Bisexuality and Non-Suicidal Self-Injury: an analysis of risk and exploration of associated psychological variables

Abstract

This thesis explored the relationship between bisexuality and Non-Suicidal Self-Injury (NSSI). This thesis consists of four chapters: 1) a meta-analysis of risk and narrative synthesis of associated variables, 2) a quantitative empirical study, 3) a qualitative empirical study and 4) a critical appraisal and reflection of the research process and associated considerations. In the meta-analysis and narrative synthesis (Paper 1), 24 papers were identified. Bisexual people had around six times the odds of engaging in NSSI compared to heterosexual people, and around four-and-a-half times the odds when compared to gay and lesbian people. When compared to any other sexuality, the overall weighted odds ratio was 3.50. From six papers included in the narrative synthesis, symptoms of anxiety and depression were most often, and most strongly, associated with NSSI for this group. This review emphasises the need for bisexual people to be studied independently of other sexual minorities when researching NSSI, given clear differences. Targeted support for bisexual people is recommended, with further research needed to investigate this behaviour for bisexual people. The quantitative empirical paper (Paper 2) was a six-week microlongitudinal online survey study. The aim of this paper was to examine if the psychological variables of self-esteem and thwarted belongingness were associated at the same point in time with NSSI urges, and if such variables were also associated with next week urges. The total sample was N=207, with participants from 25 countries taking part. Results indicated that self-esteem and thwarted belongingness were both strongly associated with NSSI urges at the same point in time. Additionally, when self-esteem was lagged in a mixed model linear regression with covariates, NSSI urges could be reliably predicted. Paper 3 reports on a qualitative investigation of bisexuality and NSSI. A subset of participants from Paper 2 were invited to take part in an online interview of their experiences of bisexuality, NSSI and the COVID19 pandemic. The total sample for this paper was N=15, and results were analysed using thematic analysis. Four themes were constructed from the data: 1) coping with a heteronormative and binary-focused world, 2) relationship between bisexuality and NSSI, 3) experiences of lockdown and 4) meaning and consequences of NSSI. Results were taken back to a subset of participants for member-checking. Results are discussed with reference to epistemic injustice and the finding that NSSI was used to manage negative reactions from others, rather than an implicit dislike of bisexuality. It is recommended that future research should explore the nuances of intersecting identities to further unpack this relationship. The final paper, Paper 4, provides a critical reflection and appraisal of the research process. This includes how the qualitative study came to be, a discussion of challenges encountered and decisions made, and an update of literature relevant to the meta-analysis, given that this paper was published in 2020.

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Peter Taylor (Supervisor)