Abstract
Nonsuicidal self-injury (NSSI) is a complex behaviour and occurs most commonly during adolescence. This developmental period is characterized by the drive to establish an equilibrium between personal autonomy and connectedness with primary caregivers. When an adolescent self-injures, caregivers often experience confusion about how to react. Reports of feeling guilt, fear, and shame are common in the wake of learning about a child’s self-injury. This cascade of negative feelings and self-appraisals may lead to hypervigilance and increased caregiver efforts to control the child’s behaviour. The adolescent may experience this as an intrusion, leading to worse family functioning and increased risk of NSSI. This cascade is not well acknowledged or articulated in current literature. This article remedies this gap by presenting the NSSI Family Distress Cascade.
Highlights
Non-suicidal self-injury (NSSI) is defined as the direct, deliberate destruction of one’s own body tissue without suicidal intent [1] and includes behaviors such as cutting, burning, and hitting oneself
Engagement in NSSI is strongly associated with various adverse mental health outcomes such as low self-esteem, depression, anxiety, and suicide attempts [5, 6]
Several recent studies [7, 8] suggest that NSSI in adolescence is a predictor for depression, anxiety, and suicide attempts later in life
Summary
Non-suicidal self-injury (NSSI) is defined as the direct, deliberate destruction of one’s own body tissue without suicidal intent [1] and includes behaviors such as cutting, burning, and hitting oneself. The impact of NSSI on caregivers through secondary stress/distress, can disrupt family dynamics and impede family functioning [16, 17]. Studies examining family functioning from the adolescent perspective, find that youth who self-injure report less emotional support, more criticism, and excessive behavioral control from family members [18] when compared to youth who do not self-injure.
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