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

Department of Psychology, University of Denver, Denver, Colorado 80208, USA.
PEDIATRICS (Impact Factor: 5.47). 06/2012; 130(1):39-45. DOI: 10.1542/peds.2011-2094
Source: PubMed


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.

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    • "Barrocas et al. (2011) suggested that methodological factors may have contributed to discrepancies, such as the lack of differentiation between NSSI and suicide attempt behaviors. Due to the inconsistency in the literature on gender differences in NSSI, some experts conclude that additional research is needed to better understand the magnitude of any gender differences (Barrocas et al., 2012). Prior research has provided a theoretical framework for the function of NSSI. "
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    ABSTRACT: This study examined the prevalence, characteristics and functions of Non-suicidal Self-injury (NSSI) among Spanish adolescents. The sample consisted of 1,864 adolescents aged between 12 and 19 years (Mean Age = 15.32, SD = 1.97, 51.45% girls). The participants completed a modified version of the self-report scale Functional Assessment of Self-Mutilation (FASM; Lloyd, Kelley, & Hope, 1997) to assess rates and methods of NSSI used during the last 12 months. They also indicated the functions of NSSI. NSSI behaviors are common among Spanish adolescents. More than half of the sample showed such behavior in the past year, and 32.2% had carried out severe NSSI behaviors. The functions of NSSI were examined by using confirmatory factor analyses. Results supported a hierarchical model consisting of two second-order factors: automatic reinforcement, which explained both positive and negative automatic reinforcement, and social reinforcement, which explained both positive and negative social reinforcement. These dimensions are critical to understand the factors that maintain NSSI behavior and have implications for treatments.
    Full-text · Article · Aug 2015 · Psicothema
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    • "Participants for this study were 72 mother - offspring dyads . They were a subset of mothers and offspring who were selected from a larger study investigating the development of emotional distress disorders ( see Barrocas et al . , 2012 ) . Briefly , children and adolescents for the larger parent study were recruited by letters sent home to families with a child in 3rd , 6th , or 9th grades of public schools . Interested par - ents called the laboratory and responded to a brief phone screen that established that both the parent and child were fluent in English , and th"
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    ABSTRACT: Parental Posttraumatic Stress Disorder (PTSD), particularly maternal PTSD, confers risk for stress-related psychopathology among offspring. Altered hypothalamic-pituitary-adrenal (HPA) axis functioning is one mechanism proposed to explain transmission of this intergenerational risk. Investigation of this mechanism has been largely limited to general stress response (e.g., diurnal cortisol), rather than reactivity in response to an acute stressor. We examined cortisol reactivity in response to a laboratory stressor among offspring of mothers with a lifetime diagnosis of PTSD (n=36) and age- and gender- matched control offspring of mothers without PTSD (n=36). Youth (67% girls; mean age=11.4, SD=2.6) participated in a developmentally sensitive laboratory stressor and had salivary cortisol assessed five times (one pre-stress, one immediate post-stress, and three recovery measures, spaced 15min apart). Results were consistent with the hypothesis that offspring of mothers with PTSD would exhibit a dysregulated, blunted cortisol reactivity profile, and control offspring would display the expected adaptive peak in cortisol response to challenge profile. Findings were maintained after controlling for youth traumatic event history, physical anxiety symptoms, and depression, as well as maternal depression. This finding contributes to the existing literature indicating that attenuated HPA axis functioning, inclusive of hyposecretion of cortisol in response to acute stress, is robust among youth of mothers with PTSD. Future research is warranted in elucidating cortisol reactivity as a link between maternal PTSD and stress-related psychopathology vulnerability among offspring. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Preview · Article · Jan 2015 · Psychoneuroendocrinology
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    • "Some research suggests that girls report engaging in NSSI at higher rates than boys do (e.g., Giletta et al. 2012; Muehlenkamp and Gutierrez 2007; Ross and Heath 2002), whereas other studies do not (e.g., Muehlenkamp and Gutierrez 2004; Hilt et al. 2008). Further, it has recently been demonstrated that gender differences in NSSI engagement might emerge during adolescence (see Barrocas et al. 2012). Therefore, research examining adolescent NSSI, should pay particular attention to the role of sex. "
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    ABSTRACT: Although prevalence rates of nonsuicidal self-injury (NSSI) has been established throughout adolescence, little is known about the progression of NSSI, and consequently, about the risk factors for youth NSSI engagement. This study aimed to describe the overall longitudinal course of NSSI and the latent trajectory classes of NSSI in a population-based sample of adolescents using multi-wave data. Moreover, this study examined whether sex, lifetime history of depression, rumination, and negative attributional style predicted the longitudinal course of NSSI and trajectory group membership. Participants were 617 Chinese adolescents in Grades 10 through 12 (51.4 % girls). NSSI was assessed across eight waves of data. History of depression, rumination, and negative attributional style were assessed at baseline. Latent growth curve modeling revealed that only lifetime depression predicted the longitudinal course of NSSI from Grades 10 to 12, with depressed adolescents showing greater and more stable NSSI engagement over time than non-depressed adolescents. Group-based trajectory modeling yielded three distinct trajectory classes of NSSI engagement: low (69.2 %), moderate (26.1 %), and chronic (4.7 %). Negative attributional style distinguished adolescents in the chronic vs. low and moderate NSSI trajectory classes. Sex, rumination, and lifetime depression predicted membership in the chronic and/or moderate vs. low NSSI trajectory class. NSSI trajectory classes, based on frequency of NSSI, exist and are differentiated by sex, depression history, rumination, and negative attributional style. This study suggests that during this period of adolescence NSSI may be a relatively stable behavior, especially for some adolescents. Negative attributional style may be a salient risk factor for chronic NSSI engagement.
    Full-text · Article · Jun 2014 · Journal of Abnormal Child Psychology
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