Nonsuicidal Self-injury Characteristics Research Articles

Relationships between the frequency and severity of non-suicidal self-injury and suicide attempts in youth with borderline personality disorder.

Non-suicidal self-injury (NSSI) is a recognized indicator of suicide risk. Yet, the ubiquity of this behaviour in borderline personality disorder (BPD) limits its utility as a predictor of risk. Consequently, this study aimed to elucidate the relationship between other features of NSSI, including frequency and severity, and suicide attempts. Participants included 107 youth (15 to 25 year olds) with BPD who were assessed for BPD severity, depressive symptoms, 12-month frequency of NSSI and suicide attempts, as well as the levels of treatment sought following each self-harm event. Three-quarters (75.7%) of youth with BPD reported NSSI and two-thirds (66.4%) reported a suicide attempt over the previous 12 months. The frequency of NSSI over the previous 12 months did not show a linear or quadratic relationship with the number of suicide attempts when adjusting for severity of depression, impulsivity and interpersonal problems. NSSI severity was not associated with more frequent suicide attempts. Only impulsivity and depression were uniquely predictive of suicide attempt frequency. A relative increase in the frequency and severity of NSSI occurred in the months prior to a suicide attempt. The prevalence of NSSI and suicide attempts among youth presenting for their first treatment of BPD appear to be perilously high, considerably higher than rates reported by adults with BPD. Findings suggest that clinicians should give more weight to average levels of impulsivity and depression, rather than the absolute frequency and severity of NSSI, when assessing for risk of suicide attempts. Notwithstanding this, a relative increase in the frequency and severity of NSSI appears to be predictive of a forthcoming suicide attempt.

How much is enough? Examining frequency criteria for NSSI disorder in adolescent inpatients.

To empirically evaluate the diagnostic relevance of the proposed Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; APA, 2013) Criterion-A frequency threshold for nonsuicidal self-injury (NSSI) disorder. Archival, de-identified, self-reported clinical assessment data from 746 adolescent psychiatric patients (Mage = 14.97; 88% female; 76% White) were used. The sample was randomly split into 2 unique samples for data analyses. Measures included assessments of NSSI, proposed DSM-5 NSSI-disorder criteria, psychopathology, dysfunction, distress, functional impairment, and suicidality. Discriminant-function analyses run with Sample A identified a significant differentiation of groups based on a frequency of NSSI at 25 or more days in the past year, Λ = .814, χ2(54) = 72.59, p < .05, canonical R2 = .36. This cutoff was replicated in the second sample. All patients were coded into 1 of 3 empirically derived NSSI-frequency cutoff groups: high (>25 days), moderate (5-24 days), and low (1-4 days) and compared. The high-NSSI group scored higher on most NSSI features, including DSM-5-proposed Criterion-B and -C symptoms, depression, psychotic symptoms, substance abuse, borderline personality-disorder features, suicidal ideation, and suicide plans, than the moderate- and low-NSSI groups, who did not differ from each other on many of the variables. The currently proposed DSM-5 Criterion-A frequency threshold for NSSI disorder lacks validity and clinical utility. The field needs to consider raising the frequency threshold to ensure that a meaningful and valid set of diagnostic criteria are established, and to avoid overpathologizing individuals who infrequently engage in NSSI. (PsycINFO Database Record

Adolescent self-injurers: Comparing non-ideators, suicide ideators, and suicide attempters

Adolescent non-suicidal self-injury (NSSI) and suicidality are serious health concerns; however, factors that contribute to the transition from NSSI to suicide ideation and suicide attempts are unclear. To address this gap, we investigated whether demographic characteristics, child maltreatment, and psychiatric factors are associated with the level suicidality among adolescents with a history of self-injury. Participants were three groups of adolescent inpatient self-injurers (n = 397, 317 female), aged 13–18 years (M = 15.44, SD = 1.36): (a) non-ideators (n = 96; no current suicide ideation and no lifetime suicide attempts), (b) suicide ideators (n = 149; current ideation and no lifetime attempts), and (c) suicide attempters (n = 152; current ideation and at least one lifetime attempt). Participants completed interviews assessing psychiatric diagnoses, suicidality, and NSSI characteristics, as well as questionnaires on childhood trauma, psychiatric symptoms, and risky behavior engagement. Depression severity was associated with greater odds being a suicide ideator (p < 0.001, OR = 1.04) and an attempter (p < 0.001, OR = 1.05) compared to a non-ideator. Suicide attempters used more NSSI methods and reported greater risky behavior engagement than non-ideators (p = 0.03, OR = 1.29 and p = 0.03, OR = 1.06, respectively) and ideators (p = 0.015, OR = 1.25 and p = 0.04, OR = 1.05, respectively); attempters used more severe NSSI methods (e.g., burning). Our results identify a wide range of risk markers for increasing lethality in a sample at high risk for suicide mortality; future research is needed to refine risk assessments for adolescent self-injurers and determine the clinical utility of using risk markers for screening and intervention.

