan, H. M. (2012). Coping styles in patients with anxiety and depression. International Scholarly Research Notices, 2012. https://doi.org/10.5402/2012/128672.
Latimer, S., Covic, T., Cumming, S. R., & Tennant, A. (2009). Psychometric analysis of the Self-Harm Inventory using Rasch modelling. BMC Psychiatry, 9, 1–9. https://doi.org/10.1186/1471-244X-9-53
McKenzie, K. C., & Gross, J. J. (2014). Nonsuicidal self-injury: An emotion regulation perspective. Psychopathology, 47(4), 207–219. https://doi.org/10.1159/000358097
Mikulincer, M., & Shaver, P. R. (2012). Augmenting the sense of attachment security in group contexts: The effects of a responsive leader and a cohesive group. International Journal of Group Psychotherapy, 67(2), 161–175. https://doi.org/10.1080/00207284.2016.1260462
Moller, C. I., Tait, R. J., & Byrne, D. G. (2013). Deliberate self-harm, substance use, and negative affect in nonclinical samples: A systematic review. Substance Abuse, 34(2), 188–207. https://doi.org/10.1080/08897077.2012.693462
Müller, A., Claes, L., Smits, D., & Brähler, E. (2016). Prevalence and Correlates of Self-Harm in the German General Population. PLoS ONE, 11(6), e0157928. https://doi.org/10.1371/journal.pone.0157928
Patra, B. N., Sen, M. S., Sagar, R., & Bhargava, R. (2023). Deliberate self-harm in adolescents: A review of literature. Industrial Psychiatry Journal, 32(1), 9. https://doi.org/10.4103/ipj.ipj_215_21
Rabenu, E., Yaniv, E., & Elizur, D. (2017). The relationship between psychological capital, coping with stress, well-being, and performance. Current Psychology, 36, 875–887. https://doi.org/10.1007/s12144-016-9477-4
Rahat, E., & İlhan, T. (2016). Coping styles, social support, relational self-construal, and resilience in predicting students’ adjustment to university life. Educational Sciences: Theory & Practice, 16(1).
Ramadan, A. A., & Mohamed, N. A. (2019). Prevalence and Correlates of Deliberate Self-Harming Behaviors among Nursing Students. IOSR Journal of Nursing and Health Science, 8(2), 52–61. https://doi.org/10.9790/1959-0802075261
Reas, D. L., Wisting, L., & Lindvall Dahlgren, C. (2023). Co-occurrence of nonsuicidal self-injury and eating disorder pathology in adolescents. International Journal of Eating Disorders, 56(2), 439–445. https://doi.org/10.1002/eat.23826
SabetDizkuhi, K., & KafieMasooleh, S. M. (2021). The Frequency of Self-harm Behaviors among University Students. Journal of Modern Psychology, 1(3), 9–24. https://doi.org/10.22034/jmp.2021.285993.1016
Sagone, E., & De Caroli, M. E. (2014). A correlational study on dispositional resilience, psychological well-being, and coping strategies in university students. American Journal of Educational Research, 2(7), 463–471. https://doi.org/10.12691/education-2-7-5
Sansone, R. A., Wiederman, M. W., & Sansone, L. A. (1998). The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder. Journal of Clinical Psychology, 54(7), 973–983. https://doi.org/10.1002/(SICI)1097-4679(199811)54:7%3c973::AID-JCLP11%3e3.0.CO;2-H
Sarno, I., Madeddu, F., & Gratz, K. L. (2010). Self-injury, psychiatric symptoms, and defense mechanisms: Findings in an Italian nonclinical sample. European Psychiatry, 25(3), 136–145. https://doi.org/10.1016/j.eurpsy.2009.05.007
Schoenmakers, E. C., Van Tilburg, T. G., & Fokkema, T. (2015). Problem-focused and emotion-focused coping options and loneliness: How are they related? European Journal of Ageing, 12, 153–161. https://doi.org/10.1007/s10433-015-0336-1
Shahzad, M., Munawar, K., & Riaz, F. (2021). Understanding prevalence and association of suicidal ideation, deliberate self-harm, stress, anxiety depression, and mood swings in Pakistan University students: a multilevel analysis. Nature-Nurture Journal of Psychology, 1(2), 12–21. https://doi.org/10.53107/nnjp.v1i2.12
Shnaigat, W. M., Abdallat, A., Bawaneh, K., Ru’od, A., & Salim, H. A. (2006). Sociodemographic and Clinical Profile of Deliberate Self-Harm Syndrome in Jordanian Patients. Pan Arab Medical Journal, 2005(5), 56–61.
