Introduction: Reported rates of non-suicidal self-injury (NSSI) differ by gender but may be under-reported and under-recognised in men. People engaging in NSSI rarely seek professional help without encouragement, so others play a key role in its identification and potential intervention. The current research investigated others’ interpretations of NSSI, examining whether gender affects the likelihood of NSSI identification and views of how common and acceptable NSSI is. Method: Participants (N = 429; 74.1% female, 23.3% male; please see below for further demographic information) responded to two vignettes describing a person self-injuring by punching a wall or by cutting themselves. The person’s gender in each vignette was manipulated. Following each vignette, the participants rated the level to which they agreed the behaviour was common for the gender of the person described, as well as the level to which they agreed the behaviour was acceptable for the gender of the person described, on a 5-point Likert scale. Following both vignettes, participants were presented with a definition of NSSI and rated the level to which they agreed cutting and wall-punching were forms of NSSI on 5-point Likert scales. Independent-samples t tests and goodness of fit χ2 tests were conducted as appropriate. Results: Participants were more likely to identify wall-punching as common for men and cutting as common for women. However, there was no significant difference in whether wall-punching was identified as NSSI or considered to be an acceptable behaviour, regardless of the gender of the person engaging in it. That is, although research suggests that men are far more likely to engage in wall-punching as a form of NSSI than women, participants did not recognise this. Overall, the results indicated a gender-dependent difference in how acceptable and common NSSI is thought to be, but no noticeable difference in identification of a behaviour as NSSI. Wall-punching, typically a form of NSSI engaged in by males, tended not to be identified as such. Conclusion: There is an effect of gender on how NSSI is interpreted, and it seems that men’s NSSI is, and will continue to be, under-recognised. This has important implications for the treatment of men’s NSSI, which is more likely to be seen as aggression and therefore deserving of punishment than an attempt at emotion regulation.

1.
Garisch
JA
,
Wilson
MS
.
Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: cross-sectional and longitudinal survey data
.
Child Adolesc Psychiatry Ment Health
.
2015 Jul 8
9
28
.
2.
Wester
K
,
Trepal
H
,
King
K
.
Nonsuicidal self-injury: increased prevalence in engagement
.
Suicide Life Threat Behav
.
2018
;
48
(
6
):
690
8
.
3.
Klonsky
ED
.
The functions of deliberate self-injury: a review of the evidence
.
Clin Psychol Rev
.
2007
;
27
(
2
):
226
39
.
4.
Andover
MS
,
Primack
JM
,
Gibb
BE
,
Pepper
CM
.
An examination of non-suicidal self-injury in men: do men differ from women in basic NSSI characteristics
.
Arch Suicide Res
.
2010
;
14
(
1
):
79
88
.
5.
Bresin
K
,
Schoenleber
M
.
Gender differences in the prevalence of nonsuicidal self-injury: a meta-analysis
.
Clin Psychol Rev
.
2015
;
38
:
55
64
.
6.
Kimbrel
NA
,
Thomas
SP
,
Hicks
TA
,
Hertzberg
MA
,
Clancy
CP
,
Elbogen
EB
.
Wall/object punching: an important but under-recognized form of nonsuicidal self-injury
.
Suicide Life Threat Behav
.
2018
;
48
(
5
):
501
11
.
7.
Patel
TA
,
Dillon
KH
,
Cassiello-Robbins
C
,
Calhoun
PS
,
Beckham
JC
,
Kimbrel
NA
.
Anger, impulsivity and wall/object punching in a sample of US. veterans with psychiatric disorders
.
J Psychiatr Res
.
2022
;
147
:
269
73
.
8.
Fitzgerald
J
,
Curtis
C
.
Non-suicidal self-injury in a New Zealand student population: demographic and self-harm characteristics
.
NZ J Psychol
.
2017
;
46
(
3
):
156
63
.
9.
Whitlock
J
,
Muehlenkamp
J
,
Purington
A
,
Eckenrode
J
,
Barreira
P
,
Baral Abrams
G
.
Nonsuicidal self-injury in a college population: general trends and sex differences
.
J Am Coll Health
.
2011
;
59
(
8
):
691
8
.
10.
Curtis
C
.
Young women’s experiences of self-harm
.
Young
.
2016
;
24
(
1
):
17
35
.
11.
Gratz
KL
,
Roemer
L
.
Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale
.
J Psychopathol Behav Assess
.
2004
;
26
(
1
):
41
54
.
12.
Chapman
AL
,
Gratz
KL
,
Brown
MZ
.
Solving the puzzle of deliberate self-harm: the experiential avoidance model
.
Behav Res Ther
.
