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

Lloyd-Richardson, Elizabeth E.; Perrine, Nicholas; Dierker, Lisa; Kelley, Michelle L.

doi:10.1017/s003329170700027x

Cited by 719 publications

(770 citation statements)

References 31 publications

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“…The majority of our self-injurig adolescents were selfmutilators. The finding and other results are in accordance with the findings of related literature in many aspects: the age range of the patients [12], the preferred body regions being the arms/elbow/hands/ legs/chest, which is similar to data drawn from a community sample of adolescents [27].…”

Section: Discussionsupporting

confidence: 92%

“…Non-suicidal self-injury, the term recently coined by Lloyd-Richardson as a contrast to its counterpart suicidal self-injury (SSI) seems to eradicate the previous terminological confusion [27]. In accordance with this recent viewpoint, the specific terms self-injury, suicidal and non-suicidal self-injury and their acronyms (SI, SSI, NSSI) are used in this study and both the former terminological formulations (parasuicide, self-mutilation, self-carving, etc.)…”

Section: Introductionmentioning

confidence: 99%

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Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury

Csorba

Dinya

Plener

et al. 2009

Eur Child Adolesc Psychiatry

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Objective: Self-injury (SI), self-injurious behaviour (SIB), including suicidal or non-suicidal self-injury (SSI, NSSI) represent an increasing problem among teenagers amounting to a 6–17% prevalence rate in adolescence, yet little data exists on detailed characteristics and associated factors of SI reaching clinical severity. There is also a scarcity of data distinguishing between suicidal and non-suicidal subsamples of self-injuring patients, i.e. showing which predictors contribute to develop self-injurious behaviour with a previous suicidal history (SSI). Method: Clinical diagnoses and characteristics of risk behaviour were examined in a crosssectional design in suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injurious behaviour. From the total pool of 708 new patients consecutively referred with various psychiatric problems in five regional child psychiatric centres in Western-Hungary over an 18-month period, 105 adolescent outpatients suffering from self-injurious behaviour participated in the study (28 males and 77 females aged from 14 to 18 years, mean age 15.97, SD 1.05). The Ottawa/Queen’s self-injury questionnaire (OSI) was used to measure the characteristics of risk behaviour, while the comorbid clinical diagnoses were confirmed by the M.I.N.I. Plus International Neuropsychiatric Interview. Descriptive statistics presented the frequencies of the characteristics of SI, bilateral comparisons were used to reveal relevant items to differentiate between sex, duration of practice and SSI versus NSSI and logistic regression was performed to identify significant predictors of suicidal subtype of self-injuring practice. Results: A total of 60% of the clinical SI population experienced a present or past episode of major depression. The motivation of patients to resist impulses and to discontinue malpractice was low. Cutting and scratching was the most common self-injuring methods. Two-thirds of the sample practised the impulsive type of SI, while 30% practised premeditated SI having an incubation time from 30 min to days and weeks before carrying out SI. Although duration of SI did not distinguish the sample in important aspects, girls and boys differed in several aspects of SI practice. SSI adolescents differed from their NSSI peers in a number of important characteristics including the frequency of actions, injured areas, methods, specific stresses and motivations. SSI adolescents were more likely to favour cutting of the lower leg and drug overdose as modes of SI. SSI adolescents were more likely to report addictive features than their peers with no suicidal motivation. From the aspect of self-injurious practice, logistic regression analysis found only two significant predictors for the combined pathology

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury

Csorba

Dinya

Plener

et al. 2009

Eur Child Adolesc Psychiatry

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“…As outlined in the top left corner of Figure 2, this creates the four functions of automatic negative reinforcement (i.e., removal or distraction from aversive thoughts or feelings), automatic positive reinforcement (i.e., feeling generation), social positive reinforcement (i.e., obtaining a favorable social response), and social negative reinforcement (i.e., removal or distraction from external events). The structural validity, internal consistency reliability, and construct validity of the FFM have been supported in our earlier work (Nock & Prinstein, 2004, 2005 and the model has received independent support from other research groups (e.g., Hilt, Cha, & Nolen-Hoeksema, 2008;Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007).…”

