Nonsuicidal Self-injury Methods Research Articles

Pain tolerance as a ‘barrier’ to nonsuicidal self-injury: A longitudinal study

Theoretical perspectives underscore that low pain tolerance may be a relevant ‘barrier’ to non-suicidal self-injury (NSSI). However, there is limited longitudinal work on the link between pain tolerance and NSSI, which is needed to assess if pain tolerance precedes NSSI engagement, and/or if NSSI precedes altered pain tolerance. Further, assessing both NSSI frequency and versatility (or number of NSSI methods), in addition to engagement, can provide a more nuanced understanding of the influence of pain on NSSI severity. In the present study, 1125 undergraduate students at a large university (72 % female, Mage = 17.96) reported on their NSSI frequency, NSSI versatility, and perceived pain tolerance. Four individual regressions were run to examine the potential bidirectional nature of the association between NSSI frequency and pain tolerance, and NSSI versatility and pain tolerance. Pain tolerance predicted both NSSI frequency and versatility over time. Neither NSSI frequency nor versatility predicted pain tolerance. Results suggest that high pain tolerance may be a risk factor for severe NSSI engagement.

A latent class analysis of non-suicidal self-injury and associations with constructs from the interpersonal theory of suicide in a sample of sexual minority young adults

Introduction: Self-directed violence (SDV), comprising both non-suicidal self-injury (NSSI) and suicide, is elevated among sexual minority populations. NSSI age of onset has been shown to impact severity of SDV outcomes. Components of the Interpersonal Theory of Suicide (ITS), which includes perceived burdensomeness (PB), thwarted belongingness (TB), and acquired capability for suicide (ACS), may be useful to understanding NSSI subgroups, especially among under-researched groups such as sexual minority persons. Methods: This study examined subtypes of NSSI and associations with constructs from the ITS. A sample of 473 sexual minority young adults with a history of NSSI completed self-report measures assessing demographics, SDV, and ITS constructs. More than half of the sample (59.7%) reported engaging in NSSI during their lifetime. For suicidal thoughts and behaviors, a majority of the sample reported having thoughts of suicide in their lifetime (87.3%), and one-third reported a lifetime suicide attempt (33.0%). Results: Latent class analysis revealed three classes: (1) lower NSSI, (2) moderate NSSI, and (3) higher NSSI. NSSI age of onset, intensity of suicidal thoughts, suicide plan likelihood, duration of NSSI, and number of NSSI methods differentiated groups. Multivariate Analysis of Variance (MANOVA) revealed that the lower NSSI group reported lower PB and TB than the moderate NSSI group. No differences were found for ACS across NSSI classes. Discussion: Results are discussed in terms of their theoretical implications and application for counseling at-risk sexual minority young adults. This study identifies factors associated with subgroups of self-directed violence among sexual minority young adults. Such findings inform gaps in self-directed violence prevention research and clinical practice for sexual minority persons.

Online and school bullying roles: are bully-victims more vulnerable in nonsuicidal self-injury and in psychological symptoms than bullies and victims?

BackgroundBullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated.MethodsThe aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (Mage = 16.81; SD = 1.41) participated.ResultsLifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month.ConclusionsResults highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills.

Nonsuicidal self-injury characteristics: A mixed methods analysis of differences between veterans and civilians

Nonsuicidal self-injury (NSSI) is a well-established risk factor for suicidal behavior, with certain NSSI characteristics being associated with increased risk. In the United States (U.S.), the veteran suicide rate is elevated, though lifetime prevalence rates of NSSI appear similar between veterans and civilians. There is limited research that directly compares veterans and civilians across multiple NSSI characteristics to examine between-group differences in NSSI behavior and provide important context for the application of NSSI research with the veteran population. This study examined differences between U.S. veterans and civilians with a history of suicidal ideation across several NSSI characteristics, including method, severity, age of onset, shame, distress, and reason for initial NSSI engagement. A sample of 527 veterans and civilians completed measures of direct and indirect NSSI behaviors along with supplemental questions designed to further assess endorsed NSSI behaviors. Additionally, respondents provided written responses to an open-ended question about their reasons for initial engagement in NSSI, which were coded for post-hoc analysis. Chi-square difference tests and t-tests were conducted, revealing significant group differences between veterans and civilians in NSSI method, lifetime versatility, age of onset, age at last occurrence, and reasons for initial engagement. No significant differences were found in NSSI frequency, severity, shame, or distress. These findings provide valuable information on similarities and differences in NSSI behavior characteristics between U.S. veterans and civilians with lifetime suicidal ideation to inform future research and the assessment of NSSI in these populations.

