Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample

ArticleinPEDIATRICS 130(1):39-45 · June 2012with28 Reads
DOI: 10.1542/peds.2011-2094 · Source: PubMed
Abstract
The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. Youth in the third, sixth, and ninth grades (ages 7-16) at schools in the community were invited to participate in a laboratory study. A total of 665 youth (of 1108 contacted; 60% participation rate) were interviewed about NSSI over their lifetime via the Self-Injurious Thoughts and Behaviors Interview. Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. There was a significant grade by gender interaction; girls in the ninth grade (19%) reported significantly greater rates of NSSI than ninth-grade boys (5%). Behavioral methods of NSSI differed by gender. Girls reported cutting and carving skin most often, whereas boys reported hitting themselves most often. Finally, 1.5% of youth met some criteria for the proposed fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of NSSI. Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. Behavioral methods of NSSI also vary by grade and gender. As possible inclusion of an NSSI diagnosis in the fifth edition of the DSM-5 draws near, it is essential to better understand NSSI engagement across development and gender.
    • "For youth who engage in NSSI, multiple methods and/or locations of injuries, a longer history of NSSI, and/or recent worsening (e.g., increased frequency and/or severity), and cooccurring substance use are known to be associated with increased risk for suicide (Klonsky, 2007). In addition, a youth's perception that he or she is " addicted to the self-injury " is associated with more a severe profile of NSSI (Barrocas, Hankin, Young, & Abela, 2012). Although the severity of the youth's injury may be of concern, researchers suggest that it is inappropriate to ask to see the injuries, as revealing them may be experienced as highly aversive for the youth (). "
    [Show abstract] [Hide abstract] ABSTRACT: Non-suicidal self-injury (NSSI), the immediate and deliberate destruction of one’s own body tissue, without suicidal intent, and not for purposes that are socially accepted, is a critical concern for youth in schools. Despite significant scholarly advances and increasing clinical awareness of NSSI, many school mental health professionals (MHPs) continue to report feeling ill equipped to support students who self-injure, and emphasize a need for formal education about NSSI and its management in schools. Thus, the first part of this article summarizes current NSSI research on prevalence, age of onset, gender differences, functions, risk factors, and associations with suicide. Emerging from this review, the second part offers research-informed recommendations for MHPs managing NSSI in schools, including guidelines for (a) identifying students at elevated risk of self-injury, (b) developing a protocol for school personnel’s initial response to student self-injury, (c) first-level assessment of NSSI, and (d) managing critical issues related to NSSI contagion and online activity.
    Full-text · Article · Apr 2016
    • "The SITBI has excellent inter-rater reliability and test-retest reliability (Nock et al. 2007). Prior studies show that the SITBI is a valid measure for youth ages 7–16 (Barrocas et al. 2012). Depressive Symptoms The Children's Depression Inventory is a 27-item self-report questionnaire designed to assess youth depressive symptoms (Kovacs 2003). "
    [Show abstract] [Hide abstract] ABSTRACT: Despite literature suggesting a relationship between child maltreatment and suicidal ideation, few studies have examined the prospective course of this relationship. The current study examined this relationship in a sample of 682 community youth who were followed over the course of 3 years. Repeated measures of suicidal ideation, emotional maltreatment, and depressive symptom severity were examined in multi-wave path analysis models. Overall, results suggest that emotional maltreatment over time contributes uniquely to the prospective prediction of suicidal ideation, even when controlling for age, previous suicidal ideation, biological sex, and depression symptom severity. Unlike previous studies that have only measured emotional maltreatment at one-time point, the current study demonstrates that emotional maltreatment contributes unique risk to suicidal ideation prospectively among youth. Results speak to the importance of examining emotional maltreatment and suicidal ideation within prospective models of risk and suggest that emotional maltreatment is a robust predictor of suicidal ideation, over and above history of suicidal ideation and depression.
    Full-text · Article · Mar 2016
    • "The age of onset for NSSI is typically during adolescence with an average prevalence of approximately 18% within this age group (Muehlenkamp et al., 2012). The prevalence of NSSI was increasing around the turn of the century (O'Loughlin and Sherwood, 2005), and have remained stable at this high level (Barrocas et al., 2012; Muehlenkamp et al., 2012). Because NSSI occurs in patients with a range of disorders, such as major depressive disorder (MDD; Hintikka et al., 2009), borderline personality disorder (BPD; Cerutti et al., 2011), other disorders (Apter et al., 2008; Chartrand et al., 2012; Fliege et al., 2009; MaClean et al., 2010; Serras et al., 2010) and no disorder (Stanford and Jones, 2009 ), it is important to consider NSSI independent of diagnosis. "
    [Show abstract] [Hide abstract] ABSTRACT: Non-suicidal self-injury (NSSI) commonly starts in adolescence and is associated with an array of negative outcomes. Neurobiological research investigating NSSI is in its early stages and most studies have examined this behavior within the context of specific diagnoses. However, the Research Domain Criteria (RDoC) initiative encourages researchers to examine brain-behavior relationships across diagnoses. This review on the neurobiology associated with NSSI is organized using the domains proposed by RDoC: Negative Valence, Positive Valence, Cognitive, Social Processes, and Arousal/Regulatory Systems. Evidence of neurobiological anomalies is found in each of these domains. We also propose future research directions, especially in regard to human development. Future NSSI studies should address this behavior independent of diagnosis, examine relevant constructs across multiple units of analysis, and assess how systems change across development and course of illness. These advances will be essential for guiding neurobiologically informed intervention and prevention strategies to target NSSI. In doing so, we may prevent the associated negative outcomes across the lifespan.
    Full-text · Article · Sep 2015
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