Content uploaded by Patricia K Kerig
Author content
All content in this area was uploaded by Patricia K Kerig on Dec 18, 2017
Content may be subject to copyright.
Self-Destructive Behavior
PATRICIA K. KERIG
e term “self-destructive behavior” refers to a
wide range of self-harming acts that are seen at
high rates among youth in the juvenile justice
system. In fact, early psychoanalytically derived
theories of delinquency posited that antisocial
behavior itself was a form of self-destructiveness,
driven by alienation, low self-regard, and per-
ceived or actual rejection by others. More recently,
in addition to overtly suicidal behavior, two other
constructs related to self-destructiveness have
received empirical attention in the literature on
justice-involved youth: nonsuicidal self-injury
and reckless behavior. Notably, all of these forms
of self-destructiveness are prevalent among the
large proportion of youth in detention and cor-
rectional settings who have been exposed to
psychological trauma.
Suicide
Completed suicide can be dierentiated from
suicidal thoughts, intentions/plans, or attempts,
although evidence indicates these constructs
are interrelated in that successfully completed
suicides by justice-involved youth typically are
prefaced by suicidal ideation and unsuccess-
ful attempts. Suicide is the third leading cause
of adolescent death in the United States and
research on community samples indicates that
theriskishighestamongstyouthwhoexhibit
delinquent behaviors, especially when these are
accompanied by depression and substance abuse
(Kerig, Ludlow, and Wenar, 2012). Moreover, the
prevalence of suicide is even greater for youth
in detention or correctional facilities, whose
ratesare3to18timeshigherthanthoseoftheir
age-mates who are not incarcerated (Casiano
et al., 2013). e rst large-scale national mor-
tality study of completed suicide among youth in
correctional facilities (Hayes, 2009) found that
race played a signicant role, with Caucasian
and American Indian youth, who respectively
e Encyclopedia of Juvenile Delinquency and Justice. Edited by Christopher J. Schreck.
© 2017 John Wiley & Sons, Inc. Published 2017 by John Wiley & Sons, Inc.
DOI: 10.1002/9781118524275.ejdj0137
comprise only 38% and 2% of the overall popu-
lation of juveniles detained in the United States,
accounting for 68% and 11.4% of those who
committed suicide. Further, almost two-thirds
of youth who killed themselves while detained
had been diagnosed with a psychiatric disorder,
particularly depression. A known history of sex-
ual abuse was present in a quarter of the cases,
but for an equal number information about prior
maltreatment was unavailable. Almost 70% of
the youth had engaged previously in suicidal
behavior, including suicide attempts (46%), sui-
cidal thoughts (31%), and self-harming (24%).
Rates for boys and girls were consistent with their
respective representation in the population of
youth in corrections, and the majority of youth
who committed suicide had been charged with
nonviolent oenses.
Regarding suicidal thoughts and behaviors, one
of the largest-scale surveys conducted to date,
which included over 1,800 youth conned in 39
correctional facilities across the United States,
found that, within the previous year, almost 22%
of the youth had seriously considered suicide,
20% had made a plan, 16% had made at least one
attempt, and 8% had made an attempt serious
enough to cause injury (Morris et al., 1995);
in each case, these rates are higher than those
reported by youth in nationally representative
community samples. Other studies nd that as
many as 50–60% of youth in detention report
suicidal thoughts, and 33–44% have histories of
suicidal behavior (Casiano et al., 2013; Esposito
and Clum, 2002). More recently, a study of 1,829
youthdetainedinChicagofoundthatonehalfof
girls and one third of boys had suicidal thoughts
in the 6 months prior to their incarceration
(Abram et al., 2014). In addition, girls and youth
with anxiety disorders were those most likely to
have made a recent suicide attempt. Strikingly,
fewer than half of the sample had conded in
anyone about their suicidal thoughts.
One study focused not on youth in detention
or correctional facilities, but rather on the larger
population of justice-involved youth who remain
in the community on diversion, probation, or
observation (Wasserman and McReynolds, 2006).
