Abstract
Background/HypothesesAs risk factors for nonsuicidal self-injury (NSSI), most studies highlight the importance of internalising disorders, while only a few researches show the connection between externalising disorders and NSSI. Although some papers have introduced the idea that increasing prevalence rates of NSSI are connected to the broader use of the internet, associations between NSSI and pathological internet use (PIU) are understudied. According to our hypothesis, there is a connection between PIU and NSSI, but this is mediated by psychopathological factors from both internalising and externalising dimensions.MethodsIn line with the dimensional approach of psychiatric disorders, participants (N = 363) were recruited from both clinical (N = 202 psychiatric inpatient) and nonclinical (N = 161 adolescents from secondary schools) settings. Measurements: Demographic Questionnaire; Strengths and Difficulties Questionnaire (SDQ); Deliberate Self-Harm Inventory (DSHI); Young Diagnostic Questionnaire for Internet Addiction (YDQ), Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).ResultsThere was high NSSI frequency (39.9%–71% of them were girls) in our sample. NSSI was significantly more frequent among those who showed threshold symptoms on SDQ than in the subthreshold group [H(3) = 53.293, p <.001]. In the NSSI frequency, there was also a significant difference between ‘normal’ internet users and both ‘maladaptive’ and ‘pathological’ internet users [H(2) = 10.039, p <.05 p = .007]. According to the mediator models, the relationship between PIU and NSSI is not a direct association; it is mediated by all examined psychopathological factors (M.I.N.I. kid diagnoses) except for obsessive-compulsive disorder (OCD), alcohol abuse and dependence, and adjustment disorder.ConclusionsWe found a high frequency of NSSI. According to our results, PIU in itself is not a risk factor for NSSI but might become a risk factor in the presence of comorbid psychiatric disorders. All of these findings draw the attention of clinicians to the importance of careful screening of comorbid disorders with PIU.
Highlights
Due to the high prevalence of nonsuicidal self-injury (NSSI) in the past two decades, there is growing scientific interest in this phenomenon [1]
We examined our subjects according to internet use: we divided our subjects into three subgroups: normal internet users (0–2 score on YDQ), maladaptive internet users (3–4 score on YDQ), and pathological internet users
The whole study population consisted of 363 adolescents, of whom 202 were included from clinical setting and 161 adolescents from nonclinical settings; mean age of participating adolescents (N = 363) was 15.12 years (SD = 1.31)
Summary
Due to the high prevalence of nonsuicidal self-injury (NSSI) in the past two decades, there is growing scientific interest in this phenomenon [1]. It has become a proposed diagnosis in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders [2]. The symptoms of NSSI in DSM-5 follow the main instructions of the definition of the ‘International Society for the Study of Self-injury’ (ISSS) made in 2007: NSSI is a deliberate self-injurious act with a nonsuicidal purpose, which is not socially sanctioned. As a criterion for the proposed disorder, DSM-5 suggests: there should be 5 or more days in the past year when this kind of self-injurious acts happened. The nonadaptive ‘coping strategy’ nature of NSSI is important: the individual who engages in NSSI must have the aim of reaching a better emotional state after the action [2]
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