Experience Of Non-suicidal Self-injury Research Articles

Non-Suicidal Self-Injury and Its Relationship with Family Psychological Function and Perceived Social Support among Iranian High School Students.

Background: Non-suicidal self-injury (NSSI) has become one of the serious public health concerns among adolescents. Factors like family and social environment of adolescents may be important determinants of the NSSI. This study aimed to investigate the relationship between family psychological function and perceived social support with the NSSI experience among adolescents. Study design: A cross-sectional study. Methods: Overall, 4216 high school students (15-18 yr old) of Tabriz City, northwestern Iran were selected using multi-stage cluster random sampling method in October and November 2017. Participants completed survey including demographic characteristics, NSSI status, Iranian family psychological function, and perceived social support. After six months, NSSI status was reassessed. The data were analyzed using logistic regression model. Results: 8.5% of the students had NSSI experience. In addition, the weak family psychological function increased the odds of experiencing the NSSI by 13 times compared to the strong psychological function (OR = 13.15, 95% CI: 7.19, 23.80). Besides, the low level of perceived social support increased the odds of experiencing the NSSI by about 7 times compared to the high perception of social support (OR= 6.67, 95% CI: 4.01, 11.11). Conclusion: Low levels of psychological functioning of the families and perception of social support significantly can increase the odds of experiencing the NSSI among adolescents. Therefore, special attention should be paid to these factors in the development of relevant preventive programs in adolescence period.

Beliefs About One’s Non-Suicidal Self-Injury: The Experiences of Self-Injury Questionnaire (ESIQ)

Objective The goal of this study was to develop and validate a measure of self-rated positive and negative beliefs about one’s non-suicidal self-injury (NSSI), the Experiences of Self-Injury Questionnaire (ESIQ). Method Psychometric properties and validation against NSSI severity and shame were tested in two U.S. and two U.K. samples of individuals who endorsed a history of NSSI. Results Exploratory and confirmatory factor analyses indicated five factors. Subscales were labeled Positive Beliefs, Personal Dislike, Interpersonal Concern, Emotional Suppression, and Emotional Expression. The Positive Beliefs Subscale covers beliefs that NSSI is valuable. Scores on this subscale were associated with endorsement of NSSI frequency, NSSI urges, and perceived likelihood of future NSSI. Other subscales showed validity in that they all showed unique effects on outcome indices of NSSI severity or shame. Conclusion The ESIQ shows promise as a brief reliable measure of beliefs about and experiences of NSSI.

Understanding self-injury recovery: Views from individuals with lived experience.

Nonsuicidal self-injury (NSSI) recovery has typically been conceptualized through the lens of formal frameworks or as the cessation of NSSI. These understandings, however, have been developed largely devoid of views from those with lived NSSI experience, who may offer novel and critical insights. To advance the conception of NSSI recovery, the current study elicited such views. Two hundred and thirty-three emerging adults with a history of NSSI (77% female, mean age = 18.9 years), responded to open-ended questions regarding recovery. Results were thematically analyzed using an inductive approach. Responses yielded seven themes: (a) recovery is complete NSSI cessation; (b) recovery is more than cessation; (c) recovery involves lingering NSSI features; (d) recovery involves developing resilience; (e) recovery is a process; (f) evolution in understanding recovery; and (g) recovery is a subjective experience. Recovery seems to be multifarious, nonlinear, and subjective. Conceptual and clinical implications are discussed.

The moderating role of trait hope in the association between adolescent depressive symptoms and nonsuicidal self-injury

The present study examined the relationship between trait hope (including two dimensions: pathways thinking and agency thinking) and adolescent nonsuicidal self-injury and whether and how trait hope moderated the association between depressive symptoms and nonsuicidal self-injury. Participants included 1026 Chinese secondary school students (447 girls; Mage = 13.76, SD = 1.27). Adolescents reported their depressive symptoms, trait hope, and nonsuicidal self-injury experiences. Results revealed that hope negatively related to adolescent NSSI, and that hope, particularly the dimension of pathways thinking but not agency thinking, attenuated the association between depressive symptoms and nonsuicidal self-injury among female adolescents. The moderating role of trait hope in the association between depressive symptoms and NSSI is discussed.

In Their Own Words: Perspectives on Nonsuicidal Self-Injury Disorder Among Those With Lived Experience.

Nonsuicidal self-injury (NSSI) is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition warranting further study. Although potential advantages and disadvantages regarding this prospect have been documented, no study has examined the perspectives of those who self-injure. The goal of the current study was to give voice to these views. Seventy-six participants with an NSSI history completed quantitative and qualitative measures assessing perspectives about NSSI being included as a DSM disorder. Findings revealed mixed views overall. Thematic analysis of open-ended responses highlighted several unique advantages (i.e., enhanced understanding of NSSI, validation of the NSSI experience, facilitation of NSSI treatment, encouragement of NSSI help-seeking, reduction of NSSI stigma) and disadvantages (i.e., exacerbation of NSSI stigma, diminishment of underlying concerns). These findings speak to the need to consider the perceptions of those with lived NSSI experience; future directions and implications are discussed.