2SELF-DESTRUCTIVE BEHAVIOR
In this sample, about 10% of youth reported
suicidal ideation or attempts in their lifetime
and 3% admitted to a recent suicide attempt. e
odds of a recent suicide attempt were increased
for youth who were female, met criteria for a
diagnosis of depression, and had committed a
violent oense.
One explanation for the elevated rates of sui-
cide amongst justice-involved youth is that they
demonstrate to a high degree characteristics
that are associated with increased risk of suicide
amongst adolescents generally, including mental
health disorders; substance abuse problems; his-
tories of physical, emotional, and sexual abuse;
emotional or physical separation from caregivers;
and exposure to recent interpersonal stressors,
losses, or life changing events – such as arrest
and incarceration (Kerig et al., 2012). Another
risk factor specic to youth in correctional insti-
tutions is isolation. In the national survey data
reported by Hayes (2009), over half of the youth
who committed suicide were isolated by being
placed on “room connement” at the time, usu-
ally as a punishment for committing institutional
infractions. Isolation in solitary connement is
well known to be major risk factor for suicide
amongst incarcerated adults, and clinical obser-
vations of adolescents concur: “When placed in
a cold and empty room by themselves, suicidal
youth have little to focus on – except all of their
reasons for being depressed and the various ways
that they can attempt to kill themselves” (Boesky,
2002: 210).
A history of sexual abuse also appears to be
a particularly strong predictor of suicide for
justice-involved youth. For example, one study of
youth in a correctional facility found that sexual
abuse was associated with a more than two times
greater likelihood of suicidal ideation and almost
three times greater likelihood of suicide attempts
(Morris et al., 1995).
Nonsuicidal Self-Injury
Nonsuicidal self-injury (NSSI), also termed
intentional self-harm, self-injury, self-mutilative
behavior, or parasuicide, refers to youth pur-
posefully engaging in acts that cause physical
pain or harm to themselves in the absence of
intentions to actually commit suicide. Common
examples of NSSIs among adolescents include
cutting, burning, head-banging, severe scratch-
ing, or interfering with the healing of wounds.
Youth in secure settings whose access to sharp
implements is restricted may nd surreptitious
ways of inicting self-injury, such as by digging
ngernails into the skin or showering in scalding
hot water. Although such behaviors might be dis-
missed as “attention seeking,” evidence suggests
they should be taken seriously given that they
are robust predictors of actual suicide attempts
and completions, perhaps because they serve as a
form of “practicing” (Joiner et al., 2005).
Inasystematicreviewoftheavailablestudieson
youth in correctional facilities, Casiano and col-
leagues (2013) found a wide variety of prevalence
rates in NSSI, ranging from 6% to 44%. However,
generally, investigators nder higher rates of
NSSI in samples of detained youth in comparison
to community populations. Rates of self-harm
are highest amongst justice-involved youth who
exhibit psychiatric problems, including depres-
sion, borderline personality traits, substance
abuse, anxiety, and impulse control disorders. For
example, in one study of justice-involved youth
who were referred for a mental health evalua-
tion, 30% reported engaging in self-mutilating
behavior while in detention (Penn et al., 2003).
In addition, just as with samples of youth in
clinical and community populations, studies of
detained youth nd that engagement in NSSI is
predicted by exposure to childhood trauma and
subsequent symptoms of posttraumatic stress
(Weierich and Nock, 2008). In particular, child-
hoodsexualabuseisfoundtobetheformof
maltreatment that is most strongly predictive of
engagement in NSSI amongst justice-involved
adolescents (Chaplo et al., 2015), particularly
girls (Belknap, Holsinger, and Little, 2012).
In order to understand the phenomenon of
NSSI, investigators have interviewed adolescents
about the functions such behavior serves. Notably,
youth provide a wide variety of responses and
there appear to be signicant individual dier-
ences in the motivations for such behavior (Nock
and Prinstein, 2005). For example, some youth
report that injuring themselves helps distract
them from their emotional pain, whereas others
report that focusing on the pain of self-injury
helps them to end episodes of dissociation by
reassuring themselves that they are “real”; some
SELF-DESTRUCTIVE BEHAVIOR 3
report that self-injury serves to punish them-
selvesorothers;andyetotheryouthreportthat
self-injury and the resulting marks on their bod-
ies attract wanted attention or provide evidence
that they are “tough” or “cool” (Klonsky, 2007).