Descriptive Characteristics and Initial Psychometric Properties of the Non-Suicidal Self-Injury Disorder Scale

Non-suicidal self-injury (NSSI) is highly prevalent and associated with tissue damage, emotional distress, and psychiatric disorders. While often discussed in the context of Borderline Personality Disorder and suicide, research demonstrates that NSSI is distinct from these constructs and should be viewed as an independent diagnostic category. Recently, Non-Suicidal Self-Injury Disorder (NSSID) was included in the revised Diagnostic and Statistical Manual of Mental Disorders as a condition for further study. In this article, we describe the properties of a self-report measure designed to assess proposed criteria for NSSID. Undergraduate students at 2 large, public universities completed the NSSID Scale (NSSIDS) along with other measures of NSSI characteristics and psychopathology. Among participants with a history of NSSI, approximately half (54.55%) met diagnostic criteria for NSSID. Participants were most frequently excluded from an NSSID diagnosis on the basis of criterion A (frequency of NSSI) and criterion E (distress or impairment related to NSSI), while participants were least likely to be excluded from diagnosis on the basis of criterion D (NSSI method exclusions) and criterion F (diagnostic “rule-outs”). Consistent with previous literature, the most commonly reported precipitants to NSSI were negative feelings or thoughts (criterion C2). Participants who met criteria for NSSID reported more severe depression, anxiety, and NSSI than participants who engaged in NSSI but did not meet criteria for NSSID. These results support the use of the NSSIDS as a reliable and valid self-report measure of NSSID symptoms.

Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder.

Recent studies have examined non-suicidal self-injury in community and clinical samples, but there is no published research on non-suicidal self-injury in individuals with autism spectrum disorder. This lack of research is surprising, since individuals with autism spectrum disorder have high rates of risk factors for non-suicidal self-injury, including depression and poor emotion regulation skills. Using an online survey, we examined non-suicidal self-injury methods, frequency, severity, functions, and initial motivations in adults with autism spectrum disorder ( n = 42). We also compared their non-suicidal self-injury characteristics to those of a gender-matched group of adults without autism spectrum disorder ( n = 42). Of the participants with autism spectrum disorder, 50% reported a history of non-suicidal self-injury. This proportion is higher than non-suicidal self-injury rates previously reported for college students, adult community samples, and adolescents with autism spectrum disorder, which suggests that adults with autism spectrum disorder have increased risk for engaging in non-suicidal self-injury. Women with autism spectrum disorder were significantly more likely to endorse non-suicidal self-injury, relative to men with autism spectrum disorder. A history of non-suicidal self-injury was not related to current depression or emotion dysregulation for the participants with autism spectrum disorder. Non-suicidal self-injury characteristics among the adults with autism spectrum disorder were similar to non-suicidal self-injury in adults without autism spectrum disorder. These preliminary findings highlight the need for increased awareness and further research about non-suicidal self-injury within autism spectrum disorder.

Nonsuicidal self-injury and suicide attempts among ED patients older than 50 years: comparison of risk factors and ED visit outcomes

