Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T05:20:05.203Z Has data issue: false hasContentIssue false
  • English
  • Français

Longitudinal predictors of past-year non-suicidal self-injury and motives among college students

Published online by Cambridge University Press:  12 September 2011

H. C. Wilcox ,
A. M. Arria ,
K. M. Caldeira ,
K. B. Vincent ,
G. M. Pinchevsky  and
K. E. O'Grady
H. C. Wilcox*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
A. M. Arria
Affiliation:
Center on Young Adult Health and Development (CYAHD), University of Maryland School of Public Health, Department of Family Science, College Park, MD, USA Treatment Research Institute, Philadelphia, PA, USA
K. M. Caldeira
Affiliation:
Center on Young Adult Health and Development (CYAHD), University of Maryland School of Public Health, Department of Family Science, College Park, MD, USA
K. B. Vincent
Affiliation:
Center on Young Adult Health and Development (CYAHD), University of Maryland School of Public Health, Department of Family Science, College Park, MD, USA
G. M. Pinchevsky
Affiliation:
Department of Criminology and Criminal Justice, University of South Carolina, Columbia, SC, USA
K. E. O'Grady
Affiliation:
Department of Psychology, University of Maryland, College Park, MD, USA
*
*Address for correspondence: H. C. Wilcox, Ph.D., The Johns Hopkins Hospital, 550 North Broadway, Room 206A, Baltimore, MD 21205, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Non-suicidal self-injury (NSSI) is the deliberate and direct injuring of body tissue without suicidal intent for purposes not socially sanctioned. Few studies have examined the correlates of NSSI among young adults. This study aimed to identify predictors of lifetime and past-year NSSI, and describe motives for NSSI and disclosure of NSSI to others.

Method

Interviews were conducted annually with 1081 students enrolled in the College Life Study, a prospective longitudinal study conducted at a large public mid-Atlantic university. NSSI characteristics were assessed at Year 4. Demographic and predictor variables were assessed during Years 1 to 4. Multivariate logistic regression models were used to identify correlates of lifetime NSSI and predictors of past-year NSSI.

Results

The prevalence of past-year and lifetime NSSI was 2% and 7% respectively (>70% were female for both lifetime and past-year NSSI). Seven percent of NSSI cases self-injured once, whereas almost half self-injured six or more times. Independent predictors of past-year NSSI were maternal depression, non-heterosexual orientation, affective dysregulation and depression. Independent predictors of lifetime NSSI were depression, non-heterosexual orientation, paternal depression and female sex. One in six participants with NSSI had attempted suicide by young adulthood. The three most commonly reported motives for NSSI were mental distress, coping and situational stressors. Most (89%) told someone about their NSSI, most commonly a friend (68%).

Conclusions

This study identified unique predictors of NSSI, which should help to elucidate its etiology and has implications for early identification and interventions.

