Abstract
Research has identified more than a dozen functions of non-suicidal self-injury (NSI), but the conceptual and empirical overlap among these functions remains unclear. The present study examined the structure of NSI functions in two large samples of patients receiving acute-care treatment for NSI. Two different measures of NSI functions were utilized to maximize generalizability of findings: one sample (n = 946) was administered the Inventory of Statements About Self-injury (ISAS; Klonsky and Glenn in J Psychopathol Behav Assess 31:215–219, 2009), and a second sample (n = 211) was administered the Functional Assessment of Self-Mutilation (FASM; Lloyd et al. in Self-mutilation in a community sample of adolescents: descriptive characteristics and provisional prevalence rates. Poster session at the annual meeting of the Society for Behavioral Medicine, New Orleans, LA, 1997). Exploratory factor analyses revealed that both measures exhibited a robust two-factor structure: one factor represented Intrapersonal functions, such as affect regulation and anti-dissociation, and a second factor represented Social functions, such as interpersonal influence and peer bonding. In support of the two-factor structure’s construct validity, the factors exhibited a pattern of correlations with indicators of NSI severity that was consistent with past research and theory. Findings have important implications for theory, research, and treatment. In particular, the two-factor framework should guide clinical assessment, as well as future research on the implications of NSI functions for course, prognosis, treatment, and suicide risk.
Highlights
Non-suicidal self-injury (NSI) refers to the intentional destruction of one’s own body tissue without suicidal intent and for purposes not socially sanctioned (ISSS [13])
The Functional Assessment of Self-Mutilation (FASM) was administered for the first year of data collection, at which point the FASM was replaced with the ISAS for the last 3 years to provide a more comprehensive assessment of NSI functions
The number of factors to retain was based on an integration of considerations: inspection of the scree plot to identify the number of factors above the ‘elbow’, overlap or redundancy of factors, the conceptual interpretability of factors, and the size of eigenvalues/amount of variance explained for each factor [30]
Summary
Non-suicidal self-injury (NSI) refers to the intentional destruction of one’s own body tissue without suicidal intent and for purposes not socially sanctioned (ISSS [13]). Klonsky and Glenn [17] utilized EFA to examine the structure of the 13 scales in a sample of 235 university students with histories of NSI and found that they were best conceptualized as representing two superordinate factors: Intrapersonal and Interpersonal functions. Klonsky and Glenn [17] concluded that these Intrapersonal and Interpersonal factors were conceptually equivalent to Nock and Prinstein’s [26] Automatic and Social factors, respectively This two-factor structure was later further supported by a confirmatory factor analysis in a large (n = 529) Turkish sample of high school students with NSI histories [3]. Research has yet to empirically examine the structure of the ISAS at the item-level Both studies utilized non-clinical samples; many participants may have engaged in infrequent or sub-clinical NSI, which may limit generalizability to treatmentseeking populations. No significant differences were found for demographic variables (age, gender, race/ethnicity) or for NSI behaviors between participants who completed the ISAS and the FASM (all ps > .05)
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