Section: Elaboration On the Social Functions Of Nssimentioning

confidence: 56%

Actions speak louder than words: An elaborated theoretical model of the social functions of self-injury and other harmful behaviors

Nock

2008

Applied and Preventive Psychology

215

232

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The question of why some people do things that are intentionally harmful to themselves continues to puzzle scientists, clinicians, and the public. Prior studies have demonstrated that one fairly extreme, direct form of self-harm, non-suicidal self-injury (NSSI), is maintained by both automatic (i.e., intrapersonal) as well as social (i.e., interpersonal) reinforcement. However, the majority of theoretical and empirical papers on this topic focus almost exclusively on the automatic functions. The purpose of this paper is to provide a more comprehensive analysis of the social functions of NSSI. Evidence is presented supporting the notion that NSSI is maintained by social reinforcement in at least a substantial minority of instances. Moreover, an elaborated theoretical model of the social functions of NSSI is outlined that proposes that this behavior represents a high intensity social signal used when less intense communication strategies fail (e.g., speaking, yelling, crying). The model further proposes that NSSI can serve not only as a signal of distress that is reinforced primarily by the caregiving behavior it elicits from others, but that it also can serve as a signal of strength and fitness that is reinforced by warding off potential threats (e.g., peer victimization), and in some cases can strengthen affiliation with others. Support for this theoretical model is drawn from diverse literatures including psychology, evolutionary biology, and cultural anthropology. The paper concludes with specific recommendations for empirical tests of the proposed model of the social functions of NSSI, as well as other harmful behaviors such as alcohol and drug use.

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“…Moreover, our inclusion criteria focused on NSSI in general, rather than a particular form of NSSI. As a result, the methods of NSSI observed in this study frequently included minor forms of NSSI, such as self-scratching and biting (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007). Given that the interpersonal sequelae of NSSI may differ depending on the method of NSSI (e.g., cutting may elicit more intense responses from other, relative to minor NSSI), future research examining NSSI method as a moderator of the relations between NSSI and interpersonal support and conflict is needed.…”

Section: Discussionmentioning

confidence: 99%

The role of interpersonal conflict and perceived social support in nonsuicidal self-injury in daily life.

Turner¹,

Cobb²,

Gratz³

et al. 2016

Journal of Abnormal Psychology

113

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Although accumulating microlongitudinal research has examined emotion regulatory models of nonsuicidal self-injury (NSSI), few studies have examined how interpersonal contingencies influence daily NSSI behavior. Participants with repeated NSSI (N = 60) provided daily ratings of perceived social support, interpersonal conflict, and NSSI urges and behaviors for 14 days. Consistent with interpersonal models of NSSI, we hypothesized that participants would be more likely to engage in NSSI on days when they experienced high levels of interpersonal conflict, that NSSI acts that were revealed to others would be followed by desirable interpersonal changes (i.e., greater support, less conflict), and that these interpersonal changes would, in turn, predict stronger NSSI urges and more frequent NSSI behavior. Consistent with hypotheses, daily conflict was associated with stronger same-day NSSI urges and greater likelihood of NSSI acts. Perceived support increased following NSSI acts that had been revealed to others, but not unrevealed NSSI acts. This perceived support was, in turn, associated with a stronger NSSI urges and greater likelihood of engaging in NSSI on the following day. Moreover, participants whose NSSI was revealed to others engaged in more total NSSI acts during the diary period than those whose NSSI was not revealed to others. Inconsistent with hypotheses, interpersonal conflict did not decrease following NSSI, regardless of whether or not these acts were revealed to others. Together, these results provide preliminary support for interpersonal reinforcement models of NSSI and highlight the importance of expanding research in this area to include interpersonal contingencies that may influence this behavior.

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

Cited by 719 publications

References 31 publications

Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury

Clinical diagnoses, characteristics of risk behaviour, differences between suicidal and non-suicidal subgroups of Hungarian adolescent outpatients practising self-injury

Actions speak louder than words: An elaborated theoretical model of the social functions of self-injury and other harmful behaviors

The role of interpersonal conflict and perceived social support in nonsuicidal self-injury in daily life.

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