Ecological momentary assessment of nonsuicidal self-injury in youth with borderline personality disorder.

Nonsuicidal self-injury (NSSI) is highly prevalent among individuals with borderline personality disorder (BPD). The aim of this study was to investigate the cognitive, emotional, and contextual experience of NSSI in 107 youth (aged 15-25 years) with BPD who had minimal prior exposure to treatment. Using ecological momentary assessment, participants completed a randomly prompted questionnaire about their affect, self-injurious thoughts, and behaviors six times per day for 6 days. Twenty-four youth with BPD engaged in 52 counts of NSSI, with 56 motives identified. Open-ended questions revealed that on occasions of NSSI, a large minority of participants could identify neither their motives (27%, n = 15) nor the environmental precipitants (46%, n = 24) for NSSI. Changes in affect revealed a pattern of increasing negative and decreasing positive affect prior to NSSI, with a reduction in negative and an increase in positive affect following NSSI. These changes were absent for those who did not engage in NSSI. Initial self-injurious thoughts and changes in negative and positive affect occurred a median of 35, 15, and 10 hr prior to NSSI, respectively. These findings suggest that youth with BPD have limited capacity to reflect on their motives and environment preceding NSSI. The patterns of affect change indicate that NSSI is maintained by reward incentives as well as negative reinforcement. The time between initial self-injurious thoughts and engagement in NSSI reveals a window of opportunity for intervention. (PsycINFO Database Record

The qualities of attachment with significant others and self-compassion protect adolescents from non suicidal self-injury.

Nonsuicidal self-injury (NSSI) is a serious public health problem. Identifying the factors that could help prevent or reduce NSSI is important. The current study examined the protective roles of the perceived qualities of current attachment to significant others (i.e., mothers, fathers, and peers) and self-compassion in adolescent NSSI. The potential mediating effect of self-compassion in the relationships between attachment relationships with mothers, fathers, and peers and adolescent NSSI was also explored. Self-reported data on mother, father, and peer attachment (each included 3 dimensions; i.e., trust, communication, and closeness); self-compassion; and NSSI were collected from 658 secondary school students (59.9% male; Mage = 13.58 years). Participants with NSSI experiences scored significantly higher on the perceived qualities of current attachment with parents and self-compassion than those reporting no NSSI experience. Attachment with peers did not distinguish the NSSI group from the Non-NSSI group. Further mediation analyses indicated that self-compassion mediated the relationships of closeness with mothers, fathers (partially), and peers to NSSI as well as the relationship of peer communication to NSSI. Limitations of this study and implications regarding the protective roles of attachment and self-compassion in the prevention and intervention for NSSI are discussed. (PsycINFO Database Record

Parents’ Experiences of Nonsuicidal Self-Injury Among Adolescents and Young Adults

We assessed the impact of adolescent nonsuicidal self-injury (NSSI) on parents in two studies. In Study 1, 16 Australian parents of adolescents with a history of nonsuicidal self-injury responded to open-ended questions about their child’s nonsuicidal self-injury. Data from 10 of the adolescents were matched with parents’ responses regarding the nature and extent of nonsuicidal self-injury, revealing that parents underestimated the frequency of nonsuicidal self-injury, the age of onset, and the likelihood their child would continue to self-injure. In Study 2, 22 American parents of adolescents with a history of nonsuicidal self-injury participated in interviews about their experiences. Parents in both studies reported changes in the parent–adolescent relationship after self-injury, which posed challenges to the family unit. When professional help had been sought, experiences were largely negative. Results support further investigation into family-based interventions to equip parents with tools to better relate to, and communicate with, their adolescent following self-injury. Results also suggest that mental-health professionals and general practitioners may require further training for nonsuicidal self-injury.

Participants' Experiences of Non-suicidal Self-Injury: Supporting Existing Theory and Emerging Conceptual Pathways

Due to the increase in prevalence of non-suicidal self-injury, various models of self-injury have been proposed. Researchers have found empirical support for components of these models but have not explored the models in their entirety, nor supported them through the voices of participants. Eighty-eight participants' experiences of non-suicidal self-injury were explored in the current study, providing support for the existing models of self-injury by Nock and Chapman and colleagues, as well as support for Joiner's (2005) suggestion that self-injury can desensitize individuals to suicide. However, through content analysis and correlations, new categories emerged from participants' stories that have not been included in previous models, as well as suggested pathways within the existing models. Implications for counselors are proposed.

