Nonsuicidal Self-injury Methods Research Articles

Identifying a physical indicator of suicide risk: Non-suicidal self-injury scars predict suicidal ideation and suicide attempts

BackgroundSuicide risk is challenging to quantify due to reliance on self-report, which is limited by individuals' lack of insight and the desire to conceal such intentions. Non-suicidal self-injury (NSSI) is one of the most robust predictors of suicidal ideation (SI) and suicide attempts (SA). Although NSSI often leads to permanent scarring, which can be assessed by objective physical examination, no research has examined whether scarring denotes tangible risk for SI and SA. The present study examined whether NSSI scar presence and number predict current SI and SA history. Further, we examined whether brooding would exacerbate the effects of NSSI scarring on SI or SA. MethodsYoung adults (N=231; M=21.24 years; 78% female) completed self-report questionnaires assessing SA history, frequency of NSSI, presence/number of NSSI scars, brooding, current depressive symptoms, and SI. ResultsNSSI scar presence and number predicted current SI and SA history after controlling for current depressive symptoms. Moreover, scar presence and number predicted current SI over and above the effects of SA history and NSSI frequency, method, and medical severity. Further, NSSI scar presence and number predicted SI more strongly among individuals with greater levels of brooding than among individuals with lower levels of brooding. ConclusionsThe presence and number of NSSI scars are objective physical indicators of risk for SI and SAs. Brooding may further heighten the risk of SI for individuals bearing NSSI scars.

Using Implicit and Explicit Measures to Predict Nonsuicidal Self-Injury Among Adolescent Inpatients

To examine the use of implicit and explicit measures to predict adolescent nonsuicidal self-injury (NSSI) before, during, and after inpatient hospitalization. Participants were 123 adolescent psychiatric inpatients who completed measures at hospital admission and discharge. The implicit measure (Self-Injury Implicit Association Test [SI-IAT]) and one of the explicit measures pertained to the NSSI method of cutting. Patients were interviewed at multiple time points at which they reported whether they had engaged in NSSI before their hospital stay, during their hospital stay, and within 3 months after discharge. At baseline, SI-IAT scores differentiated past-year self-injurers and noninjurers (t121 = 4.02, p < .001, d = 0.73). These SI-IAT effects were stronger among patients who engaged in cutting (versus noncutting NSSI methods). Controlling for NSSI history and prospective risk factors, SI-IAT scores predicted patients' subsequent cutting behavior during their hospital stay (odds ratio (OR) = 8.19, CI = 1.56-42.98, p < .05). Patients' explicit self-report uniquely predicted hospital-based and postdischarge cutting, even after controlling for SI-IAT scores (ORs = 1.82-2.34, CIs = 1.25-3.87, p values <.01). Exploratory analyses revealed that in specific cases in which patients explicitly reported low likelihood of NSSI, SI-IAT scores still predicted hospital-based cutting. The SI-IAT is an implicit measure that is outcome-specific, a short-term predictor above and beyond NSSI history, and potentially helpful in cases in which patients at risk for NSSI explicitly report that they would not do so in the future. Ultimately, both implicit and explicit measures can help to predict future incidents of cutting among adolescent inpatients.

