To the Editor:

We would like to respond to the work of Lloyd-Richardson et al. (Reference Lloyd-Richardson, Perrine, Dierker and Kelley2007), who reported a 28% rate of moderate/severe non-suicidal self-injury (NSSI) from a community sample of 633 adolescents (mean age 15·5 years). The authors speculated whether these high rates may be due to their form of assessment or whether ‘NSSI may be more prevalent in the community than previously suspected’ (p. 8).

We would like to emphasize the second point by offering reference to two other recent studies that have found comparable rates using a different assessment tool. Specifically, Muehlenkamp & Gutierrez (Reference Muehlenkamp and Gutierrez2007) reported a 23·2% prevalence rate of NSSI and 8·9% rate of suicide attempts in a community sample of 540 US adolescents using the Self Harm Behavior Questionnaire (SHBQ; Gutierrez et al. Reference Gutierrez, Osman, Barrios and Kopper2001). Using a translated, validated German version of the SHBQ (Fliege et al. Reference Fliege, Kocalevent, Walter, Gratz, Gutierrez and Klapp2006), a prevalence rate of 25·9% for NSSI and of 7·12% for suicidal attempts was found in our own study of a German adolescent school sample.

These additional studies, representing a cross-national comparison of rates of NSSI, seem to be analogous to those reported by Lloyd-Richardson et al. although another assessment instrument was used. The complementary findings point to the fact that NSSI seems to be a phenomenon on the rise in adolescents in Western cultures.