Applying social cognitive theory to understanding the disclosure of non-suicidal self-injury: A scoping review

Facilitating voluntary disclosures of non-suicidal self-injury (NSSI) has emerged as a promising approach to catalysing personal recovery and early support-seeking for people who self-injure. However, approximately half of individuals who self-injure have never disclosed their NSSI. To date, there is a lack of theoretical explanations available to conceptualise the decision to disclose NSSI. However, various anticipatory cognitions (e.g., anticipated stigma) have been implicated in the disclosure process. As such, this scoping review used Social Cognitive Theory as a theoretical framework to identify and synthesise the social cognitive factors underlying NSSI disclosure. This review considered all published empirical articles and theses that 1) reported on populations with a history of NSSI, 2) examined NSSI disclosures, and 3) reported on at least one social cognitive factor associated with NSSI disclosures. The review was guided by Arksey and O'Malley's 5-step methodological framework and Joanna Briggs Institute's guidelines for conducting scoping reviews. The findings from 43 studies support the applicability of Social Cognitive Theory in conceptualising NSSI disclosures. Specifically, factors underlying the decision to disclose often aligned with the theory's fundamental tenets of self-efficacy, outcome expectancies, and social modelling. Across the literature, we identified cognitions that were consistently implicated as barriers or facilitators of NSSI disclosure. The findings indicate that expectancy-challenge interventions may be effective in facilitating disclosures of NSSI. Despite this, the findings of the review call for future research validating the utility of Social Cognitive Theory in the disclosure context, particularly among culturally diverse populations.