However, a primary motivation for self-injury
appears to be the function it serves for regulating
emotion (Klonsky, 2009). A majority of youth
who self-injure report feeling a release of emo-
tional pressure aer self-harming and that the
behavior is in a sense “addictive” in that no other
method so eectively imparts relief from their
emotional distress.
Trauma-informed theories also suggest that
NSSI serves the function of an emotion regula-
tionstrategy.Whenayouth’sadaptivecapacities
for self-regulation have been overwhelmed
by exposure to traumatic stress, particularly
when trauma occurs in a context in which it is
inescapable, such as via parental abuse, youth
may resort to maladaptive strategies such as NSSI.
One particular posttraumatic symptom of dys-
regulated emotion – dissociation, a state of mind
in which the self or surroundings are experienced
as unreal – also has emerged as a predictor of
NSSI in a variety of samples, including adoles-
cents in the justice system (Kenny, Lennings,
and Munn, 2008). For example, in one study of
detained youth, both emotional dysregulation
and dissociation accounted for the link between
trauma exposure and NSSI, and this eect was
particularly strong for girls (Chaplo et al., 2015).
Reckless Behavior
A large body of research has accumulated to
conrm that exposure to traumatic stress is a
signicant predictor of adolescent involvement
in the juvenile justice system in general (see
Kerig and Becker, 2010, 2015), and that trauma
increases the risk of suicidal and nonsuici-
dal self-injury amongst justice-involved youth
in particular (Chaplo et al., 2015). erefore,
trauma-informed theories of delinquency have
emerged, which propose that posttraumatic
reactions contribute to diverting youth down the
pathway to antisocial behavior by disrupting their
capacities for adaptive self-regulation and infor-
mation processing (Ford et al., 2006). Moreover,
clinical observations of the reactions displayed by
troubled adolescents in the aermath of trauma
have suggested a new category of symptoms,
termed “reckless or self-destructive behavior,”
which was recently incorporated into the revised
diagnosis of posttraumatic stress disorder (Amer-
ican Psychiatric Association, 2013). In addition
to overtly suicidal behavior and NSSI, this new
category of symptoms includes more covert
actions such as dangerous driving, excessive
substance use, thrill seeking, and engaging in
high-risk activities, which may not be recog-
nized by youth or those around them as forms of
self-destructiveness. Engagement in these kinds
of behaviors, in which youth put themselves at
risk by rushing headlong into unsafe situations,
may reect a kind of fear-deance that is charac-
teristic of those traumatized youth who engage
in delinquency (Ford et al., 2010; Bennett et al.,
2014); moreover, engaging in these kinds of risky
activities may in fact be what brings a teenager
into contact with the juvenile justice system in
the rst place. As Pynoos and colleagues (2009)
suggest, the experience of childhood trauma
interferes with the stage-salient development in
adolescence of a balance between the need for
safety and the drive for self-ecacy; the result
is a youth with an impaired ability to accurately
recognize danger combined with precocious
independence and denial of the need for pro-
tection. is can propel adolescents toward
increasing engagement in reckless or high-risk
behaviors, especially those that confer a false
sense of safety and self-suciency, such as get-
ting high on drugs or experiencing the thrill of
surviving a dare-devil stunt.
Because this category of posttraumatic reck-
lessness is such a new addition to the diagnostic
criteria for PTSD, only a few studies have begun
to investigate its association with adolescent
involvement in the justice system. Compelling
research also has emerged from another con-
text, that of youth living in communities under
the constant threat of terrorist violence. In a
study of Israeli adolescents exposed to recurrent
terrorist attacks, Pat-Horenczyk and colleagues
(2007) found that higher levels of exposure to
violence were related to posttraumatic stress
symptoms which, in turn, were related to engage-
ment in risk-taking behaviors such as drug use,
driving recklessly, having unprotected sex, car-
rying a weapon, defying authorities, and other
4SELF-DESTRUCTIVE BEHAVIOR
dangerous behaviors. e investigators suggest
that engaging in these behaviors may be an ado-
lescent’s maladaptive way of attempting to regain
a developmentally important sense of mastery
andcontrolinthefaceofunpredictableand
uncontrollable stress.