Keywords

College studentsdeliberate self-harmNSSIself-injurious behavioryoung adults
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 717 - 726
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adrian, M, Zeman, J, Erdley, C, Lisa, L, Sim, L (2011). Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. Journal of Abnormal Child Psychology 39, 389–400.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. American Psychiatric Press: Washington, DC.Google Scholar
APA (2010). DSM-5 Development (www.dsm5.org/). Accessed 1 October 2010.Google Scholar
Arria, AM, Caldeira, KM, O'Grady, KE, Vincent, KB, Fitzelle, DB, Johnson, EP, Wish, ED (2008 a). Drug exposure opportunities and use patterns among college students: results of a longitudinal prospective cohort study. Substance Abuse 29, 19–38.CrossRefGoogle ScholarPubMed
Arria, AM, Caldeira, KM, Vincent, KB, O'Grady, KE, Wish, ED (2008 b). Perceived harmfulness predicts nonmedical use of prescription drugs among college students: interactions with sensation-seeking. Prevention Science 9, 191–201.CrossRefGoogle ScholarPubMed
Briere, J, Gil, E (1998). Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. American Journal of Orthopsychiatry 68, 609–620.CrossRefGoogle ScholarPubMed
Bureau, JF, Martin, J, Freynet, N, Poirier, AA, Lafontaine, MF, Cloutier, P (2010). Perceived dimensions of parenting and non-suicidal self-injury in young adults. Journal of Youth and Adolescence 39, 484–494.CrossRefGoogle ScholarPubMed
Compas, BE, Davis, GE, Forsythe, CJ, Wagner, BM (1987). Assessment of major and daily stressful events during adolescence: the Adolescent Perceived Events Scale. Journal of Consulting and Clinical Psychology 55, 534–541.CrossRefGoogle ScholarPubMed
Crowell, SE, Beauchaine, TP, McCauley, E, Smith, CJ, Vasilev, CA, Stevens, AL (2008). Parent-child interactions, peripheral serotonin, and self-inflicted injury in adolescents. Journal of Consulting and Clinical Psychology 76, 15–21.CrossRefGoogle ScholarPubMed
Deliberto, TL, Nock, MK (2008). An exploratory study of correlates, onset, and offset of non-suicidal self-injury. Archives of Suicide Research 12, 219–231.CrossRefGoogle ScholarPubMed
Garrison, CZ, Addy, CL, McKeown, RE, Cuffe, SP, Jackson, KL, Waller, JL (1993). Nonsuicidal physically self-damaging acts in adolescents. Journal of Child and Family Studies 3, 339–352.CrossRefGoogle Scholar
Gratz, KL, Conrad, SD, Roemer, L (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry 72, 128–140.CrossRefGoogle ScholarPubMed
Hankin, BL, Abela, JRZ (2011). Nonsuicidal self-injury in adolescence: prospective rates and risk factors in a 2½ year longitudinal study. Psychiatry Research 186, 65–70.CrossRefGoogle Scholar
Heath, NL, Ross, S, Toste, JR, Charlebois, A, Nedecheva, T (2009). Retrospective analysis of social factors and nonsuicidal self-injury among young adults. Canadian Journal of Behavioural Science 41, 180–186.CrossRefGoogle Scholar
Herpertz, S, Sass, H, Favazza, A (1997). Impulsivity in self-mutilative behavior: psychometric and biological findings. Journal of Psychiatric Research 31, 451–465.CrossRefGoogle ScholarPubMed
Jacobson, CM, Gould, M (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: a critical review of the literature. Archives of Suicide Research 11, 129–147.CrossRefGoogle ScholarPubMed
Jacobson, CM, Muehlenkamp, JJ, Miller, AL, Turner, JB (2008). Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. Journal of Clinical Child and Adolescent Psychology 37, 363–375.CrossRefGoogle ScholarPubMed
Johnson, EO, Arria, AM, Borges, G, Ialongo, N, Anthony, JC (1995). The growth of conduct problem behaviors from middle childhood to early adolescence: sex differences and the suspected influence of early alcohol use. Journal of Studies on Alcohol 56, 661–671.CrossRefGoogle ScholarPubMed
Kaess, M, Hille, M, Parzer, P, Maser-Gluth, C, Resch, F, Brunner, R (2011). Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury. Psychoneuroendocrinology. Published online: 13 June 2011. doi:10.1016/j.psyneuen.2011.05.009.Google ScholarPubMed
Kliem, S, Kroger, C, Kosfelder, J (2010). Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology 78, 936–951.CrossRefGoogle ScholarPubMed
Klonsky, ED (2009). The functions of self-injury in young adults who cut themselves: clarifying the evidence for affect-regulation. Psychiatry Research 166, 260–268.CrossRefGoogle ScholarPubMed
Klonsky, ED (2011). Non-suicidal self-injury in United States adults: prevalence, sociodemographics, topography, and functions. Psychological Medicine 41, 1981–1986.CrossRefGoogle ScholarPubMed
Laye-Gindhu, A, Schonert-Reichl, KA (2005). Nonsuicidal self-harm among community adolescents: understanding the ‘whats’ and ‘whys’ of self-harm. Journal of Youth and Adolescence 34, 447–457.CrossRefGoogle Scholar