Do It Yourself: Examination of Self-Injury First Aid Tips on YouTube.

Individuals who engage in nonsuicidal self-injury (NSSI) may prefer the Internet as a medium to communicate about NSSI experiences and obtain NSSI information. Recent research suggests that NSSI first aid information is shared. Yet, no research has examined the context in which this information occurs. This study examined the nature and scope of NSSI first aid tips on YouTube using a content analysis to examine 40 NSSI first aid videos. Findings indicated that videos were viewed 157,571 total times; they were typically favorably viewed. Most had a neutral purpose and neither encouraged nor discouraged NSSI. Messages encouraging NSSI help seeking were scant. Similarly, medical help seeking was not commonly encouraged, with several videos providing "safe" NSSI instructions. Overall, videos with NSSI first aid information may contribute to NSSI reinforcement and the belief that professional and medical help may not be needed for NSSI. Findings have implications for research, clinical work, and e-outreach, which are discussed.

On the Creative Edge: Exploring Motivations for Creating Non-Suicidal Self-Injury Content Online.

The last decade has witnessed an exponential growth in user-generated online content featuring Non-Suicidal Self-Injury (NSSI), including photography, digital video, poems, blogging, and drawings. Although the increasing visibility of NSSI content has evoked public concern over potential health risks, little research has investigated why people are drawn to create and publish such content. This article reports the findings from a qualitative analysis of online interviews with 17 individuals who produce NSSI content. A thematic analysis of participants' narratives identified two prominent motives: self-oriented motivation (to express self and creativity, to reflect on NSSI experience, to mitigate self-destructive urges) and social motivation (to support similar others, to seek out peers, to raise social awareness). Participants also reported a double-edged impact of NSSI content both as a trigger and a deterrent to NSSI.

Comparing among the Experiences of Self-Cutting, Hitting, and Scratching in Chinese Adolescents Attending Secondary Schools: An Interview Study

This study examined adolescents’ experiences associated with nonsuicidal self-injury (NSSI) and compared among the experiences of self-cutting, hitting, and scratching. Participants included 42 Chinese adolescents attending secondary schools. They had at least three NSSI episodes in the preceding year. Information about their experiences of NSSI was assessed by structured interviews. Regardless of the methods, NSSI primarily served the affect regulation function and was usually preceded by negative affects and followed by positive affect. Additionally, as compared to self-hitting and scratching, self-cutting indicated a higher level of distress, resulted in less subjective feelings of pain, and was more likely to be performed to relieve dysphoric affects. This study suggests that different NSSI methods may signal different underlying psychopathologies.

Life Span History of Non-fatal Suicidal Behaviours in a Large Sample of General Practitioners’ Patients: Data from Rovigo, Northern Italy

A survey about history of non-fatal suicidal behaviour was performed on 1,171 subjects in the waiting room of general practitioners' practices in the territory of Rovigo (Northern Italy). The mean age of interviewed subjects was 52.9±17.0, with a majority of female individuals. Two and two percent admitted previous experience of non-suicidal self-injury, 4.7% admitted having had serious suicidal thoughts/plans, and 1.8% reported at least one suicide attempt. Compared to the rest of the sample, people with history of suicidal behaviours resulted to be of younger age (p<.05), whilst their level of well-being was poorer (p<.001). When compared to the results of the Italian arm of the European Study of the Epidemiology of Mental Disorders, carried out on general population samples, the present study produces higher rates of suicidality, despite the much higher mean age of the interviewed subjects compared to the general population.

Daily Emotion in Non-Suicidal Self-Injury

While major theories of non-suicidal self-injury (NSSI) emphasize the behavior's role in emotion regulation, little is known about the daily emotional experiences of self-injurers. This study investigated the specific emotions that are characteristic of those who engage in NSSI. University students (n = 84) with either no history or a recent history of NSSI completed daily diary and retrospective measures of emotional experience. To evaluate generalizability of findings, the retrospective measure was also administered to a diverse sample of U.S. adults (n = 92) with and without histories of NSSI. Results indicate that self-injurers experience greater negative emotionality, particularly self-dissatisfaction, compared to individuals with no NSSI history. Self-injurers also reported less positive emotion, but these effects were smaller. The pattern of results was similar when controlling for Axis I psychopathology and borderline personality disorder symptoms. Individuals who engage in NSSI experience more negative emotions, generally, and more self-dissatisfaction, specifically. Findings contribute to the growing literature on the role of emotion in the etiology and functions of NSSI.

