Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults

Victor, Sarah E.; Muehlenkamp, Jennifer J.; Hayes, Nicole; Lengel, Gregory J.; Styer, Denise M.; Washburn, Jason J.

doi:10.1016/j.comppsych.2018.01.009

Cited by 85 publications

(76 citation statements)

References 45 publications

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“…This raises the question of whether self-harming males are less prone to seeking help from the health care system and/or if they are adequately assessed for self-harm. It has also been suggested that males may present with a different clinical picture, including lower reported severity levels of self-harm correlates [23]. Self-harm has a history of being thought of as a problem mainly affecting females [24], but reporting levels may also be influenced by perceived stigma [25,26] as well as professional bias based on assumptions of sex difference.…”

Section: Discussionmentioning

confidence: 99%

Comparison of suicide risk and other outcomes among boys and girls who self-harm

Ohlis

Bjureberg

Lichtenstein

et al. 2020

Eur Child Adolesc Psychiatry

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Little is known about sex differences in outcomes of self-harm, and there are inconclusive results concerning the association between sex, self-harm, and suicide attempts. The aim of this study was to explore sex differences in outcomes of self-harm in adolescence. In this cohort study, all individuals (0-17 years) enrolled at the child-and adolescent mental health services (CAMHS) in Stockholm between 2001 and 2015 (N = 110,072) were followed in national registers from their last contact with the CAMHS, until end of 2015. Exposure was self-harm as reason for contact, outcome measures were: alcohol-/ substance use disorder, psychiatric hospitalization, non-violent or violent crime, and suicide. Differences in outcomes rates between exposed versus unexposed males, and exposed versus unexposed females, were examined using Cox regressions, expressed as hazard ratios (HR) with 95% confidence intervals (CI). Median follow-up time was 5.8 years (Q1: 2.3 years; Q3: 9.7 years). Self-harm was documented in 2.2% (N = 1241) males and 8.7% (4716) females. Exposed individuals had higher HR for all outcomes as compared with unexposed individuals of their own sex. Exposed females had more pronounced risk for drug use disorder (HR 11.2; 95% CI 9.9-12.7) compared with exposed males (HR 6.5, 95% 5.2-8.0). Both males and females who had engaged in self-harm had elevated risks for future suicide. Adjusting for socioeconomic status and age at start of follow-up only marginally affected the associations. Females and males with self-harm had similarly elevated risk for suicide, and self-harm was also an important risk marker for other adverse outcomes within both sexes.

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Section: Discussionmentioning

confidence: 99%

Comparison of suicide risk and other outcomes among boys and girls who self-harm

Ohlis

Bjureberg

Lichtenstein

et al. 2020

Eur Child Adolesc Psychiatry

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“…Possible sex differences in the ideation-to-action transition might pertain in part to differing uses and features of NSSI in autistic men and women, which have not been addressed by previous studies of NSSI in autistic adults without intellectual disability [35,40]. In non-autistic samples, there are some differences in the features of NSSI (for instance, wallpunching being a more common and often underrecognized form of self-injury in men [96], and cutting being more common in women [97]), and in the functional purpose of self-injury (with men less likely to use NSSI to influence others or avoid interacting with people [98], though others contradict this [4]). Sex differences in autistic NSSI, suicide, and the ideation-action transition are certainly a worthy line of enquiry.…”

Section: Limitations and Directions For Future Studymentioning

confidence: 96%

Links between self-injury and suicidality in autism

et al. 2020

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Background: Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method: One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/ attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. Results: While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions: These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

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“…6,7 It was reported that 20% of psychiatric patients engage in NSSI, while 5.5% of the community population experience the problem. 3,8 Accumulated findings suggest that NSSI is associated with severe psychopathologies including depressive disorders, anxiety disorders, personality disorders, eating disorders and substance use disorders [9][10][11] thereby highlighting the importance of research on NSSI among clinical populations.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Non-Suicidal Self-Injury and Suicide Attempts among Psychiatric Patients in Korea: A Retrospective Chart Review

Bae

Seong

Kim

et al. 2020

Psychiatry Investig

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Objective Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study, we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts.Methods We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric department of a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of three groups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristics and psychological assessments.Results Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likely to be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorder than the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8, RC9 in MMPI-2.Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychological disturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.

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Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults

Cited by 85 publications

References 45 publications

Comparison of suicide risk and other outcomes among boys and girls who self-harm

Comparison of suicide risk and other outcomes among boys and girls who self-harm

Links between self-injury and suicidality in autism

Clinical Characteristics of Non-Suicidal Self-Injury and Suicide Attempts among Psychiatric Patients in Korea: A Retrospective Chart Review

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