Prevalence, correlates and common methods of non-suicidal self-injury in South Asia: a systematic review

IntroductionThe dynamics of self-harm vary substantially around the world, yet it is severely under-researched outside of a small number of high-income ‘Western’ countries. South Asia is disproportionately impacted by suicide,...

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.

Pattern of non-suicidal self-injury in Chinese male prisoners: A latent class analysis.

Nonsuicidal self-injury (NSSI) occurs more frequently in the prisoner population than in the general population. Monitoring and management of this behavior is challenging because NSSI may present in diverse ways. People often use more than one method of NSSI, and there are many possible combinations of these behaviors. We used latent class analysis (LCA) to identify subgroups of male inmates based on methods and frequency of NSSI. A total of 1042 male prisoners in China (Mage = 38.45, SD = 10.67) completed measures of hopelessness, sensation seeking, identity integration, and suicidal ideation, and NSSI was assessed in a structured interview. Results of the LCA supported a three-class model: high-NSSI (1.8%), moderate-NSSI (8.0%), and no-or-negligible NSSI (90.2%). Multinomial logistic regression analyses showed that prisoners in the high-NSSI and moderate-NSSI classes were significantly more likely than those in the no-or-negligible NSSI class to show high hopelessness, high sensation seeking, and low identity. Furthermore, suicidal ideation was significantly higher in the high-NSSI and moderate-NSSI classes than in the no-or-negligible NSSI class. Classifying groups of prisoners based on features of NSSI is potentially useful for understanding risk factors and for developing tailored prevention and treatment strategies.

Function of Nonsuicidal Self-Injury Among Iranian University Students: A Factor Structure Analysis.

Emerging non-Western studies indicate new patterns in the functionality of nonsuicidal self-injury (NSSI) warranting further investigation in different cultures. The current study aims to investigate the function (etiology and underlying mechanism) of NSSI among a sample of university students in Tehran, Iran, using the Inventory of Statements About Self-Injury (ISAS). The ISAS was administered to 63 students who self-injured (52.4% female; Mage = 22.15). An exploratory factor analysis using the Bayesian estimation method was conducted. A three-factor model of NSSI functions emerged including an intrapersonal factor representing within-self functions (e.g., self-punishment); a social identification factor consisting of functions establishing a sense of self/identity (e.g., peer bonding); and a communication factor representing an influencing/communicating functionality (e.g., marking distress). Intrapersonal and social identification factors were associated with greater severity of NSSI method and increased anxiety. Findings support the use of the ISAS among an Iranian sample and revealed additional patterns beyond the commonly referenced two-factor model (intrapersonal and interpersonal functions) in a culturally novel sample. The results are situated within the sample's sociocultural context.

Differences in Non-suicidal Self-injury Behaviors between Unipolar Depression and Bipolar Depression in Adolescent Outpatients.

Non-suicidal self-injury (NSSI) has a higher prevalence in adolescents with depressive disorders than in community adolescents. This study examined the differences in NSSI behaviors between adolescents with unipolar depression (UD) and those with bipolar depression (BD). Adolescents with UD or BD were recruited from 20 general or psychiatric hospitals across China. The methods, frequency, and function of NSSI were assessed by Functional Assessment of Self-Mutilation. The Beck Suicide Ideation Scale was used to evaluate adolescents' suicidal ideation, and the 10-item Kessler Psychological Distress Scale to estimate the anxiety and depression symptoms. The UD group had higher levels of depression (19.16 vs.17.37, F=15.23, P<0.001) and anxiety symptoms (17.73 vs.16.70, F=5.00, P=0.026) than the BD group. Adolescents with BD had a longer course of NSSI than those with UD (2.00 vs.1.00 year, Z=-3.39, P=0.001). There were no statistical differences in the frequency and the number of methods of NSSI between the UD and BD groups. Depression (r=0.408, P<0.01) and anxiety (r=0.391, P<0.01) were significantly and positively related to NSSI frequency. Adolescents with BD had a longer course of NSSI than those with UD. More importantly, NSSI frequency were positively and strongly correlated with depression and anxiety symptoms, indicating the importance of adequate treatment of depression and anxiety in preventing and intervening adolescents' NSSI behaviors.

