The functions of nonsuicidal self-injury: converging evidence for a two-factor structure

Abstract

Research has identified more than a dozen functions of non-suicidal self-injury (NSI), but the conceptual and empirical overlap among these functions remains unclear. The present study examined the structure of NSI functions in two large samples of patients receiving acute-care treatment for NSI. Two different measures of NSI functions were utilized to maximize generalizability of findings: one sample (n = 946) was administered the Inventory of Statements About Self-injury (ISAS; Klonsky and Glenn in J Psychopathol Behav Assess 31:215–219, 2009), and a second sample (n = 211) was administered the Functional Assessment of Self-Mutilation (FASM; Lloyd et al. in Self-mutilation in a community sample of adolescents: descriptive characteristics and provisional prevalence rates. Poster session at the annual meeting of the Society for Behavioral Medicine, New Orleans, LA, 1997). Exploratory factor analyses revealed that both measures exhibited a robust two-factor structure: one factor represented Intrapersonal functions, such as affect regulation and anti-dissociation, and a second factor represented Social functions, such as interpersonal influence and peer bonding. In support of the two-factor structure’s construct validity, the factors exhibited a pattern of correlations with indicators of NSI severity that was consistent with past research and theory. Findings have important implications for theory, research, and treatment. In particular, the two-factor framework should guide clinical assessment, as well as future research on the implications of NSI functions for course, prognosis, treatment, and suicide risk.

Confirmatory factor analysis of the Inventory of Statements About Self‐injury in a Spanish clinical sample

“…Therefore, the authors suggested that future studies should examine the best conceptualization for this subscale, as either an intrapersonal or interpersonal function. Similar results to ours were found by Kortge et al () and Klonsky et al (), who found that item 17 (referred to self‐care) loaded on the intrapersonal factor.…”

“…The ISAS has been used in a large number of studies with community and university samples to explore the functionality of NSSI (e.g., Bentley, Sauer-Zavala, & Wilner, 2015;Klonsky & Olino, 2008) and in clinical samples (e.g., Klonsky et al, 2015;Lindholm, Bjärehed, & Lundh, 2011). The findings show that it is able to identify different profiles of self-injurers with different levels of severity, and they reveal the clinical utility of the instrument (Klonsky & Olino, 2008).…”

The DSM-5 nonsuicidal self-injury disorder among incoming college students: Prevalence and associations with 12-month mental disorders and suicidal thoughts and behaviors

“…A second possibility is that the presence of one condition increases risk of another. For example, people with mental disorders may use NSSI to regulate strong aversive internal and social experiences (Klonsky, Glenn, Styer, Olino, & Washburn, ; Nock & Prinstein, ). However, over time, NSSI itself may also lead to significant distress (e.g., feelings of shame; Mahtani, Melvin, & Hasking, ) and disability (e.g., social isolation; Stänicke, Haavind, & Gullestad, ).…”

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

“…Functions of NSSI, across samples and settings [15,16], are best described by two conceptually distinguishable constructs: (1) intrapersonal functions (i.e., affect and stress regulation) and (2) social functions (i.e., interpersonal influence) [17]. NSSI in adolescents is most frequently performed as dysfunctional strategy to regulate intense emotions, in particular to (momentarily) reduce negative affect [18].…”