SEE ALSO: Gender (Correlations and Contexts
of Delinquency); Juvenile Victimization; Mental
Illness and Competency; Physical Abuse; Psycho-
logical eories of Crime; Sexual Abuse; Victim-
ization as a Correlate of Oending
References
Abram, K. M., Cho e, J. Y., Washbur n, J. J. , Teplin,
L. A., King, D. C., Dulcan, M. K., and Bassett, E.
D. (2014). Suicidal thoughts and behaviors among
detained youth.Washington,DC:OceofJuvenile
Justice and Delinquency Prevention, US Department
of Justice.
American Psychiatric Association. (2013). Diagnostic
and statistical manual of mental disorders, Fih Edi-
tion (DSM-5). Arlington, VA: American Psychiatric
Publishing.
Belknap, J., Holsinger, K., and Little, J. (2012). Sexual
minority status, abuse, and self-harming behaviors
among incarcerated girls. JournalofChild&Adoles-
cent Trauma, 5(2): 173–185.
Bennett,D.C.,Kerig,P.K.,Chaplo,S.D.,McGee,
A. B., and Baucom, B. R. (2014). Validation of
the ve-factor model of PTSD symptom structure
among delinquent youth. Psychological Trauma, 6(4):
438–447.
Boesky, L. (2002). Juve nile oenders with mental
health disorders: Who are they and what do we do
with them? Lanham, MD: American Correctional
Association.
Casiano, H., Katz, L. Y., Globerman, D., and Sareen, J.
(2013). Suicide and deliberate self-injurious behavior
in juvenile correctional facilities: A review. Journal of
the Canadian Academy of Child and Adolescent Psy-
chiatry, 22(2): 118.
Chaplo,S.D.,Kerig,P.K.,Bennett,D.C.,and
Modrowski, C. A. (2015). e roles of emotion
dysregulation and dissociation in the association
between sexual abuse and self-injury among juvenile
justice-involved youth. Journal of Trauma & Dissoci-
ation, 16(3): 272–285.
Esposito, C. L., and Clum, G. A. (2002). Social sup-
port and problem-solving as moderators of the rela-
tionship between childhood abuse and suicidality:
Applications to a delinquent population. Journal of
Traumatic Stress, 15(2): 137–146.
Ford, J. D., Chapman, J., Mack, M., and Pearson,
G. (2006). Pathways from traumatic child vic-
timization to delinquency: Implications for juve-
nile and permanency court proceedings and deci-
sions. Juvenile and Family Court Journal, 57(1):
13–26.
Ford,J.D.,Elhai,J.D.,Connor,D.F.,andFrueh,B.
C. (2010). Poly-victimization and risk of posttrau-
matic, depressive, and substance use disorders and
involvement in delinquency in a national sample
of adolescents. Journal of Adolescent Health, 46(6):
545–552.
Hayes, L. M. (2009) Juvenile suicide in connement: A
national survey.Washington,DC:OceofJuvenile
Justice and Delinquency Prevention, US Department
of Justice.
Joiner,T.E.,Conwell,Y..Fitzpatrick,K.K.,Witte,T.K.,
Schmidt, N. B., Berlim, M. T., …, Rudd, M. D.
(2005). Four studies on how past and current suici-
dality relate even when “everything but the kitchen
sink” is covaried. Journal of Abnormal Psychology,
114(2): 291.
Kenny, D. T., Lennings, C. J., and Munn, O. A. (2008).
Risk factors for self-harm and suicide in incarcer-
ated young oenders: Implications for policy and
practice. Journal of Forensic Psychology Practice, 8(4):
358–382.