Current status of nonsuicidal injuries and associated factors among junior high school students in Hainan Province, China: a cross-sectional study

BackgroundTo summarize the general status of nonsuicidal self-injury (NSSI) behaviour and the characteristics of junior high school students and to determine the risk factors associated with NSSI behaviour.MethodsFive middle schools in the rural and urban areas of Hainan Province were randomly selected for this cross-sectional study, and junior high school students were administered questionnaires, including the General Sociodemographic Questionnaire, Ottawa Self-Injury Scale, Anxiety Self-Rating Scale, Depression Self-Rating Scale, Adolescent Lifestyle Scale, and Parenting Style Scale.ResultsThe NSSI rate among junior high school students in Hainan Province was 28.9%, with a higher prevalence among girls than boys (P < 0.05). The age range was 11–16 years, with a mean age of 13.08 ± 0.911 years. The most common form of self-injury was scratching/bruising, followed by hitting oneself, pulling out hair, biting, head banging, and cutting. The NSSI methods of scratching/bruising, hitting oneself and cutting more commonly occurred in girls than boys (P < 0.05). The most common sites of self-injury were the face, scalp, lips, forearm/elbow, axilla/wrist, hands/fingers, and thighs/knees. Significant differences were observed in the distribution of self-injury sites (nose, lips, genitals, and axillae/wrists) between the two genders (p < 0.05). The most important motivation for undertaking NSSI behaviours was to release negative emotions. The risk factors affecting NSSI behaviours were female gender (OR = 1.793), depression (OR = 1.961), anxiety (OR = 1.495), interpersonal relationship factors (OR = 1.099), academic stress factors (OR = 1.062), maternal emotional warmth (OR = 0.97), and maternal overinterference (OR = 1.036).ConclusionsThe NSSI rate among junior high school students in Hainan was 28.9%, affecting girls more than boys. The form and site of self-injury between boys and girls were significantly different. The motivation for committing self-injurious behaviours was mainly to regulate bad emotions. Risk factors for NSSI behaviours included female gender, anxiety, depression, interpersonal relationship factors, academic stress factors, and maternal emotional overinterference, while maternal emotional warmth was a protective factor.

Non-suicidal self-injury function: prevalence in adolescents with depression and its associations with non-suicidal self-injury severity, duration and suicide.

Given that adolescents with depression are at the highest risk for non-suicidal self-injury (NSSI), a thorough understanding of their NSSI functions, as well as associations between functions and severe behavioral consequences, is essential for risk assessment and invention development. Adolescents with depression from 16 hospitals across China, for whom data was available regarding their NSSI function, frequency, number of methods used, time characteristics, and suicide history were included. Descriptive statistical analyses were performed to determine the prevalence of NSSI functions. Regression analyses were conducted to explore the relationship between NSSI functions and behavioral characteristics of NSSI and suicide attempts. Affect regulation was the primary function of NSSI and followed by anti-dissociation in adolescents with depression. Females recognized automatic reinforcement functions more frequently than males, while males had a higher prevalence of social positive reinforcement functions. Automatic reinforce functions played the prominent role in associations between NSSI functions and all the severe behavioral consequences. Specifically, functions of anti-dissociation, affect regulation, and self-punishment were all associated with NSSI frequency, while higher levels of endorsements for anti-dissociation and self-punishment were linked to more NSSI methods, and greater level of endorsement for anti-dissociation was related to longer NSSI duration. Only the increase in endorsement of self-punishment was associated with a greater hazard of suicide attempts. The dominant functions of NSSI in adolescents with depression was automatic reinforcement, specifically affect regulation. And prevalence of NSSI function differed between males and females. Anti-dissociation and self-punishment seemed to be the most risky factors as they were linked to severe NSSI or suicide behaviors. More attention should be given to these functions in risk evaluation, and the targeted interventions should be developed accordingly in a timely manner.