BackgroundAlthough the number of older adults who engage in nonsuicidal self-injury (NSSI) is not insignificant, research on older adults' NSSI is scant. The current study examined the prevalence and characteristics of NSSI compared to suicide attempt (SA) in adults older than 50 years who were seen at Emergency Departments (EDs) and their ED visit outcomes. MethodsData came from the 2012 Nationwide Emergency Department Sample. We used binary logistic regression analysis to examine demographic and clinical characteristics of NSSI versus SA among 67,069 visits with a diagnosis of either SA or NSSI, and multinomial logistic regression analysis to examine associations between NSSI versus SA and ED outcomes. ResultsOf self-inflicted intentional injuries, 76.89% were SA and 23.11% were NSSI. Visits for NSSI were associated with lower levels of psychiatric disorders and alcohol use disorders than SA and were more likely than SA visits to occur among older age groups (65-74 and 75+), females, and those with multiple injuries and drug use disorders. NSSI visits were also associated with greater risks of hospital admission (relative risk ratio [RRR]=1.45, 95% CI=1.36-1.54) and death (RRR=18.64, 95% CI=14.19-24.49), as opposed to treat-and-release, but lower risks of facility transfer/discharge with home health care (RRR=0.77, 95% CI=0.72-0.83). ConclusionsThe findings of higher hospitalization and death rates among those with NSSI than SA show how lethal intentional self-destructive behaviors in late life can be even if they are not classified as suicide attempts. The need for mental health and substance abuse treatment is discussed.

Subjective pain during NSSI as an active agent in suicide risk

Non-suicidal self-injury (NSSI) has been identified as a correlate and predictor of suicidal ideation and attempts. Given the high-rates of NSSI presence among adolescents and young adults, it is important to identify specific characteristics of NSSI that might place individuals who engage in this behavior at highest risk for suicidal behavior. NSSI is thought to increase the acquired capability for suicide via habituation to self-harm, though the NSSI characteristics most responsible for this relationship are unclear. The current study examined three characteristics of NSSI (frequency, number of methods, and subjective pain) that may help to elucidate this risk relationship. University students (N=997) with a history of NSSI completed measures assessing lifetime NSSI frequency, number of NSSI methods employed, and subjective experience of pain during NSSI, as well as suicide attempt (SA) history. Results indicated that NSSI frequency, number of NSSI methods, and subjective pain experienced during NSSI were each positively associated with SA history. Further, subjective pain experienced during NSSI moderated the relationship between NSSI frequency and SA history, such that the association between NSSI frequency and SA history was stronger for individuals who experienced lower levels of subjective pain.

Co-Occurring Non-Suicidal Self-Injury and Firesetting Among At-Risk Adolescents: Experiences of Negative Life Events, Mental Health Problems, Substance Use, and Suicidality

Co-occurring internalizing and externalizing problem behaviors in adolescence typically marks more severe psychopathology and poorer psychosocial functioning than engagement in a single problem behavior. We examined the negative life events, emotional and behavioral problems, substance use, and suicidality of school-based adolescents reporting both non-suicidal self-injury (NSSI) and repetitive firesetting, compared to those engaging in either behavior alone. Differences in NSSI characteristics among self-injurers who set fires, compared to those who did not, were also assessed. A total of 384 at-risk adolescents aged 12–18 years (58.8% female) completed self-report questionnaires measuring NSSI, firesetting, and key variables of interest. Results suggest that adolescents who both self-injure and deliberately set fires represent a low-prevalence but distinct high-risk subgroup, characterized by increased rates of interpersonal difficulties, mental health problems and substance use, more severe self-injury, and suicidal behavior. Implications for prevention and early intervention initiatives are discussed.

Non-suicidal self-injury with and without borderline personality disorder: Differences in self-injury and diagnostic comorbidity

Although non-suicidal self-injury (NSSI) occurs in people with and without borderline personality disorder (BPD), few studies have compared the clinical characteristics of these two groups. The present study sampled adults with a history of NSSI and compared those with and without BPD on (a) NSSI features, (b) co-occurring psychiatric disorders, and (c) severity of depression, suicidal ideation and emotion dysregulation. Participants (NSSI+BPD, n=46; NSSI Only, n=54) completed semi-structured interviews and self-report measures. Whereas the groups did not differ in age of NSSI onset, the NSSI+BPD group engaged in more frequent, recent and severe NSSI, and reported higher rates of skin carving, head banging, self-punching and self-scratching than the NSSI Only group. Participants with BPD also showed greater diagnostic comorbidity, particularly for anxiety disorders, but did not differ from participants without BPD in rates of mood, substance or psychotic disorders. The NSSI+BPD group reported more severe depressive symptomatology, suicidal ideation and emotion dysregulation than the NSSI Only group. Supplementary analyses on the subset of participants with recent (past year) NSSI revealed similarly medium to large differences between those with and without BPD. Implications for assessment and treatment are discussed.