2006
;
44
(
3
):
371
94
.
13.
Nock
MK
.
Why do people hurt themselves?: new insights into the nature and functions of self-injury
.
Curr Dir Psychol Sci
.
2009
;
18
(
2
):
78
83
.
14.
Swannell
SV
,
Martin
GE
,
Page
A
,
Hasking
P
,
St John
NJ
.
Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression
.
Suicide Life Threat Behav
.
2014
;
44
(
3
):
273
303
.
15.
Lucena
NL
,
Rossi
TA
,
Azevedo
LMG
,
Pereira
M
.
Self-injury prevalence in adolescents: a global systematic review and meta-analysis
.
Child Youth Serv Rev
.
2022
;
142
:
106634
.
16.
Robinson
K
,
Wilson
MS
.
Open to interpretation? Inconsistent reporting of lifetime nonsuicidal self-injury across two common assessments
.
Psychol Assess
.
2020
;
32
(
8
):
726
38
.
17.
Barrett
LF
,
Bliss-Moreau
E
.
She’s emotional. He’s having a bad day: attributional explanations for emotion stereotypes
.
Emotion
.
2009
;
9
(
5
):
649
58
.
18.
Hayes
SC
,
Strosahl
K
,
Wilson
KG
,
Bissett
RT
,
Pistorello
J
,
Toarmino
D
.
Measuring experiential avoidance: a preliminary test of a working model
.
Psychol Rec
.
2004
;
54
(
4
):
553
78
.
19.
Nolen-Hoeksema
S
.
Emotion regulation and psychopathology: the role of gender
.
Annu Rev Clin Psychol
.
2012
;
8
:
161
87
.
20.
Tamres
LK
,
Janicki
D
,
Helgeson
VS
.
Sex differences in coping behavior: a meta-analytic review and an examination of relative coping
.
Pers Soc Psychol Rev
.
2002
;
6
(
1
):
2
30
.
21.
Victor
SE
,
Muehlenkamp
JJ
,
Hayes
NA
,
Lengel
GJ
,
Styer
DM
,
Washburn
JJ
.
Characterizing gender differences in nonsuicidal self-injury: evidence from a large clinical sample of adolescents and adults
.
Compr Psychiatry
.
2018 Apr
82
53
60
.
22.
Lloyd-Richardson
EE
,
Perrine
N
,
Dierker
L
,
Kelley
ML
.
Characteristics and functions of non-suicidal self-injury in a community sample of adolescents
.
Psychol Med
.
2007 Aug
37
8
1183
92
.
23.
Green
JD
,
Kearns
JC
,
Ledoux
AM
,
Addis
ME
,
Marx
BP
.
Masculinity and men’s self-harm behaviors: implications for non-suicidal self-injury disorder
.
Am J Men’s Health
.
2018 Jan
12
1
30
40
.
24.
Inckle
K
.
Strong and silent
.
Men Masc
.
2014
;
17
(
1
):
3
21
.
25.
Bresin
K
,
Sand
E
,
Gordon
KH
.
Non-suicidal self-injury from the observer’s perspective: a vignette study
.
Arch Suicide Res
.
2013
;
17
(
3
):
185
95
.
26.
Levant
RF
,
Wimer
DJ
,
Williams
CM
.
An evaluation of the Health Behavior Inventory-20 (HBI-20) and its relationships to masculinity and attitudes towards seeking psychological help among college men
.
Psychol Men Masc
.
2011
;
12
(
1
):
26
41
.
27.
Seidler
ZE
,
Dawes
AJ
,
Rice
SM
,
Oliffe
JL
,
Dhillon
HM
.
The role of masculinity in men’s help-seeking for depression: a systematic review
.
Clin Psychol Rev
.
2016 Nov
49
106
18
.
28.
Collins
NL
,
Miller
LC
.
Self-disclosure and liking: a meta-analytic review
.
Psychol Bull
.
1994 Nov
116
3
457
75
.
29.
Eagly
AH
,
Crowley
M
.
Gender and helping behavior: a meta-analytic review of the social psychological literature
.
Psychol Bull
.
1986
;
100
(
3
):
283
308
.
30.
Ellemers
N
.
Gender stereotypes
.
Annu Rev Psychol
.
2018 Jan 4
69
1
275
98
.
31.
Plant
EA
,
Hyde
JS
,
Keltner
D
,
Devine
PG
.
The gender stereotyping of emotions
.
Psychol Women Q
.
2000
;
24
(
1
):
81
92
.
32.
Shields
SA
.
Gender and emotion
.
Psychol Women Q
.
2013
;
37
(
4
):
423
35
.
33.
