A typology of nonsuicidal self‐injury in a clinical sample: A latent class analysis

Abstract

Nonsuicidal self-injury(NSSI) is a behavioural concern and can present in diverse ways, varying by method, frequency, severity, function and so forth. The possible combinations of these features of NSSI produce an array of profiles that makes evaluation and management of this behaviour challenging. The aim of this study was to build upon previous work that reduces the heterogeneity of NSSI patterns by using latent class analysis (LCA) to identify a typology of NSSI. Participants consisted of 235 outpatients aged 14-35 years attending a tertiary psychiatric hospital in Singapore who had reported at least one NSSI behaviour within the last year. Eight indicators captured using the Functional Assessment of Self-Mutilation were used in the LCA: frequency of NSSI, length of contemplation before engaging in NSSI, usage of more than three NSSI methods, suicidal ideation and four psychological functions of NSSI, that is, social-positive, social-negative, automatic-positive and automatic-negative. The LCA revealed three distinct groups: Class 1-Experimental/Mild NSSI, Class 2-Multiple functions NSSI/Low Suicide Ideation and Class 3-Multiplefunctions NSSI/Possible Suicide Ideation. Multinomial logistic regression analyses were conducted to examine the associations between class membership and sociodemographic variables as well as measures of emotion dysregulation, childhood trauma, depression and quality of life. Females were overrepresented in Class 3. In general, Class 3 had the poorest scores followed by Class 2. Our analyses suggest that different NSSI subtypes require different treatment indications. Profiling patterns of NSSI may be a potentially useful step in guiding treatment plans and strategies.

Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis

“…Interestingly, the “high suicidal ideation NSSI group” had the shortest length of contemplation before committing the NSSI. This is inconsistent with data depicting that the severe NSSI group have a more extended period of contemplation before committing NSSI [ 65 ]. However, the current study is consistent with Hamza et al [ 65 ], demonstrating that severe adolescents with NSSI have a shorter period of contemplation before committing NSSI, indicating higher negative urgency than normal people.…”

“…This is inconsistent with data depicting that the severe NSSI group have a more extended period of contemplation before committing NSSI [ 65 ]. However, the current study is consistent with Hamza et al [ 65 ], demonstrating that severe adolescents with NSSI have a shorter period of contemplation before committing NSSI, indicating higher negative urgency than normal people. The urgency theory suggests that highly impulsive individuals may be particularly motivated to act rashly in the context of negative emotions because long-term benefits become less important than the immediate short-term gains of emotion regulation [ 66 ].…”

“…Specifically, the course of NSSI can be classified into two heterogeneous sub-groups or cohorts: the “high suicidal ideation NSSI group” and the “low suicidal ideation NSSI group”, the two classes of adolescents with NSSI identified in this study. The first subgroup identified contains 39.6% of adolescents and is congruent to the “The high-risk NSSI group” and “Multiple functions NSSI/Possible Suicide Ideation group” of earlier studies [ 64 , 65 ]. Individuals in this group are characterized by high-frequency engagement in NSSI in the past year, participation in more methods of NSSI, and a high probability of a past suicide attempt (compared with class 2).…”

Latent profile analyses of disordered eating behaviors and nonsuicidal self‐injury among Vietnamese adolescents

“…Mixture modeling has also been used to identify distinct patterns of NSSI behavior clustering in clinical and community‐based samples (Case et al, 2020; Dhingra et al, 2016; Klonsky & Olino, 2008; Shahwan et al, 2020; Somer et al, 2015; Whitlock et al, 2008). A range of NSSI behavior profiles have been identified, distinguished by frequency, number of behaviors used, functions endorsed, etc.…”

“…A range of NSSI behavior profiles have been identified, distinguished by frequency, number of behaviors used, functions endorsed, etc. For example, classes corresponding to mild engagement in NSSI, engagement in NSSI for multiple functions, and engagement in NSSI for multiple functions and endorsement of suicidal ideation were identified in a clinical sample of 235 adolescents and young adults in Singapore (Shahwan et al, 2020). In a sample of 10,069 Chinese adolescents, Xin and colleagues (2016) identified classes characterized by low engagement in NSSI and other risky behaviors, high engagement in both NSSI and other risky behaviors (e.g., overeating, substance use), endorsement of both NSSI and suicidal ideation/planning, and endorsement of other risky behaviors but not NSSI.…”