Self-Efficacy Pathways Between Relational Aggression and Nonsuicidal Self-Injury

The authors recruited college students (N = 648) and investigated relationships among academic and social self-efficacy, relational aggression from parents and peers, and nonsuicidal self-injury (NSSI). Results indicated that both types of self-efficacy were related inversely to NSSI. Academic self-efficacy mediated the relationship between parental emotional abuse and NSSI, whereas social self-efficacy mediated the relationship between peer victimization and NSSI. Clinical implications of these findings for college counselors are discussed. Keywords: nonsuicidal self-injury, self-efficacy, relational aggression ********** Nonsuicidal self-injury (NSSI) is an increasingly common presenting issue in college counseling centers (Whitlock, Eells, Cummings, & Purington, 2009). This behavior pertains to the deliberate damaging of one's own bodily tissue without suicidal intent and outside of social norms (Favazza, 1998). Although prevalence rates for NSSI vary, they are consistently high among college students: Researchers have reported lifetime NSSI prevalence rates for college students (i.e., engagement in NSSI at some point during an individual's lifetime) ranging from 15% to 41% (Aizenman & Jensen, 2007; Whitlock et al., 2011). Approximately 22% of college students can be classified as individuals who frequently self-injured in the past year (i.e., had performed one method of NSSI over five times or at least three different methods of NSSI in the past year; Buser, Buser, & Kearney, 2012). Indeed, the behavior has become substantially prevalent to warrant a new diagnostic proposal for NSSI (American Psychiatric Association [APA], 2012) in revisions to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev; APA, 2000). Unfortunately, according to the results of Whitlock et al. (2009), only 28% of college mental health professionals believe that they know enough about NSSI to deliver effective care. Knowledge about its possible causes may be particularly useful in this regard. Researchers have indicated that NSSI often occurs within the context of relational aggression from others, including parental and peer sources (Adrian, Zernan, Erdley, Lisa, & Sim, 2011; Buser et al., 2012; Classman, Weierich, Hooley, Deliberto, & Nock, 2007; Hilt, Cha, & Nolen-Hoeksema, 2008; Weierich & Nock, 2008; Yates, Tracy, & Luthar, 2008). However, there is less understanding of the explanatory mechanisms linking aggression from others with an individual's use of NSSI (Yates et al., 2008). Recent investigations have begun to address this issue. Researchers have identified some variables, such as emotional dysregulation, posttraumatic stress symptoms, self-criticism, and alienation toward parents, that appear to mediate the association between NSSI and various forms of aggression from others (Adrian et al., 2011; Glassman et al., 2007; Weierich & Nock, 2008; Yates et al., 2008). Many of these studies, however, have been conducted with adolescent populations. Adrian et al. (2011), for example, collected data from an adolescent inpatient sample (N= 99) and found that emotional dysregulation served as a mediator in the link between peer victimization and NSSI, as well as the link between family relational problems and NSSI. Similarly, Glassman et al. (2007) reported that self-criticism among adolescents (N = 86) partially explained the association between NSSI and emotional abuse from parents. Considering that these studies focused on younger populations, more research that examines the pathways for the NSSI-relational aggression association among college students is needed. Such investigations may yield dissimilar results. Findings have shown, for example, that types of relational aggression (e.g., peer victimization) dissipate with age (Nansel et al., 2001). The aim of this study was to test a theory-driven model of variables that predicted NSSI frequency in the past year among college students. …

Nonsuicidal self-injury: a condition for further study.

Nonsuicidal self-injury: a condition for further study.

Non-suicidal self-injury among Dutch and Belgian adolescents: Personality, stress and coping

BackgroundThis study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. MethodsA total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age=15.52; SD=1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure. ResultsLifetime prevalence of NSSI was 24.31%. Neuroticism; perceived stress; and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness; and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping. ConclusionOur study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events.

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.

Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample.

The entry for nonsuicidal self-injury (NSI) disorder in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides a criterion-based definition of clinically relevant NSI. NSI disorder is currently classified in the DSM-5 as a condition requiring further study. The present study aimed to examine the reliability, validity, and clinical utility of a self-report measure of NSI disorder, the Alexian Brothers Assessment of Self-Injury (ABASI). The sample included 511 patients admitted to an acute care treatment program designed to treat NSI. Patients were administered the ABASI as part of a clinical assessment and routine outcome evaluation. The sample included a broad age range, as well as sufficient numbers of males and Hispanics to examine sociodemographic differences. The ABASI demonstrated adequate internal consistency and test-retest reliability, and the factor structure reflects NSI disorder criteria. Among patients being treated for NSI, 74% met criteria for NSI disorder. No differences in the rate of NSI disorder were observed by sex, ethnicity, or age. Although NSI disorder is associated with a worse presentation of self-injurious behavior, NSI disorder provides limited clinical utility as a dichotomous diagnosis, at least when compared with common NSI characteristics such as number of methods of NSI and the urge to self-injure. Instead, findings support a dimensional approach to NSI disorder. Analyses of specific symptoms of NSI disorder indicate concerns with Criterion B as currently defined by the DSM-5. Recommendations for a more parsimonious revision of NSI disorder are discussed.

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.

Prevalence and functions of non-suicidal self-injury in Spanish adolescents.

This study examined the prevalence, characteristics and functions of Non-suicidal Self-injury (NSSI) among Spanish adolescents. The sample consisted of 1,864 adolescents aged between 12 and 19 years (Mean Age = 15.32, SD = 1.97, 51.45% girls). The participants completed a modified version of the self-report scale Functional Assessment of Self-Mutilation (FASM; Lloyd, Kelley, &amp; Hope, 1997) to assess rates and methods of NSSI used during the last 12 months. They also indicated the functions of NSSI. NSSI behaviors are common among Spanish adolescents. More than half of the sample showed such behavior in the past year, and 32.2% had carried out severe NSSI behaviors. The functions of NSSI were examined by using confirmatory factor analyses. Results supported a hierarchical model consisting of two second-order factors: automatic reinforcement, which explained both positive and negative automatic reinforcement, and social reinforcement, which explained both positive and negative social reinforcement. These dimensions are critical to understand the factors that maintain NSSI behavior and have implications for treatments.