Seeking Validation in Unlikely Places: The Nature of Online Questions About Non-Suicidal Self-Injury

Recent research points to the salience of the Internet as a means to seek information about non-suicidal self-injury (NSSI) but no research has explored what is asked about NSSI online. The current study examined the nature of NSSI questions asked on Yahoo! Answers. One hundred and eight questions were analyzed using a content analysis. The most frequently asked questions pertained to seeking validation for NSSI experiences (30.56%); however, the responses provided were sometimes quite invalidating. Other common questions included those related to general NSSI information (17.59%), scar concealment (11.11%), and NSSI-related media (11.11%). Efforts are needed to provide NSSI resources and support online but websites may need to be monitored to safeguard against unhelpful responses.

Helpful or Harmful? An Examination of Viewers' Responses to Nonsuicidal Self-Injury Videos on YouTube

To examine viewers' comment responses to nonsuicidal self-injury (NSSI) YouTube videos to determine the potential risks (e.g., NSSI continuation) and benefits (e.g., recovery-oriented social support) of the videos. Viewers' comments from the 100 most-viewed NSSI videos on YouTube were examined using two coding rubrics, one for the global nature of comments and one for recovery-oriented themes. Both rubrics were developed using an inductive (bottom-up) approach and had high coding inter-rater reliability (exceeding .80 in all cases). For the global nature of comments, 869 randomly selected comments were evaluated using the rubric, which included 8 coding categories and 22 subcategories. For the examination of recovery-oriented themes, self-disclosure comments (n = 377) were evaluated for nature of recovery statements. Results revealed that the most frequent comments were self-disclosure comments in which individuals shared their own NSSI experiences (38.39%), followed by feedback for the video uploader, including admiration of the video quality (21.95%) or message (17.01%), and admiration for the uploader (15.40%) or encouragement to the video uploader (11.15%). Evaluation of the common self-disclosure comments for recovery-oriented content revealed that the majority did not mention recovery at all (42.89%) and indicated that they were still self-injuring (34.00%). Positive recovery statements were uncommon. Results suggest that viewers' responses to videos may maintain the behavior (by sharing their own self-injury experiences) and rarely encourage or mention recovery. It is evident that sharing their own experience online is a strong motivator for viewers of NSSI YouTube videos.

Non-suicidal self-injury, youth, and the Internet: What mental health professionals need to know

Non-suicidal self-injury (NSSI) content and related e-communication have proliferated on the Internet in recent years. Research indicates that many youth who self-injure go online to connect with others who self-injure and view others’ NSSI experiences and share their own through text and videos platforms. Although there are benefits to this behaviour in terms of receiving peer support, these activities can introduce these young people to risks, such as NSSI reinforcement through the sharing of stories and strategies, as well as, risks for triggering of NSSI urges. Due to the nature of these risks mental health professionals need to know about these risks and how to effectively assess adolescents’ online activity in order to adequately monitor the effects of the purported benefits and risks associated with NSSI content. This article offers research informed clinical guidelines for the assessment, intervention, and monitoring of online NSSI activities. To help bridge the gap between youth culture and mental health culture, these essentials include descriptions of Community, Social Networking, and Video/Photo Sharing websites and the terms associated with these websites. Assessment of these behaviours can be facilitated by a basic Functional Assessment approach that is further informed using specific recommended online questions tailored to NSSI online and an assessment of the frequency, duration, and time of day of the online activities. Intervention in this area should initially assess readiness for change and use motivational interviewing to encourage substitution of healthier online activities for the activities that may currently foster harm.

Factors Distinguishing Youth Who Report Self-Injurious Behavior: A Population-Based Sample

ObjectiveTo identify factors distinguishing adolescents across 3 groups: no self-harm, nonsuicidal self-injury (NSSI) only, and NSSI and suicide attempt (NSSI + SA). MethodsData were from the 2007 Minnesota Student Survey. The sample included 61,330 students in grades 9 and 12. Logistic regression analysis determined factors that best distinguished adolescents who reported NSSI from those who reported no self-harm, and adolescents who reported NSSI + SA. Final models were developed over 3 stages of analysis that tested the importance of variables within risk factor, protective factor, and co-occurring health-risk behavior domains. ResultsFor male and female subjects, factors that consistently distinguished youth who reported NSSI from those who reported no self-harm included depressive symptoms, hopelessness, physical abuse, less parent connectedness, running away from home, and maladaptive dieting behavior. Factors that distinguished the NSSI + SA group from the NSSI only group for both sexes were a mental health problem, depressive symptoms, hopelessness, physical abuse, and running away from home. Other factors, such as sexual abuse, were significant in models for males or females only. Hopelessness constituted the leading factor to increase the likelihood that youth who self-injured also attempted suicide. ConclusionsYouth engaging in NSSI experience diverse psychosocial stressors and significant distress. Clinicians and school personnel are well-positioned to offer support to these youth. Furthermore, they can help address NSSI among youth by identifying those who self-injure early, assessing for hopelessness and suicidality, facilitating connections to prosocial adults, addressing maladaptive dieting behavior, and supporting runaway youth.