Self-injury motives: A person-centered examination

Motivations for Self-Harm in Young People and Their Correlates: A Systematic Review

Self-harm in young people is associated with increased risk of suicide and other negative long-term outcomes. Understanding the motivations driving self-harm behaviours among young people can help to inform the development of preventative and treatment interventions. Self-harm rates have been rising, but reviews of the recent quantitative literature have not been undertaken. PsycInfo, Embase and Medline were systematically searched in September 2024 for studies published in the past ten years. Quantitative studies that examined motivations for self-harm (including prevalence and/or correlates) among young people (aged 10 to 24 years) with a history of self-harm were included in the review. The review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42023429568). One hundred and seventeen studies met inclusion criteria. Intrapersonal motivations for self-harm (particularly emotion regulation, anti-dissociation and self-punishment) were more common than interpersonal motivations (e.g. peer bonding, communication). Intrapersonal motivations correlated with female gender, higher self-harm severity, current, repetitive and persistent self-harm, suicidality, poorer mental health and poorer emotion regulation. There was evidence to suggest that interpersonal motives are associated with younger age and some mental health difficulties (e.g. anxiety). Young people predominantly self-harm for intrapersonal reasons. Given that self-harm for intrapersonal reasons is associated with greater self-harm severity, suicidality and poor mental health, steps should be taken to prevent and reduce self-harm. Interventions for self-harm require a multifaceted approach that not only provides young people with alternate ways of regulating their emotions, but also targets risk factors that contribute to self-harm.

Subgroups of non-suicidal self-injury in a large diverse sample of online help-seekers

Introduction

Many young people access information and resources for nonsuicidal self-injury (NSSI) online; yet our understanding of who accesses such information is limited. NSSI is a behavior with varied presentations. Understanding heterogeneity can help guide person-centered intervention. The present study aimed to (1) empirically identify classes of individuals with NSSI and (2) compare the classes according to demographic and clinical characteristics.

Methods

Data were collected from a survey posted to a national advocacy group website. Latent class analysis was used to derive classes based on characteristics associated with NSSI severity. Relationships between the latent classes and variables along five dimensions (behavior change, consequences or life interference, expectancies, functions, and NSSI across lifetime) were explored via logistic regression models.

Results

11,262 individuals reporting past month NSSI were included in analyses. The 4-class model provided the most clinically interpretable groups. Class 1 was the smallest (16.8%), scored highest on all items and reported the youngest age of onset. Class 3 was the largest (31.8%), scored lowest on all items and reported the latest age of onset. Classes 2 (29.3%) and 4 (22.2%) had moderate scores on most items and differed in levels of suicidal ideation.

Conclusion

Classes presented with more severe symptoms than what is typical in samples in extant literature underscoring the importance of tailoring interventions for dissemination in online contexts.

Similarities and differences in the functions of non-suicidal self-injury (NSSI) across gender non-conforming and cisgender young adults

BACKGROUND

Non-suicidal self-injury (NSSI) can be motivated by a broad range of functions and many individuals report multiple reasons for self-injuring. Most NSSI research has involved predominantly female samples and few studies have examined gender similarities and differences in function endorsement.

METHODS

We characterise the prevalence and versatility of NSSI functions within a gender-diverse online sample of cisgender women (cis-women; n = 280), cisgender men (cis-men; n = 176), and transgender, non-binary, and other gender non-conforming young adults (TGNC; n = 80) age 18-30 (M = 23.73, SD = 3.55). The Ottawa Self-Injury Inventory (OSI-F) assessed 24 intrapersonal and social functions across nine domains: affect regulation, self-punishment, anti-dissociation, anti-suicide, sensation seeking, sexuality, interpersonal influence, and body image.

RESULTS

TGNC participants and cis-women were significantly more likely to report intrapersonally motivated NSSI and greater function versatility than cis-men. Low mood, emotional distress, suicidality, and trauma symptomology appeared to contribute to gender differences in function endorsement. Gender similarities also emerged; across groups, intrapersonal functions were substantially more common than social functions, and the most endorsed domains were affect regulation and self-punishment. No domains were gender specific.

LIMITATIONS

The OSI-F was developed from majority female samples and may not adequately capture the experiences of other gender groups.

CONCLUSIONS

Interventions which reduce distress and strengthen emotion regulation are likely to benefit individuals who self-injure regardless of gender. However, most individuals report multiple NSSI functions and person-centred interventions which address this complexity are needed. Future research should develop gender-informed treatment models which consider the unique experiences of TGNC individuals and cis-men who self-injure.

Quantifying the Importance of Non-Suicidal Self-Injury Characteristics in Predicting Different Clinical Outcomes: Using Random Forest Model

Existing research on non-suicidal self-injury (NSSI) among adolescents has primarily concentrated on general risk factors, leaving a significant gap in understanding the specific NSSI characteristics that predict diverse psychopathological outcomes. This study aims to address this gap by using Random Forests to discern the significant predictors of different clinical outcomes. The study tracked 348 adolescents (64.7% girls; mean age = 13.31, SD = 0.91) over 6 months. Initially, 46 characteristics of NSSI were evaluated for their potential to predict the repetition of NSSI, as well as depression, anxiety, and suicidal risks at a follow-up (T2). The findings revealed distinct predictors for each psychopathology. Specifically, psychological pain was identified as a significant predictor for depression, anxiety, and suicidal risks, while the perceived effectiveness of NSSI was crucial in forecasting its repetition. These findings imply that it is feasible to identify high-risk individuals by assessing key NSSI characteristics, and also highlight the importance of considering diverse NSSI characteristics when working with self-injurers.

Understanding the subtypes of non-suicidal self-injury: A new conceptual framework based on a systematic review

Non-suicidal self-injury (NSSI) is a significant public health problem, but there is no consistent evidence of its risk factors. One possibility is that there are subtypes NSSI that have different risk factors and clinical symptoms. In this review we evaluated the evidence of subtypes to determine if there were consistent subtypes of NSSI that emerged across studies. Four databases (Medline; Embase; PsycINFO; Web of Science) were searched to identify studies that used data-driven approaches and were published before November 9, 2022. There were 21 studies with 23 unique samples for review. Most of the included studies used NSSI symptoms or personal characteristics as the subtyping indicators, revealing 2-5 subtypes of NSSI. Variations in subtyping indicators, sample characteristics, and statistical methods may have contributed to the inconsistent number and characteristics of subtypes across studies. A new conceptual framework is proposed to integrate these diverse findings, highlighting the important roles of NSSI function and psychological pain in differentiating NSSI subtypes. This framework sheds light on the differences among self-injurers and offers insights for future endeavors to address the complexities of NSSI.

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.