Siedlecki, K. L., Salthouse, T. A., Oishi, S., & Jeswani, S. (2014). The relationship between social support and subjective well-being across age. Social Indicators Research, 117, 561–576. https://doi.org/10.1007/s11205-013-0361-4
Sivertsen, B., Hysing, M., Knapstad, M., Harvey, A. G., Reneflot, A., Lønning, K. J., & O’Connor, R. C. (2018). Suicide attempts and non-suicidal self-harm among university students: Prevalence study. Bjpsych Open, 5(2), e26. https://doi.org/10.1192/bjo.2019.4
Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 44(3), 273–303. https://doi.org/10.1111/sltb.12070
Taliaferro, L. A., & Muehlenkamp, J. J. (2015). Risk factors associated with self-injurious behavior among a national sample of undergraduate college students. Journal of American College Health, 63(1), 40–48. https://doi.org/10.1080/07448481.2014.953166
Taylor, S. E., Welch, W. T., Kim, H. S., & Sherman, D. K. (2007). Cultural differences in the impact of social support on psychological and biological stress responses. Psychological Science, 18(9), 831–837. https://doi.org/10.1111/j.1467-9280.2007.01987
Tham, S. G., Ibrahim, S., Hunt, I. M., Kapur, N., & Gooding, P. (2020). Examining the mechanisms by which adverse life events affect having a history of self-harm, and the protective effect of social support. Journal of Affective Disorders, 263, 621–628. https://doi.org/10.1016/j.jad.2019.11.037
Theodoratou, M., Farmakopoulou, I., Kougioumtzis, G., Kaltsouda, A., Siouti, Z., Sofologi, M., ... & Tsitsas, G. (2023). Emotion-focused coping, social support and active coping among University students: gender differences. Journal of Psychology & Clinical Psychiatry, 14(1), 5–9. https://doi.org/10.15406/jpcpy.2023.14.00720.
Thomassin, K., Guérin Marion, C., Venasse, M., & Shaffer, A. (2017). Specific coping strategies moderate the link between emotion expression deficits and nonsuicidal self-injury in an inpatient sample of adolescents. Child and Adolescent Psychiatry and Mental Health, 11, 1–8. https://doi.org/10.1186/s13034-017-0158-3
Toprak, S., Cetin, I., Guven, T., Can, G., & Demircan, C. (2011). Self-harm, suicidal ideation and suicide attempts among college students. Psychiatry Research, 187(1–2), 140–144. https://doi.org/10.1016/j.psychres.2010.09.009
Tristania, O. C., & Hanurawan, F. (2022). The Correlation Between Emotional Dysregulation and Deliberate Self-harm Among College Students in Malang. KnE Social Sciences, 325–336 https://doi.org/10.18502/kss.v7i18.12398.
Tsai, M. H., Chen, Y. H., Chen, C. D., Hsiao, C. Y., & Chien, C. H. (2011). Deliberate self-harm by Taiwanese adolescents. Acta Paediatrica, 100(11), e223–e226. https://doi.org/10.1111/j.1651-2227.2011.02357.x
Wan, Y. H., Hu, C. L., Hao, J. H., Sun, Y., & Tao, F. B. (2011). Deliberate self-harm behaviors in Chinese adolescents and young adults. European Child & Adolescent Psychiatry, 20, 517–525. https://doi.org/10.1007/s00787-011-0213-1
Wu, C. Y., Stewart, R., Huang, H. C., Prince, M., & Liu, S. I. (2011). The impact of quality and quantity of social support on help-seeking behavior prior to deliberate self-harm. General Hospital Psychiatry, 33(1), 37–44. https://doi.org/10.1016/j.genhosppsych.2010.10.006
Wu, D., Rockett, I. R., Yang, T., Feng, X., Jiang, S., & Yu, L. (2016). Deliberate self-harm among Chinese medical students: A population-based study. Journal of Affective Disorders, 202, 137–144. https://doi.org/10.1016/j.jad.2016.05.030
Ye, Y., Huang, X., & Liu, Y. (2021). Social support and academic burnout among university students: a moderated mediation model. Psychology Research and Behavior Management, 335–344. https://doi.org/10.2147/PRBM.S300797.
Zahl, D. L., & Hawton, K. (2004). Media influences on suicidal behaviour: An interview study of young people. Behavioural and Cognitive Psychotherapy, 32(2), 189–198. https://doi.org/10.1017/S1352465804001195
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
Acknowledgements
This project was a result of multidisciplinary teamwork efforts. From two different Jordanian universities; The University of Jordan and The Hashemite University, occupational therapists and nurses were working together.
Funding
This study was funded by the University of Jordan, Amman, Jordan.
Author information
Authors and Affiliations
Contributions
Hanan I. Madi, Sana M.N. Abu Dahab, Shaher H. Hamaideh, and Majd B. Jarrar were involved in the concept and design of the study, in the acquisition of the data, in drafting the manuscript, and analyzing the data.
Corresponding author
Ethics declarations
Consent
Participants gave written consent. All participants were assured that they could withdraw from the study whenever they wanted and did not need to explain the reasons. They were also assured that withdrawal would not affect their care routines.
Research Ethics
Institutional Review Board (IRB) approval from the University of Jordan was gotten for this study (19/2023/265).
Conflict of Interest
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Madi, H., Abu-Dahab, S., Hamaideh, S.H. et al. Deliberate Self-harm, Coping Styles, Social Support Among University Students in Jordan. Int J Ment Health Addiction (2024). https://doi.org/10.1007/s11469-023-01237-1
Accepted:
Published:
DOI: https://doi.org/10.1007/s11469-023-01237-1