Characteristics of nonsuicidal self-injury associated with suicidal ideation: evidence from a clinical sample of youth.

BackgroundNonsuicidal self-injury (NSSI) and suicidal ideation (SI) are both distressing and quite common, particularly in youth. Given the relationship between these two phenomena, it is crucial to learn how we can use information about NSSI to understand who is at greatest risk of suicidal thoughts. In this study, we investigated how characteristics of nonsuicidal self-injury related to SI among treatment-seeking adolescents and young adults.MethodsData were collected during routine program evaluation for a self-injury treatment program. Correlations between recent SI and NSSI characteristics were calculated for adolescent and young adult patients (N = 1502).ResultsLow severity methods of NSSI (e.g. banging) were more strongly associated with SI than high severity methods (e.g. breaking bones). SI was associated with intrapersonal (automatic) NSSI functions. SI was associated with some indices of NSSI severity, such as number of methods and urge for NSSI, but not with others, such as age of onset.ConclusionsThis study provides a valuable opportunity to expand our knowledge of suicide risk factors beyond those that may apply broadly to self-injurers and to non-injurers (e.g., depression, substance use) to NSSI-related factors that might be specifically predictive of suicidal thoughts among self-injurers. Findings inform clinical risk assessment of self-injurious youth, a population at high risk of suicidal thoughts and behaviors, and provide further insight into the complex NSSI/suicide relationship.

Predictors of self-injury cessation and subsequent psychological growth: results of a probability sample survey of students in eight universities and colleges.

BackgroundFactors affecting non-suicidal self-injury cessation are poorly understood. The aim of this study was to identify differences between individuals with current and past non-suicidal self-injury (NSSI) in a large probability sample of university students using quantitative and qualitative methods. Predictors of psychological growth related following NSSI cessation were also examined.MethodThe sample included 836 students who participated in a larger online study of well-being at eight U.S. colleges and who reported current or past history of repeated NSSI. The average age of respondents used in analysis was 21.3 years. They were 78.3 % female and 21.7 % male and were 70.7 % Caucasian, 1.4 % African American/Black, 5.5 % Hispanic, 7.8 % Asian/Asian American and 14.7 % other. Analyses tested differences in demographics, NSSI characteristics (e.g. lifetime frequency, number of NSSI functions, NSSI disclosure), formal help-seeking, psychosocial factors, and mental health and trauma histories.ResultsIndividuals with current NSSI status were more likely to be female and slightly younger, to report higher NSSI lifetime frequency, more NSSI forms and functions, thinking of themselves as a “self-injurer”, and current psychological distress. Individuals with current NSSI status were less likely to report that self-injury interfered with life, that therapy was useful in stopping, perceiving social support, having a sense of meaning in life, access to more emotion regulation strategies, and life satisfaction. Qualitative data suggested that cessation may be attributable to changes in ability to regulate emotion (62.6 %), self-awareness (38.7 %), and important relationships to others (36.0 %). Psychological growth after stopping NSSI was predicted by more severe NSSI (form and perceived NSSI dependence), having talked about NSSI with others and higher numbers of confidantes, perceived life satisfaction, and a history of suicide action.ConclusionsThese findings add to the still nascent body of literature examining processes related to NSSI cessation. Our results point to the importance of help-seeking and social support, as well as psychosocial processes in stopping NSSI.

Characteristics and associated factors of non-suicidal self-injury among Italian young people: a survey through a thematic website.

Background and AimsThe aim of this study is to examine the characteristics of non-suicidal self-injury (NSSI) in a group of young Italians who self-injure. In examining the characteristics, specific attention was given to the feelings and personal experiences associated with episodes of NSSI.MethodsThe research involved 362 young people (332 females and 30 males) who completed an online survey hosted on a website specifically geared to supporting young people who self-injure. This methodology enabled involving a diverse population of young people who self-injure, thus going beyond specific groups or clinical samples.ResultsResults show that the majority of respondents start injuring themselves between the ages of 12 and 16 years (72.38%, n = 262). Cutting was the most common self-injuring method (81.77%, n = 297). The 79.83% (n = 289) of respondents had not sought professional help for their wounds, preferring to care for their wounds on their own. More than half of the respondents (56.91%, n = 206) claimed to have experienced anxiety-spectrum disorders and almost half of the respondents (41.71%, n = 151) claimed to have experienced some type of eating disorder.Discussion and ConclusionsMany similarities have been found between this study and the literature, thus strengthening the hypothesis that NSSI is becoming a universal issue with similar characteristics across countries.

