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Characteristics and functions of non-suicidal self-injury in a community sample of adolescents

Published online by Cambridge University Press:  12 March 2007

ELIZABETH E. LLOYD-RICHARDSON*
Affiliation:
Weight Control and Diabetes Research Center, Brown Medical School, Providence, RI, USA
NICHOLAS PERRINE
Affiliation:
Wesleyan University, Middletown, CT, USA
LISA DIERKER
Affiliation:
Wesleyan University, Middletown, CT, USA
MARY L. KELLEY
Affiliation:
Louisiana State University, Baton Rouge, LA, USA
*
*Address for correspondence: Dr E. E. Lloyd-Richardson, The Miriam Hospital, Brown Medical School, 196 Richmond Street, Providence, RI 02903, USA. (Email: erichardson@lifespan.org)

Abstract

Background

Few studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This study assessed the prevalence, associated clinical characteristics, and functions of NSSI in a community sample of adolescents.

Method

A total of 633 adolescents completed anonymous surveys. NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM).

Results

Some form of NSSI was endorsed by 46·5% (n=293) of the adolescents within the past year, most frequently biting self, cutting/carving skin, hitting self on purpose, and burning skin. Sixty per cent of these, or 28% of the overall sample, endorsed moderate/severe forms of NSSI. Self-injurers reported an average of 12·9 (s.d.=29·4) incidents in the past 12 months, with an average of 2·4 (s.d.=1·7) types of NSSI used. Moderate/severe self-injurers were more likely than minor self-injurers, who in turn were more likely than non-injurers, to have a history of psychiatric treatment, hospitalization and suicide attempt, as well as current suicide ideation. A four-factor model of NSSI functions was indicated, with self-injurers likely to endorse both reasons of automatic reinforcement and social reinforcement. The most common reasons for NSSI were ‘to try to get a reaction from someone’, ‘to get control of a situation’, and ‘to stop bad feelings’.

