Psychological Medicine

Original Article

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

ELIZABETH E. LLOYD-RICHARDSONa1 c1, NICHOLAS PERRINEa2, LISA DIERKERa2 and MARY L. KELLEYa3

a1 Weight Control and Diabetes Research Center, Brown Medical School, Providence, RI, USA

a2 Wesleyan University, Middletown, CT, USA

a3 Louisiana State University, Baton Rouge, LA, USA

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.

(Online publication March 12 2007)

Correspondence

c1 *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)

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