Prevalence and Help Seeking Behavior for Non-Suicidal Self-Injury on College Students

The high prevalence of NSSI has become a widespread health issue in various countries. Unfortunately, NSSI studies in Eastern countries are not as many as in Western countries. This study aims to explore the self-injury behavior of students in Indonesia. Crowdsourcing approach is used by distributing questionnaires through Google Form. A total of 909 students aged 18-25 years (mean age = 20.3, SD = 1,329, 75.4% female) participants completed the Inventory of Statements About Self-injury (ISAS) self-report scale to comprehensively assess non suicidal self-injury (NSSI). Participants were recruited during June 2022–July 2022. The results shows 30% of students were involved in NSSI behavior. The mean age of onset was 15.5 years. As many as 55% of subjects reported having committed more than 50 acts of self-injury. The reported NSSI methods included slashing (78% hair pulling, hitting 74%, biting 57.1%, interfering wound healing 46.9%, carving 26.7%, pinching 66%, scratching 63.3%, stabbing 25.2%, and ingesting a hazardous substance 7.3%. It was reported that 88.3% used more than one method, 17.2% did not feel pain while doing self-injury. In conclusion, the prevalence of NSSI among students in Indonesia is not different from other countries. Prevention and management actions need to be developed to help people who self-injure to have strategies in dealing with problems adaptively and avoiding risky behavior.

Self-Injury in the News: A Content Analysis

Non-suicidal self-injury (NSSI) has garnered increasing academic and media attention in society. While more awareness of NSSI is welcomed, inappropriate reporting of NSSI in media could heighten the potential for stigmatization and misunderstanding of NSSI and people who engage in it. Further, certain kinds of content (e.g., graphic imagery) may be harmful to people who self-injure (e.g., provoking urges to self-injure). These concerns notwithstanding, little research has focused on how NSSI has been portrayed in news media. Such knowledge would therefore represent a first step toward illuminating the nature of media depictions of NSSI and highlight potential areas to circumvent any concerns. Using content analysis, we explored how NSSI was portrayed in 568 online news articles about NSSI, published between 2007 and 2018, from top news sources in Australia, Canada, New Zealand, the United Kingdom, and the United States. Codes were developed based on prior research investigating online NSSI content, and the available existing and proposed media guidelines for the reporting of NSSI at the time of the study. While the overall tone of the examined articles was often neutral, areas of concern included: most articles detailing specific NSSI methods, the frequent inclusion of negative imagery, an absence of clear communication about what NSSI is and why people self-injure, the use of sensationalist and stigmatizing language, and a lack of helpful resources. These preliminary findings suggest the utility of a set of newly developed media guidelines on the reporting of NSSI as one component in an effort to address the stigmatization and misunderstanding of NSSI and individuals who self-injure.

Characteristics, Methods, And Functions Of Non-Suicidal Self-Injury Among Highly Dissociative Individuals

ABSTRACT Upto 86% of dissociative individuals engage in non-suicidal self-injury (NSSI). Research suggests that people who dissociate utilize NSSI to regulate posttraumatic and dissociative experiences, as well asrelated emotions. Despite high rates of NSSI, no quantitative study has examined the characteristics, methods, and functions of NSSIwithin a dissociative population. The present study examined thesedimensions of NSSI among dissociative individuals, as well aspotential predictors of intrapersonal functions of NSSI. The sample included 295 participants who indicated experiencing one or more dissociative symptoms and/or having been diagnosed with a trauma- or dissociation-related disorder. Participants were recruited through online trauma- and dissociation- related forums. Approximately 92% of participants endorsed a history of NSSI. The most common methods of NSSI were interfering with wound healing (67%), hitting oneself (66%), and cutting (63%). After controlling for age and gender, dissociation was uniquely associated with cutting, burning, carving, interfering with wound healing, rubbing skin against rough surfaces, swallowing dangerous substances, and other forms of NSSI. Dissociation was correlated with affect regulation, self-punishment,anti-dissociation, anti-suicide, and self-care functions of NSSI;however, after controlling for age, gender, depressive symptoms, emotion dysregulation, and PTSD symptoms, dissociation was no longer associated with any function of NSSI. Instead, only emotion dysregulation was associated with the self-punishment function ofNSSI and only PTSD symptoms were associated with the anti-dissociation function of NSSI. Understanding the unique properties of NSSI among dissociative individuals may improve the treatment of people who dissociate and engage in NSSI.