Kerig, P. K., and Becker, S. P. (2010). From internalizing
to externalizing: eoretical models of the processes
linking PTSD to juvenile delinquency. In S. J. Egan
(Ed.), Posttraumatic stress disorder (PTSD): Causes,
symptoms and treatment (pp. 1–46). Hauppauge, NY:
Nova Science Publishers.
Kerig, P. K., and Becker, S. P. (2015). Early abuse
and neglect as risk factors for the development of
criminal and antisocial behavior. In J. Morizot and
L. Kazemian (Eds.), e development of criminal
and antisocial behavior (pp. 181–199). New York:
Springer.
Kerig,P.K.,Ludlow,A.,andWenar,C.
(2012). Developmental psychopathology: From
infancy through adolescence (6th ed.). Maidenhead,
UK: McGraw-Hill.
Klonsky, E. D. (2007). e functions of deliberate
self-injury: A review of the evidence. Clinical Psychol-
ogy Review, 27(2): 226–239.
Klonsky, E. D. (2009). e functions of self-injury
in young adults who cut themselves: Clarifying the
evidence for aect-regulation. Psychiatry Research,
166(2–3): 260–268.
Morris, R. E., Harrison, E. A., Knox, G. W., Tro-
manhauser, E., Marquis, D. K., and Watts, L.
L. (1995). Health risk behavioral survey from
39 juvenile correctional facilities in the United
States. Journal of Adolescent Health, 17(6):
334–344.
SELF-DESTRUCTIVE BEHAVIOR 5
Nock, M. K., and Prinstein, M. J. (2005). Contextual
features and behavioral functions of self-mutilation
among adolescents. Journal of Abnormal Psychology,
114(1): 140–146.
Pat-Horenczyk, R., Peled, O., Miron, T., Brom, D.,
Villa, Y., and Chemtob, C. (2007). Risk-taking behav-
iors among Israeli adolescents exposed to recur-
rent terrorism: Provoking danger under continu-
ous threat? American Journal of Psychiatry, 164(1):
66–72.
Penn, J. V., Esposito, C. L., Schaeer, L. E., Fritz, G.
K., and Spirito, A. (2003). Suicide attempts and
self-mutilative behavior in a juvenile correctional
facility. Journal of the American Academy of Child &
Adolescent Psychiatry , 42(7): 762–769.
Pynoos, R. S., Steinberg, A. M., Layne, C. M., Briggs,
E. C., Ostrowski, S. A., and Fairbank, J. A. (2009).
DSM-5PTSDdiagnosticcriteriaforchildrenand
adolescents: A developmental perspective and rec-
ommendations. Journal of Traumatic Stress, 22(5):
391–398.
Wasserman, G. A., and McReynolds, L. S. (2006).
Suicide risk at juvenile justice intake. Suicide and
Life-reatening Behavior, 36(2): 239–249.
Weierich, M. R., and Nock, M. K. (2008). Posttrau-
matic stress symptoms mediate the relation between
childhood sexual abuse and nonsuicidal self-injury.
Journal of Consulting and Clinical Psychology, 76(1):
39–43.
Further Reading
Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V.,
Hoven, C. W., …, Wasserman, D. (2014). Life-time
prevalence and psychosocial correlates of adolescent
direct self-injurious behavior: A comparativestudy of
ndings in 11 European countries. Journal of Child
Psychology and Psychiatry, 55(4): 337–348.
Gunter,T.D.,Chibnall,J.T.,Antoniak,S.K.,Philibert,
R. A., and Black, D. W. (2013). Childhood trauma,
traumatic brain injury, and mental health disorders
associated with suicidal ideation and suicide-related
behavior in a community corrections s ample. Journal
of the American Academy of Psychiatry and the Law,
41(2): 245–255.
Kerig, P. K. (2014). Psychological trauma and juvenile
delinquency: New directions in research and interven-
tion.NewYork:Routledge.
Nock, M. K. (2012). Future directions for the study of
suicide and self-injury. Journal of Clinical Child &
Adolescent Psychology, 41(2): 255–259.