Dissociation as a Mediator of the Relationship Between Childhood Trauma and Nonsuicidal Self-Injury in Females: A Path Analytic Approach

New theoretical models of nonsuicidal self-injury (NSSI) postulate that symptoms subsequent to childhood maltreatment rather than childhood maltreatment itself may lead to engagement in NSSI. However, little is known concerning which specific syndromes serve as underlying mechanisms. In this study we sought to examine the mediating effects of dissociative, posttraumatic, and depressive symptoms, 3 often comorbid syndromes following childhood trauma. In addition, we aimed to assess differences between women with and without NSSI. A sample of 87 female inpatients with a history of childhood abuse and neglect was divided into 2 subgroups (NSSI: n = 42, no NSSI: n = 45). The assessment included measures of NSSI characteristics; adverse childhood experiences; and posttraumatic, dissociative, and depressive symptoms. The NSSI group reported significantly more cases of childhood maltreatment and higher levels of current dissociative, posttraumatic, and depressive symptoms than patients without NSSI. The results of a path analysis showed that only dissociation mediated the relationship between a history of child maltreatment and NSSI when all 3 psychopathological variables were included in the model. The findings point toward a strong and rather specific association between dissociative experiences and NSSI and therefore have important implications for clinical practice.

Non-suicidal self-injury in patients with eating disorder: associations with identity formation above and beyond anxiety and depression.

In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI.

Prevalence and Correlates of Eating Disorder Symptoms in a Community Sample with Non-Suicidal Self-Injury

This study aimed to examine (1) the presentation of binge eating and compensatory weight-control behaviors in a community sample of individuals who engage in non-suicidal self-injury (NSSI), (2) the relationship of NSSI features and ED symptoms, and (3) the relationship of psychopathology with ED symptoms. Participants with histories of NSSI (n = 118) were recruited from online self-injury forums and completed measures of ED, NSSI, general psychiatric symptoms and borderline personality (BP) symptoms through online questionnaires. Two thirds of the participants (66.1 %) engaged in compensatory weight-control behaviors at least once per week within the past 3 months, 57.6 % engaged in weekly fasting, and 57.6 % engaged in weekly binge eating. Greater versatility and medical severity of NSSI were positively associated with ED symptoms. Furthermore, BP symptoms were positively associated with increased ED symptoms, even after controlling for general psychiatric symptoms. These findings highlight NSSI versatility, NSSI medical severity and BP symptoms as important correlates of increased ED symptoms in individuals who engage in NSSI, and highlight a need to integrate assessment for ED among individuals who engage in NSSI.

Assessment of nonsuicidal self-injury: development and initial validation of the Non-Suicidal Self-Injury-Assessment Tool (NSSI-AT).

Research tools for assessing nonsuicidal self-injury (NSSI) epidemiology in community populations are few and are either limited in the scope of NSSI characteristics assessed or included as part of suicide assessment. Though these surveys have been immensely useful in establishing the presence of NSSI and in documenting basic epidemiological characteristics, they have been less useful in describing secondary NSSI features such as NSSI context, habituation, or perceived life impact. The aim of the current study was to examine the reliability of the test scores and validity of test score interpretations in a university population for the Non-Suicidal Self-Injury-Assessment Tool (NSSI-AT), a web-based measure of NSSI designed to assess primary (such as form, frequency, and function) and secondary (including but not limited to NSSI habituation; contexts in which NSSI is practiced; and NSSI perceived life interference, treatment, and impacts) NSSI characteristics for research purposes. Data for these analyses were drawn from 3 samples, all of which were originally part of a 2007 study of randomly selected students from 8 northeast and midwest public and private universities that participated in a web-based study entitled the Survey of Student Wellbeing. Overall, results provide support for the reliability of NSSI-AT test scores (as assessed by test-retest) and validity of NSSI-AT test score interpretations for the behavior and frequency modules (as assessed using concurrent, convergent, and discriminant evidence) in this population. Implications for research as well as next steps are discussed.