Non-Suicidal Self-Injury and Suicide Risk Among Adult Medical Inpatients.

Non-suicidal self-injury (NSSI) is a potent risk factor for suicide among youth. There is limited research, however, on the association between NSSI and suicide risk among adults, particularly among adult medical patients, who are a population at increased risk for suicide. To address this research gap, the current analysis aimed to describe the association between lifetime history of NSSI and suicide risk in an adult medical inpatient population. Adult medical inpatients aged 18 or older from one of four United States hospitals were screened for suicide risk and a lifetime history of NSSI. Suicide risk was determined using the Ask Suicide-Screening Questions (ASQ). NSSI history, methods, frequency, and severity were assessed via a structured interview based on the Self-Injurious Thoughts and Behaviors Interview. A total of 621 adult medical inpatients were included in this secondary analysis (55.2% male; 60.9% White; M[SD] age = 50.3[16.7]); 5.8% of patients (36/621) reported a lifetime history of NSSI and 16.1% (100/621) screened positive for suicide risk. Patients with a lifetime history of NSSI were significantly more likely to screen positive for suicide risk (OR = 9.4 [95% CI, 4.4-20.8]; p < .0001). This analysis used cross sectional data and could not examine any causal relationships between NSSI and suicide risk. Adult medical inpatients with a lifetime history of NSSI were significantly more likely to screen positive for suicide risk. Research examining NSSI among adult medical patients is especially relevant for suicide risk detection and prevention efforts.

Nonsuicidal self-injury in a clinical sample of adolescents in Serbia

Background/Aim. Nonsuicidal self-injury (NSSI) among adolescents is recognized as a significant public health concern. Adolescents with mental health problems are at an especially high risk of NSSI. The aim of the study was to assess the sociodemographic and clinical characteristics of patients with NSSI and the features of NSSI, as well as the impact of emotional reactivity and internalizing/externalizing problems on them. Methods. The observational study included a clinical sample of 111 adolescents treated at the Department of Child and Adolescent Psychiatry, Psychiatric Clinic at the University Clinical Center of Vojvodina, from March 2018 to October 2019. The adolescents were divided into two groups: group A comprised of adolescents who had at least one episode of NSSI in the last year, and group B comprised of adolescents who had no NSSI episode in their experience. The following clinical scales were used to examine the differences between adolescents from group A and group B: self-report questionnaires about emotional and behavioral problems (Youth Self-Report ? YSR, Child Behavior Checklist ? CBCL), emotional reactivity (Emotion Reactivity Scale ? ERS), and suicidality (Self- Injurious Thoughts and Behaviors Interview ? SITBI). Results. Group A contained a total of 58 adolescents older than the subjects of group B and was predominated by female participants. They had the first episode of NSSI at 13.05 and the last at 14.80 years. The most common methods of NSSI were cutting, scratching, and biting. Adolescents from group A had higher scores on ERS, higher scores on internalizing and externalizing problems, as well as higher total scores on YSR, but there was no difference between groups regarding scores on the CBCL scale. Conclusion. Due to the results obtained for emotional and behavioral problems, adolescents with NSSI should have a detailed psychiatric assessment, including social support, pharmacotherapy, and psychotherapy, to better understand NSSI and help them develop better coping skills.

For Better or Worse?: The role of cognitive flexibility in the association between nonsuicidal self-injury and suicide attempt