How many times and how many ways: the impact of number of nonsuicidal self-injury methods on the relationship between nonsuicidal self-injury frequency and suicidal behavior.

Several variables have been proposed as heavily influencing or explaining the association between nonsuicidal self-injury (NSSI) and suicidal behavior. We propose that increased comfort with bodily harm may serve as an incrementally valuable variable to consider. We sought to indirectly test this possibility by examining the moderating role of number of NSSI methods utilized on the relationship between NSSI frequency and lifetime number of suicide attempts, positing that increased variability in methods would be indicative with a greater general comfort with inflicting harm upon one's own body. In both a large sample of emerging adults (n = 1,317) and a subsample with at least one prior suicide attempt (n = 143), results were consistent with our hypothesis. In both samples, the interaction term was significant, with the relationship between NSSI frequency and suicidal behavior increasing in magnitude from low to mean to high levels of NSSI methods. Although frequency of NSSI is robustly associated with suicidal behavior, the magnitude of that relationship increases as an individual engages in a wider variety of NSSI methods. We propose that this may be due to an increased comfort with the general concept of damaging one's own body resulting from a broader selection of methods for self-harm.

Non-suicidal self-injury disorder in a community sample of adults

Non-suicidal self-injury (NSSI) Disorder has been included in DSM-5 for the first time as a disorder requiring further research. The present study investigated DSM-5 criteria for NSSI Disorder in a community sample of adults and provided an initial investigation of differences between those with and without a diagnosis of NSSI Disorder and NSSI history. Participants over the age of 18 (N=548) completed an online survey using Amazon׳s MTurk. A lifetime history of NSSI was reported by 23% of the sample. Nearly 3% of the total sample and 11.2% of those with an NSSI history met criteria for NSSI Disorder. Those with NSSI Disorder were similar to participants with an NSSI history who did not meet criteria for the disorder on NSSI frequency and methods, and age of NSSI onset, use of coping strategies, and borderline symptoms, but they differed on automatic reinforcement of the behavior and reported interference with functioning. Endorsement of specific NSSI Disorder criteria, potential implications for the diagnosis, and avenues for future research are discussed.

Functions, lifetime frequency, and variety of methods of non-suicidal self-injury among college students

Borderline Personality Disorder (BPD) and intrapersonal functions of non-suicidal self-injury (NSSI) have both been found to have strong relationships with NSSI. The present study examines their role in the lifetime frequency and variety of NSSI methods, taken as indicators of severity of NSSI. We hypothesized that intrapersonal functions would explain frequency and variety of NSSI beyond the effects of interpersonal functions. Further we hypothesized that intrapersonal functions would moderate the effect of BPD characteristics on frequency of NSSI. College students (n=52) who endorsed at least one lifetime act of NSSI completed self-report measures and semi-structured interviews about NSSI behaviors, frequency, variety and functions, and BPD symptoms. Results supported the hypotheses that intrapersonal functions play a role in the lifetime frequency and variety of NSSI behaviors in addition to that of interpersonal functions, but did not support the role of intrapersonal functions as a moderator. Findings are discussed in terms of relative importance of all factors involved in explaining severity of NSSI, measured as lifetime frequency and variety.

Non-Suicidal Self-Injury and Indirect Self-Harm Among Danish High School Students

Abstract Background: Non-suicidal self-injury (NSSI) and indirect self-harm are prevalent among adolescents, but it is rare to see them described as related topics. Objective: The purpose of this study was to investigate whether there is a correlation between the frequencies of NSSI and indirect self-harm (e.g., eating problems, alcohol and drug use) and how this may be influenced by gender. Method: Questionnaires about NSSI (e.g., cutting, burning, scratching, hitting oneself) and indirect self-harm were distributed to high school students in the Copenhagen area (N = 5650; response rate 53%; females 60.8%). Results: A total of 21.5% of the survey respondents had engaged in NSSI (lifetime prevalence), and 16.2% had practiced NSSI within the previous year. Gender differences in NSSI methods were identified. A total of 53.9% of the students had engaged in one or more types of indirect self-harm. The correlation between NSSI and indirect self-harm is twice as high for males (0.44; P ` .001) as compared with females (0.20; P ` .001). Conclusions: Clinicians must be aware of both NSSI and indirect self-harm. A positive correlation is seen, especially among young males. Males often perform other kinds of NSSI as compared with females, and clinicians must look for gender-specific signs of NSSI. It is argued that NSSI can be perceived as a “social pathology,” but it is also indicated that NSSI and indirect self-harm can be evaluated as an expression of ordinary behavior among modern high school students that must not be medicalized.