Conclusions

Community adolescents reported high rates of NSSI, engaged in to influence behaviors of others and to manage internal emotions. Intervention efforts should be tailored to reducing individual issues that contribute to NSSI and building alternative skills for positive coping, communication, stress management, and strong social support.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Bentler, P. M. (2004). EQS 6 Structural Equation Program Manual. Multivariate Software Inc.: Encino, CA.Google Scholar
Briere, J. & Gil, E. (1998). Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. American Journal of Orthopsychiatry 68, 609620.CrossRefGoogle ScholarPubMed
Chowanec, G. D., Josephson, A. M., Coleman, C. & Davis, H. (1991). Self-harming behavior in incarcerated male delinquent adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 30, 202207.CrossRefGoogle ScholarPubMed
Esposito, C., Spirito, A., Boergers, J. & Donaldson, D. (2003). Affective, behavioral and cognitive functioning in adolescents with multiple suicide attempts. Suicide and Life-Threatening Behavior 33, 389399.CrossRefGoogle ScholarPubMed
Favazza, A. R. (1989). Why patients mutilate themselves. Hospital and Community Psychiatry 40, 137145.Google ScholarPubMed
Favazza, A. R. (1998). The coming of age of self-mutilation. Journal of Nervous and Mental Disease 186, 259268.CrossRefGoogle ScholarPubMed
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: an empirical and conceptual review. Clinical Psychology: Science and Practice 10, 192205.Google Scholar
Gratz, K. L., Conrad, S. D. & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry 72, 128140.CrossRefGoogle ScholarPubMed
Guertin, T., Lloyd-Richardson, E., Spirito, A., Donaldson, D. & Boergers, J. (2001). Self-mutilative behavior in adolescents who attempt suicide by overdose. Journal of the American Academy of Child and Adolescent Psychiatry 40, 10621069.CrossRefGoogle ScholarPubMed
Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S. & Stewart, A. (2003). Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. Journal of Child Psychology and Psychiatry 44, 1191.CrossRefGoogle Scholar
Hawton, K., Rodham, K., Evans, E. & Weatherall, R. (2002). Deliberate self-harm in adolescents: self-report survey in schools in England. British Medical Journal 325, 12071211.CrossRefGoogle ScholarPubMed
Joiner, T. E., Conwell, Y., Fitzpatrick, K. K., Witte, T. K., Schmidt, N. B., Berlim, M. T., Fleck, M. P. A. & Rudd, D. M. (2005). Four studies on how past and current suicidality relate even when ‘Everything but the kitchen sink’ is covaried. Journal of Abnormal Psychology 114, 291303.CrossRefGoogle Scholar
Klonsky, E. D., Oltmanns, T. F. & Turkheimer, E. (2003). Deliberate self-harm in a nonclinical population. Prevalence and psychological correlates. American Journal of Psychiatry 160, 15011508.CrossRefGoogle Scholar
Laye-Gindhu, A. & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: understanding the ‘whats’ and ‘whys’ of self-harm. Journal of Youth and Adolescence 34, 447457.CrossRefGoogle Scholar
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press: New York.Google Scholar
Lloyd, E. E., Kelley, M. L. & Hope, T. (1997). Self-mutilation in a community sample of adolescents: descriptive characteristics and provisional prevalence rates. Poster session at the annual meeting of the Society for Behavioral Medicine, New Orleans, LA.Google Scholar
Mazza, J. J. & Reynolds, W. M. (1998). A longitudinal investigation of depression, hopelessness, social support and major and minor life events and their relation to suicidal ideation in adolescents. Suicide and Life-Threatening Behavior 28, 358374.Google ScholarPubMed
Muehlenkamp, J. J. & Gutierrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior 34, 1223.CrossRefGoogle Scholar
Nock, M. K. & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology 72, 885890.CrossRefGoogle ScholarPubMed
Nock, M. K. & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology 114, 140146.CrossRefGoogle ScholarPubMed
Pattison, E. M. & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry 140, 867872.Google ScholarPubMed
Patton, G. C., Harris, R., Carlin, J. B., Hibbert, M. E., Coffey, C., Schwart, M. & Bowes, G. (1997). Adolescent suicidal behaviors: a population-based study of risk. Psychological Medicine 27, 715724.CrossRefGoogle Scholar
Penn, J., Esposito, C., Schaeffer, L., Fritz, G. & Spirito, A. (2003). Suicide attempts and self-mutilative behavior in a juvenile correctional facility. Journal of the American Academy of Child and Adolescent Psychiatry 42, 762769.CrossRefGoogle Scholar
Reynolds, W. M. (1988). Suicide Ideation Questionnaire: Professional Manual. Psychological Assessment Resources: Odessa, FL.Google Scholar
Rodham, K., Hawton, K. & Evans, E. (2004). Reasons for deliberate self-harm: comparison of self-poisoners and self-cutters in a community sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 43, 8087.CrossRefGoogle Scholar
Ross, R. R. & McKay, H. B. (1979). Self-Mutilation. Heath: Lexington, MA.Google Scholar
Ross, S. & Heath, N. (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence 31, 6777.CrossRefGoogle Scholar
Suyemoto, K. L. (1998). The functions of self-mutilation. Clinical Psychology Review 18, 531554.CrossRefGoogle ScholarPubMed
Townsend, E., Hawton, K., Attman, D. G., Arensman, E., Gunnell, D., Hazell, P., et al. (2001). The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomised controlled trials with respect to depression, hopelessness, and improvement in problems. Psychological Medicine 31, 979988.CrossRefGoogle ScholarPubMed
Valois, R. F., Zullig, K. J., Huebner, S. & Drane, J. W. (2004). Life satisfaction and suicide among high school students. Social Indicators Research 66, 81105.CrossRefGoogle Scholar
Zlotnick, C., Mattia, J. I. & Zimmerman, M. (1999). Clinical correlates of self-mutilation in a sample of general psychiatric patients. Journal of Nervous and Mental Disease 187, 296301.CrossRefGoogle Scholar
Zoroglu, S. S., Tuzun, U., Sar, V., Tutkun, H., Savas, H. A., Ozturk, M., Alyanak, B. & Kora, M. E. (2003). Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry and Clinical Neurosciences 57, 119126.CrossRefGoogle ScholarPubMed