Linehan, MM (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press: New York.Google Scholar
Lloyd-Richardson, E, Perrine, N, Dierker, L, Kelley, ML (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine 37, 1183–1192.CrossRefGoogle Scholar
Mann, RE, Sobell, LC, Sobell, MB, Pavan, D (1985). Reliability of a family tree questionnaire for assessing family history of alcohol problems. Drug and Alcohol Dependence 15, 61–67.CrossRefGoogle ScholarPubMed
MelissaDATA (2003). Income Tax Statistics Lookup (www.melissadata.com/lookups/taxzip.asp). Accessed 28 May 2008.Google Scholar
Mezzich, AC, Tarter, RE, Giancola, PR, Kirisci, L (2001). The dysregulation inventory: a new scale to assess the risk for substance use disorder. Journal of Child and Adolescent Substance Abuse 10, 35–43.CrossRefGoogle Scholar
Muehlenkamp, J, Gutierrez, PM (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior 34, 12–23.CrossRefGoogle Scholar
Nock, MK, Joiner, TE, Gordon, KH, Lloyd-Richardson, E, Prinstein, MJ (2006). Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Research 144, 65–72.CrossRefGoogle ScholarPubMed
Nock, MK, Mendes, WB (2008). Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. Journal of Consulting and Clinical Psychology 76, 28–38.CrossRefGoogle ScholarPubMed
Nock, MK, Prinstein, MJ (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology 72, 885–890.CrossRefGoogle Scholar
Nurco, DN, Blatchley, RJ, Hanlon, TE, O'Grady, KE (1999). Early deviance and related risk factors in the children of narcotic addicts. American Journal of Drug and Alcohol Abuse 25, 25–45.CrossRefGoogle ScholarPubMed
Peterson, J, Freedenthal, S, Sheldon, C, Andersen, R (2008). Nonsuicidal self injury in adolescents. Psychiatry 5, 20–26.Google ScholarPubMed
Polk, E, Liss, M (2009). Exploring the motivations behind self-injury. Counselling Psychology Quarterly 22, 233–241.CrossRefGoogle Scholar
Prinstein, MJ (2008). Introduction to the special section on suicide and nonsuicidal self-injury: a review of unique challenges and important directions for self-injury science. Journal of Consulting and Clinical Psychology 76, 1–8.CrossRefGoogle Scholar
Prinstein, MJ, Heilbron, N, Guerry, JD, Franklin, JC, Rancourt, D, Simon, V, Spirito, A (2010). Peer influence and nonsuicidal self injury: longitudinal results in community and clinically-referred adolescent samples. Journal of Abnormal Child Psychology 38, 669–682.CrossRefGoogle ScholarPubMed
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, Farmer, A, Jablenski, A, Pickens, R, Regier, DA, Sartorius, N, Towle, LH (1988). The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle ScholarPubMed
Ross, S, Heath, N (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence 31, 61–77.CrossRefGoogle Scholar
Sachsse, U, Von der Heyde, S, Huether, G (2002). Stress regulation and self-mutilation. American Journal of Psychiatry 159, 672–672.CrossRefGoogle ScholarPubMed
Sarason, IG, Johnson, JH, Siegel, JM (1978). Assessing the impact of life changes: development of the Life Experiences Survey. Journal of Consulting and Clinical Psychology 46, 932–946.CrossRefGoogle ScholarPubMed
Shaffer, D, Jacobson, C (2010). Proposal to the DSM-V Childhood Disorder and Mood Disorder Work Groups to Include Non-Suicidal Self-Injury (NSSI) as a DSM-V Disorder, pp. 1–21. American Psychiatric Association.Google Scholar
StataCorp (2007). Stata Statistical Software: Release 10. StataCorp LP: College Station, TX.Google Scholar
Substance Abuse and Mental Health Services Administration (2003). 2002 National Survey on Drug Use and Health Questionnaire. Office of Applied Studies: Rockville, MD.Google Scholar
Vaux, A (1986). The Social Support Appraisals (SS-A) scale: studies of reliability and validity. American Journal of Community Psychology 14, 195–219.CrossRefGoogle Scholar
Weierich, MR, Nock, MK (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology 76, 39–44.CrossRefGoogle ScholarPubMed
Whitlock, J, Eckenrode, J, Silverman, D (2006). Self-injurious behaviors in a college population. Pediatrics 117, 1939–1948.CrossRefGoogle Scholar
Whitlock, J, Knox, KL (2007). The relationship between self-injurious behavior and suicide in a young adult population. Archives of Pediatrics and Adolescent Medicine 161, 634–640.CrossRefGoogle Scholar
Yates, TM, Tracy, AJ, Luthar, SS (2008). Nonsuicidal self-injury among ‘privileged’ youths: longitudinal and cross-sectional approaches to developmental process. Journal of Consulting and Clinical Psychology 76, 52–62.CrossRefGoogle ScholarPubMed
Zuckerman, M (2002). Zuckerman-Kuhlman Personality Questionnaire (ZKPQ): an alternative five-factorial model. In Big Five Assessment (ed. de Raad and, B.Perugini, M.), pp. 377–396. Hogrefe & Huber: Seattle.Google Scholar