How Often, or How Many Ways: Clarifying the Relationship Between Non-Suicidal Self-Injury and Suicidality

This study clarified the association of maladaptive, potentially self-damaging behaviors with suicidality. Specifically, we examined whether greater frequency (i.e., how often) or greater versatility (i.e., how many ways) of several self-damaging behaviors, including non-suicidal self-injury (NSSI), substance use, and disordered eating, increased risk for suicide. Participants who engaged in NSSI (N = 142) completed questionnaires assessing suicidal and self-damaging behavior at baseline and engagement in suicidal behaviors (e.g., ideation, attempts, talking about suicide) 3 months later. Results suggest that the versatility rather than frequency of self-damaging behaviors is most robustly associated with suicide risk. Engaging in multiple methods of NSSI and using a greater number of illicit substances were positively associated with suicide risk. Further, versatility of NSSI interacted with depression to predict suicide risk at 3-month follow-up such that highly depressed participants who engaged in more methods of NSSI exhibited highest risk, whereas those who engaged in more methods with low depression exhibited the lowest risk.

The Importance of High Distress Tolerance in the Relationship between Nonsuicidal Self‐Injury and Suicide Potential

Research has indicated that nonsuicidal self-injury (NSSI) and suicidal behavior are strongly related to one another, with a sizable portion of individuals with a history of NSSI also reporting a history of nonlethal suicide attempts. Nonetheless, little research has examined possible moderators of this relationship. One potentially important construct is distress tolerance (DT), which has been shown to be negatively associated with NSSI and positively associated with the acquired capability for suicide. In this study, 93 adult inpatients (54.8% male) receiving treatment for substance use disorders completed a structured interview assessing prior suicidal behavior and questionnaires assessing DT, NSSI, and psychopathology. Results indicated that DT moderates the relationship between NSSI frequency (but not number of NSSI methods) and suicide potential (a continuum ranging from no prior suicidal behavior to suicidal behavior with minimal bodily harm to highly lethal suicidal behavior), ΔR(2) = .04; p < .023; f(2) = .06, with this relation increasing in strength at higher levels of DT. These results are consistent with an emerging line of research indicating that high levels of DT facilitate suicidal behavior in at-risk populations and suggest that the capacity to tolerate aversive physiological and affective arousal might be vital to engagement in serious or lethal suicidal behavior.

The Role of Sensation Seeking in Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) is a major health concern across the lifespan, yet much remains unknown about the possible causes and functions of this behavior. The goal of the current study was to examine the role of multiple facets of sensation seeking in NSSI among a sample of 1,648 undergraduate students (70.5 % female). It was hypothesized that individuals endorsing higher levels of sensation seeking, as measured at the trait level by assessing individual differences in Risk Seeking and Experience Seeking and with a functional assessment of sensation seeking as it relates to NSSI, specifically, would engage in more acts of NSSI and more types of NSSI, and would also be more likely to engage in specific types of NSSI. Results of negative binomial and logistic regressions provided partial support for study hypotheses. After controlling for Emotional Reactivity in all analyses, individuals higher in Risk Seeking were significantly more likely to have a history of NSSI and have engaged in more acts of NSSI. On the contrary, Experience Seeking did not significantly predict lifetime engagement in NSSI, and this facet, as well as Sensation Seeking Function significantly negatively predicted engagement in more acts of NSSI. Furthermore, only Sensation Seeking Function predicted the use of more types of NSSI methods. All three sensation seeking variables predicted the use of specific NSSI behaviors. Results suggest that risk seeking, in particular, may be most relevant to NSSI, as it consistently predicted lifetime NSSI, number of acts, and specific methods of NSSI. Theoretical and clinical implications are discussed.