Nonsuicidal self-injury in Asian versus Caucasian university students: who, how, and why?

The correlates of nonsuicidal self-injury (NSSI) among Asian and Caucasian university students; differences in the rates, frequency, forms, severity, and emotional contexts of NSSI among self-injuring students; and whether Asian students who are highly oriented toward Asian culture differed from those less oriented toward Asian culture in NSSI characteristics were investigated. University students (N = 931), including 360 Caucasian students (n = 95, 26.4%, with a history of ≥ 1 episode of NSSI) and 571 Asian students (n = 107, 18.7%, with a history of NSSI), completed questionnaires assessing NSSI, acculturation, and putative risk factors for NSSI. Caucasian students were more likely to report NSSI, particularly cutting behavior, self-injured with greater frequency and versatility, and reported greater increases in positively valenced, high arousal emotions following NSSI, compared to Asian students. Among Asian students, obsessive-compulsive symptoms, experiential avoidance, and anger suppression increased the likelihood of reporting a history of NSSI. Among Caucasian students, lack of emotional clarity and anger suppression increased likelihood of NSSI. Finally, some tentative findings suggested potentially important differences in rates and frequency of NSSI among Asian students who were highly oriented toward Asian culture compared with those less oriented toward Asian culture.

Non-Suicidal Self-Injury among Adolescents in Amman, Jordan

While previous research has demonstrated cross-national differences in non-suicidal self-injury (NSSI), most studies to date have taken place in North America. The present study investigated the prevalence and characteristics of NSSI in a sample of 952 Jordanian adolescents (49.8% female) between the ages of 11–19 years. Participants completed a screening measure to assess occurrence of NSSI and its characteristics. Results indicate an overall lifetime prevalence of 22.6% (n = 215), with significantly more males (26.98%, n = 129) than females (18.14%, n = 86) reporting having engaged in NSSI at least once in their lifetime. This study provides empirical evidence that adolescent engagement in NSSI occurs at similar prevalence levels in Jordan, relative to North American samples, whereas gender comparisons of prevalence and characteristics revealed several differences.

An Exploratory Study of the Nature and Extent of Nonsuicidal Self-Injury among College Women

This study assessed the extent and nature of nonsuicidal self-injury (NSSI) among 165 students attending an all-women’s college. Associations between NSSI behaviors and demographics, borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and attachment styles were investigated. Statistically significant relationships between the severity of NSSI and demographic characteristics and BPD and PTSD were explored using bivariate analysis. Within this population, presence of NSSI behavior was significantly associated with age, years in college, nonheterosexual orientation, BPD, PTSD, and preoccupied attachment styles. There were also marginally significant associations with race and financial status. Severity of NSSI behaviors was significantly associated with age, years in college, BPD pathology, and primary parent’s level of education. A logistic regression analysis was developed that predicted NSSI behavior with 67% accuracy based on these findings. This study has implications for clinical practice.

An Examination of Disclosure of Nonsuicidal Self‐injury among University Students

ABSTRACTDespite the widespread prevalence of nonsuicidal self‐injury (NSSI) among community‐based samples, little is known about which self‐injurers disclose their NSSI or the factors that promote disclosure among self‐injurers. To address this gap in the literature, we examined whether disclosers could be differentiated from nondisclosers on the basis of NSSI characteristics (e.g. frequency of NSSI and severity of NSSI), NSSI motivations (e.g. interpersonal and intrapersonal motivations) and psychosocial factors (e.g. suicidal ideation and self‐esteem). Participants consisted of a large sample of 268 self‐injuring undergraduate students (Mage = 19.07 years, 70.3% women) at a Canadian university. Results indicated that 57% of self‐injurers had never disclosed their NSSI to anyone. Self‐injurers were most likely to disclose to peers and romantic partners. Logistic regression analyses revealed that pain during NSSI, severity of NSSI, interpersonal motivations for engaging in NSSI, higher suicidal ideation and higher friendship quality were all associated with a greater likelihood of NSSI disclosure. Our findings suggest that individuals with severe NSSI and suicidal ideation may be more likely to disclose. Moreover, our findings underscore the importance of equipping friends and romantic partners with effective responses to NSSI disclosures to promote more formal help‐seeking behaviours among self‐injurers. Copyright © 2014 John Wiley &amp; Sons, Ltd.