Simon
RW
,
Nath
LE
.
Gender and emotion in the United States: do men and women differ in self-reports of feelings and expressive behavior
.
Am J Sociol
.
2004
;
109
(
5
):
1137
76
.
34.
Brescoll
VL
,
Uhlmann
EL
.
Can an angry woman get ahead? status conferral, gender, and expression of emotion in the workplace
.
Psychol Sci
.
2008
;
19
(
3
):
268
75
.
35.
Rosenfield
S
.
Gender and dimensions of the self: implications for internalizing and externalizing behavior
. In:
Frank
E
, editor.
Gender and its effects on psychopathology
Washington, DC
American Psychiatric Press
2000
. p.
23
36
.
36.
Lui
LMW
,
Lee
Y
,
Lipsitz
O
,
Rodrigues
NB
,
Gill
H
,
Ma
J
.
The influence of prescriber and patient gender on the prescription of benzodiazepines: results from the Florida Medicaid Dataset
.
CNS Spectr
.
2022 Jun
27
3
378
82
.
37.
Ussher
JM
Women’s madness: misogyny or mental illness?
Amherst, Mass
University of Massachusetts Press
1992
.
38.
McIntyre
RS
,
Chen
VC
,
Lee
Y
,
Lui
LMW
,
Majeed
A
,
Subramaniapillai
M
.
The influence of prescriber and patient gender on the prescription of benzodiazepines: evidence for stereotypes and biases
.
Soc Psychiatry Psychiatr Epidemiol
.
2021
;
56
(
6
):
1083
1089
.
39.
Rosenfield
S
,
Vertefuille
J
,
Mcalpine
DD
.
Gender stratification and mental health: an exploration of dimensions of the self
.
Soc Psychol Q
.
2000
;
63
(
3
):
208
23
.
40.
Goodwin
MH
The hidden life of girls: games of stance, status, and exclusion
Oxford
John Wiley and Sons
2007
.
41.
Lightdale
JR
,
Prentice
DA
.
Rethinking sex differences in aggression: aggressive behavior in the absence of social roles
.
Pers Soc Psychol Bull
.
1994
;
20
(
1
):
34
44
.
42.
Aguirre Velasco
A
,
Cruz
ISS
,
Billings
J
,
Jimenez
M
,
Rowe
S
.
What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review
.
BMC Psychiatry
.
2020 Jun 11
20
1
293
.
43.
Eagly
AH
,
Steffen
VJ
.
Gender and aggressive behavior: a meta-analytic review of the social psychological literature
.
Psychol Bull
.
1986
;
100
(
3
):
309
30
.
44.
Labouliere
C
,
Kleinman
M
,
Gould
M
.
When self-reliance is not safe: associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents
.
Int J Environ Res Public Health
.
2015 Apr 1
12
4
3741
55
.
45.
Doyle
L
,
Treacy
MP
,
Sheridan
A
.
Self-harm in young people: prevalence, associated factors, and help-seeking in school-going adolescents
.
Int J Ment Health Nurs
.
2015 Dec
24
6
485
94
.
46.
Han
J
,
Batterham
PJ
,
Calear
AL
,
Randall
R
.
Factors influencing professional help-seeking for suicidality
.
Crisis
.
2018 May
39
3
175
96
.
47.
Rowe
SL
,
French
RS
,
Henderson
C
,
Ougrin
D
,
Slade
M
,
Moran
P
.
Help-seeking behaviour and adolescent self-harm: a systematic review
.
Aust N Z J Psychiatry
.
2014 Dec
48
12
1083
95
.
48.
Michelmore
L
,
Hindley
P
.
Help-seeking for suicidal thoughts and self-harm in young people: a systematic review
.
Suicide Life Threat Behav
.
2012 Oct
42
5
507
24
.
49.
Hasking
P
,
Rees
CS
,
Martin
G
,
Quigley
J
.
What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers
.
BMC Public Health
.
2015
;
15
(
1
):
1039
.
50.
Bancroft
L
Why does he do that? Inside the minds of angry and controlling men
New York, NY
Berkley Books
2002
.
51.
Nielsen
E
,
Townsend
E
.
Public perceptions of self-harm — a test of an attribution model of public discrimination
.
Stigma Health
.
2018
;
3
(
3
):
204
18
.
52.
Robinson
K
,
Garisch
JA
,
Kingi
T
,
Brocklesby
M
,
O’Connell
A
,
Langlands
RL
.
Reciprocal risk: the longitudinal relationship between emotion regulation and non-suicidal self-injury in adolescents
.
J Abnorm Child Psychol
.
2019
;
47
(
2
):
325
32
.
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