The Mediatory Role of Maladaptive Schema Modes Between Parental Care and Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) is being increasingly recognised as a behaviour of significant clinical importance. Yet, there remains uncertainty regarding the underlying mechanisms of NSSI. This study aimed to explore the relationship between maladaptive schema modes, parental bonding, and NSSI. Seventy psychiatric outpatients with a history of NSSI completed the Deliberate Self-Harm Inventory, Schema Mode Inventory, and Parental Bonding Inventory. Results revealed that maladaptive schema modes were significantly associated with low parental care and with an earlier age of onset, longer duration, and higher number of methods of NSSI. Maladaptive schema modes also significantly mediated the relationship between parental care and age of onset of NSSI and between parental care and duration of NSSI. Two maladaptive schema modes (namely, Punitive Parent and Angry Child) were also found to be significant mediators in this relationship. The clinical implications of this research are discussed.

Predictors of Continuation and Cessation of Nonsuicidal Self-Injury

This paper reports the first prospective study of risk factors for continuation of nonsuicidal self-injury (NSSI) during adolescence. We examined whether NSSI became more severe among those continuing to self-injure 1 year later, as well as characteristics and predictors of continuation, relative to cessation, drawn from a sample of 1,973 community-based adolescents from five states in Australia. Multiple sociodemographic and psychosocial factors were assessed in a series of sequential logistic regressions. Of those reporting NSSI at follow-up (12% total sample), 4.1% (95% CI: 3.3%-5.0%; n = 80) continued from baseline and an additional 4.1% had stopped this behavior by follow-up (95% CI: 3.3%-5.1%, n = 81; 3.8% new cases). Frequency, potential lethality and number of methods of NSSI increased among adolescents continuing to self-injure. These individuals also had overall higher frequency and more serious wounds compared with those who had stopped self-injuring, possibly providing parameters to differentiate these groups. Continuation of NSSI was associated with higher frequency (OR = 1.06; 95% CI = .99-1.13, p = .08), lower cognitive reappraisal (OR = .86; 95% CI = .78-.95, p = .004) and higher emotional suppression (OR = 1.10; 95% CI = .98-1.22, p = .09) relative to cessation at T1. These findings may assist to better identify young people more likely to continue self-injuring and also highlight potentially modifiable factors to inform early intervention initiatives.

Nonsuicidal Self-Injury and Suicidal Behavior: A Latent Class Analysis among Young Adults

Although there is a general consensus among researchers that engagement in nonsuicidal self-injury (NSSI) is associated with increased risk for suicidal behavior, little attention has been given to whether suicidal risk varies among individuals engaging in NSSI. To identify individuals with a history of NSSI who are most at risk for suicidal behavior, we examined individual variability in both NSSI and suicidal behavior among a sample of young adults with a history of NSSI (N = 439, Mage = 19.1). Participants completed self-report measures assessing NSSI, suicidal behavior, and psychosocial adjustment (e.g., depressive symptoms, daily hassles). We conducted a latent class analysis using several characteristics of NSSI and suicidal behaviors as class indicators. Three subgroups of individuals were identified: 1) an infrequent NSSI/not high risk for suicidal behavior group, 2) a frequent NSSI/not high risk for suicidal behavior group, and 3) a frequent NSSI/high risk for suicidal behavior group. Follow-up analyses indicated that individuals in the ‘frequent NSSI/high risk for suicidal behavior’ group met the clinical-cut off score for high suicidal risk and reported significantly greater levels of suicidal ideation, attempts, and risk for future suicidal behavior as compared to the other two classes. Thus, this study is the first to identity variability in suicidal risk among individuals engaging in frequent and multiple methods of NSSI. Class 3 was also differentiated by higher levels of psychosocial impairment relative to the other two classes, as well as a comparison group of non-injuring young adults. Results underscore the importance of assessing individual differences in NSSI characteristics, as well as psychosocial impairment, when assessing risk for suicidal behavior.

Variety of Self-Injury: Is the Number of Different Methods of Non-Suicidal Self-Injury Related to Personality, Psychopathology, or Functions of Self-Injury?

This study explored the association between number of methods of Nonsuicidal Self-Injury (NSSI) and personality, psychopathology, and functions of NSSI. Two combined undergraduate samples reporting a history of NSSI (n = 149) completed measures of personality, psychopathology, and NSSI. A series of regression analyses indicated that Conscientiousness, Openness, and two functions of NSSI (i.e., Automatic Negative Reinforcement and Social Negative Reinforcement) shared significant relationships with the number of NSSI methods participants engaged in. These findings demonstrate that, after accounting for NSSI frequency, a relationship exists among specific personality factors, NSSI functions, and engagement in additional methods of NSSI.