Nonsuicidal self-injury (NSSI) has been repeatedly associated with increased suicide risk. However, the transition from NSSI to suicidal thoughts and behaviors still remains as an enigma. One possible construct that may influence this relationship is cognitive flexibility, which refers to the ability to adapt responses/strategies based on environmental feedback. It may be that greater cognitive flexibility increases one's cognitive accessibility to suicide, making it a more viable option upon distress especially for those with a prior history of NSSI. Conversely, it may be that less cognitive flexibility creates a negative bias that exacerbates the effects of NSSI on suicide. Thus, in this study, we examined how NSSI characteristics (i.e., frequency and methods) interact with cognitive flexibility to predict lifetime suicide attempt (SA) history. Participants were 505 individuals with a lifetime history of NSSI who completed a survey assessing for their NSSI experiences, cognitive flexibility, and SA history. Moderation analyses were conducted while controlling for sexual orientation, which significantly predicted SA history. Results indicated a significant interaction between number of NSSI methods endorsed and cognitive flexibility. In particular, individuals were more likely to have had a history of SA if they scored higher on the alternative subscale of cognitive flexibility. The results suggest that the adaptive value of cognitive flexibility may be context dependent, and highlight the importance of personalized care among those who engage in self-harm.

Pain analgesia or desensitization? A longitudinal lab-based study on the link between pain and nonsuicidal self-injury

Mounting evidence suggests that individuals who engage in nonsuicidal self-injury (NSSI) have lower pain sensitivity (e.g., pain thresholds and tolerances) than individuals without a history of NSSI. However, research has been largely cross-sectional, so it is unclear whether low pain sensitivity may increase risk for NSSI, or whether NSSI diminishes pain sensitivity over time. In the present study, the relations among NSSI frequency, versatility (number of NSSI methods), pain threshold, and pain tolerance were examined using a longitudinal research design. Participants included 156 undergraduate students at a large university (87% female; Mage = 19.79) with a recent history of NSSI. Participants reported on their NSSI engagement and completed a cold pressor task in a baseline session, as well as at one year follow-up. Eight regression models were run to examine the nature of the association between the two pain measures (i.e., pain threshold and tolerance) and the two NSSI measures (i.e., frequency and versatility). Pain tolerance and pain threshold predicted NSSI versatility over time, but NSSI frequency and versatility did not predict pain threshold or tolerance over time. Results suggest that low pain sensitivity may be a risk factor for severe NSSI engagement.

Nonsuicidal self-injury in veterans: Prevalence, clinical characteristics, and gender differences from a national cohort

Nonsuicidal self-injury (NSSI) is a robust predictor of suicidal thoughts and behaviors; however, while there are typically only small differences observed in the prevalence of NSSI between men and women, this condition has been largely overlooked and underestimated among men. Assessing NSSI methods more common in men may address misidentification as well as allow for more precise NSSI prevalence estimates. Survey data from a national sample of Gulf War I-Era veterans (N = 1063) was used to estimate the prevalence of NSSI and compare prevalence of NSSI methods between men and women veterans. Demographic and clinical correlates of NSSI engagement were also examined. The national lifetime prevalence rate of NSSI among Gulf War I-Era veterans was 22.40%, whereas the past year prevalence rate was 8.10%. In both men and women, wall/object punching was the most common NSSI method endorsed across the lifetime. Men had slightly higher overall NSSI prevalence rates compared with women. This study highlights the need to systematically assess NSSI, particularly among veterans, to better identify, and consequently treat, NSSI in men. This is the first available prevalence estimate of NSSI to include the assessment of wall/object punching in a national sample of adult veterans.

Association of socioeconomic status with nonsuicidal self-injury and suicidal ideation in young Korean adults.

Although nonsuicidal self-injury (NSSI) in youth is an important mental health concern worldwide, limited studies have investigated its sociodemographic correlates in early adulthood. This study explored associations between socioeconomic status (SES) and self-harm behaviors, including NSSI and suicidal ideation, in a community-based sample of young adults. A total of 414 Korean young adults engaged in NSSI and 200 controls completed online self-report questionnaires assessing sociodemographic and clinical characteristics, using logistic regression to estimate the odds ratio and analyzed risk factors for NSSI, especially the independent influence of SES on NSSI risk. Multivariate regression was performed to identify the role of socioeconomic disadvantage in suicidal ideation in NSSI people. Logistic regression showed that low SES significantly increased NSSI risk. Multivariable regression also revealed that lower SES was related to more severe suicidal ideation in young adults with NSSI after controlling for gender and the higher-severity NSSI index, including the number of NSSI methods used and NSSI intrapersonal functions. This is the first study to directly address socioeconomic gradients of a general population of young adults with NSSI and its effects, and socioeconomic status should be considered preemptively when defining suicide risks of this group and when intervening in self-injurious behaviors.