Nonsuicidal self-injury among adolescents with disorders of emotion and behavior: Clinical characteristics and association with suicidality

Abstract

Introduction: Nonsuicidal self-injury (NSSI) is defined as a separate entity in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a "condition for further study". Although the NSSI is not driven by suicidal intention, studies do show its association with suicidal phenomena, but this relationship is still unclear. Aim: The aim of this paper was to examine the characteristics of the NSSI phenomenon among adolescents with disorders of emotion and behavior, with special emphasis on its association with suicidal behavior. Material and methods: The study included 100 older adolescents with depressive disorders, anxiety disorders, adjustment disorders and mixed disorders of conduct and emotion, who were treated in day hospital. The data was obtained from the existing medical records and included information on NSSI and suicidal phenomena, psychiatric symptoms, diagnoses, rating scales for depression and global functioning, and data from personal and family history. Results: In our sample, the NSSI was more common in girls, and among younger adolescents. When it comes to clinical characteristics, this phenomenon was associated with higher depression symptom scores at admission and discharge, the presence of hypobulia-anhedonia, panic attacks, tension and restlessness, hetero-aggressive manifestations, more frequent use of alcohol and borderline personality disorder. It was also significantly associated with the presence of suicidal ideation during life, as well as with more severe suicidality level. In NSSI patients, suicidal attempts were more common among those who were neglected in childhood, with younger age of maltreatment onset, those with lower global functioning on admission, with cognitive problems, and with problematic compliance at admission. Conclusion: The high prevalence of NSSI in our sample, as well as numerous clinical features associated with it, may speak in favor of this phenomenon as a separate diagnostic entity. The observed association with suicide can be of clinical significance in terms of directing preventive steps.

Nonsuicidal self-injury in a clinical sample of adolescents in Serbia

“…Our research also confirmed earlier findings of greater frequency of NSSI in females that is particularly significant in a clinical sample of adolescents 8,14,22,23 . One of the explanations for this could be that male adolescents rarely look for help regarding their psychological difficulties due to fear of stigmatization.…”

“…More than half of the participants in our clinical sample (52.3%) had NSSI at least once in the last year. These findings have been confirmed in previous research studies indicating that the frequency of NSSI in the clinical population goes up to 60% 7,21,22,23 . Results of the current study are in line with the Kaess et al 24 research finding who found that the frequency of NSSI in a clinical sample with one NSSI is 60% and 50% for repetitive NSSI.…”