Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




Deliberate self-harm (DSH), behavior that causes minor to moderate physical injury that is undertaken without conscious suicidal intent, is a frequent behavior in institutions such as prisons. The purpose of this study was to develop a grounded theory of DSH in incarcerated women. Seven incarcerated women who self-harm were interviewed and constant comparative analysis techniques were used to develop a model of DSH in incarcerated women. The model of Needing to Act emerged from the data of this study. Adverse childhood and adult events, such as sexual and physical abuse, were the predisposing factors for both acting out (criminal offending) and acting in (DSH). Adverse emotional experiences provided the precipitating impetus for the women in this study to act. Adverse emotional experiences included the following concepts: anxiety/tension, build up of pain/ frustration/anger, and no one to listen/no words to say it. The ways in which the participants acted out included the commission of felonies and acts that led to probation revocation. Acting in was manifested by various acts of DSH, the most frequent being cutting. Several intervening conditions were identified that impacted the nature and extent of acting out or acting in. These included the influences of children, methamphetamine, and a listening, caring support system. Three consequences common to both acting out and acting in emerged also. These included short-term, immediate relief, punishment, and embarrassment/shame. This research underscores the need to replace the punishment model of treatment for DSH. Treatments designed to teach more adaptive ways of acting and ways of tension reduction need to be explored.