Identifying the Meaning System of Defensive Structures in Adolescents With Self-Injurious Behaviors

Abstract

The aim of this study was to identify the meaning system of defensive structures in adolescents with self-injurious behaviors. This qualitative study employed thematic analysis. Data were collected through semi-structured interviews with 21 adolescents with a history of self-injurious behavior in Tehran, selected via purposive sampling. Interviews continued until theoretical saturation was reached. Data were analyzed using NVivo version 12, and the trustworthiness of findings was ensured through peer review and participant validation. Data analysis led to the identification of three main themes: emotional and cognitive defenses (including emotional suppression, rationalization, projection, defensive humor, splitting, and idealization), meaning-making and identity reconstruction (self-redefinition, meaning attribution to pain, identification with suffering, search for belonging, and storytelling), and maladaptive coping strategies (avoidance, risky behaviors, bodily harm, temporary emotional relief, self-blame, and failure in impulse control). The results demonstrated that defensive strategies and meaning-making play significant roles in the cycle of repetition and maintenance of self-injurious behaviors among adolescents. A comprehensive understanding of the defensive and meaning-related dimensions of adolescent self-injurious behavior can inform the development of targeted therapeutic interventions, family education, and preventive mental health programs for adolescents.