Prevalence of non-suicidal self-injury and distinct groups of self-injurers in a community sample of adolescents.

Abstract

Adolescence is an important developmental period for the first onset of non-suicidal self-injury (NSSI), a behavior known to be associated with elevated suicide risk. Little is currently known, however, about NSSI among adolescents. The primary objectives of this research were to establish the prevalence of non-suicidal self-injury (NSSI) in a representative sample of Turkish high school students and to identify and describe distinct subgroups of self-injurers. A total of 1656 of 1676 eligible students (98.8% participation rate) from 18 schools were surveyed during the 2010-2011 academic year. Questionnaires were administered that assessed prior engagement in a variety of self-injurious behaviors, current psychiatric symptoms, suicide-related risk factors, and participation in health-risk behaviors. Latent class analysis (LCA) methods were used to identify distinct groups of self-injurers. Almost one-third of the sample (N=519) endorsed some previous engagement in NSSI behaviors. In LCA analyses restricted to youth with prior histories of NSSI, four distinct classes were identified characterized by: (1) low rates of NSSI behaviors (29%); (2) high rates of self-battery (32%); (3) high rates of self-cutting (19%); and (4) high rates of multiple NSSI behaviors (19%). These classes were further distinguished by current psychiatric symptoms, suicide risk factors, and other health-risk behaviors. Findings from the present study indicate that NSSI is a common form of behavior among adolescent youth. There is, however, considerable heterogeneity among those with NSSI histories, with about 40% at particularly high risk for ongoing distress, future acts of intentional self-harm, and suicidal behavior.