Abstract
Non-suicidal self-injury (NSSI) refers to self-inflicted physical injury without suicidal intent. NSSI is particularly common in forensic settings and associated with several psychosocial concerns, coping responses, diagnoses, and functions, but little information is available regarding NSSI in adjudicated male adolescents. The present study examined the frequency and types of NSSI among adjudicated male adolescents (n = 103) and assessed the relationships between NSSI history, psychosocial concerns, coping responses, diagnoses, and functions within this population. Approximately two-thirds (66%) reported NSSI history. Participants with NSSI history reported poorer social adaptation and greater alienation and boredom, aggression, and emotional lability than controls. Youth with high-frequency NSSI were also more likely to utilize emotional discharge as an unhealthy coping response than controls. In addition, participants with high-frequency NSSI were more likely than controls to meet criteria for a mood or anxiety disorder. Function of NSSI primarily surrounded anxiety reduction/affect regulation, punishment, dissociation reduction, and social/sensation-seeking. NSSI appears to be prevalent among male adjudicated youths, and the findings suggest that the relationship between NSSI history, psychosocial concerns, coping responses, and functions is nuanced and could inform more calibrated assessment and treatment strategies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Belknap, J., & Holsinger, K. (2006). The gendered nature of risk factors for delinquency. Feminist Criminology, 1, 48–71. https://doi.org/10.1177/1557085105282897.
Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64. https://doi.org/10.1016/j.cpr.2015.02.009.
Brown, S. A., Williams, K., & Collins, A. (2007). Past and recent deliberate self- harm: Emotion and coping strategy differences. Journal of Clinical Psychology, 63, 791–803.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394. https://doi.org/10.1016/j.brat.2005.03.005.
Coughlan, H., Tiedt, L., Clarke, M., Kelleher, I., Tabish, J., Molloy, C., & Cannon, M. (2014). Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: An Irish population-based study. Journal of Adolescence, 37, 1–9. https://doi.org/10.1016/j.adolescence.2013.10.004.
Derouin, A., & Bravender, T. (2004). Living on the edge: The current phenomenon of self-mutilation in adolescents. American Journal of Maternal/Child Nursing, 29, 12–18.
Dyer, K. F., Dorahy, M. J., Hamilton, G., Corry, M., Shannon, M., MacSherry, A., & McElhill, B. (2009). Anger, aggression, and self-harm in PTSD and complex PTSD. Journal of Clinical Psychology, 65, 1099–1114. https://doi.org/10.1002/jclp.20619.
Evans, E., Hawton, K., & Rodham, K. (2005). In what ways are adolescents who engage in self-harm or experience thoughts of self-harm different in terms of help-seeking communication and coping strategies? Journal of Adolescence, 28, 573–587. https://doi.org/10.1016/j.adolescence.2004.11.001.
Fazel, S., Doll, H., & Långström, N. (2008). Mental disorders among adolescents in juvenile detention and correctional facilities: A systematic review and metaregression analysis of 25 surveys. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1010–1019. https://doi.org/10.1097/CHI.ObO13e31817eecf3.
Fliege, H., Lee, J. R., Grimm, A., & Klapp, B. F. (2009). Risk factors and correlates of deliberate self-harm behavior: A systematic review. Journal of Psychosomatic Research, 66, 477–493. https://doi.org/10.1016/j.jpsychores.2008.10.013.
Glenn, C. R., Franklin, J. C., & Nock, M. K. (2015). Evidence-based psychosocial treatments for self-injurious thoughts and behaviors in youth. Journal of Clinical Child and Adolescent Psychology, 44, 1–29. https://doi.org/10.1080/15374416.2014.945211.
Goldstein, A. L., Flett, G. L., Wekerle, C., & Wall, A. M. (2009). Personality, child maltreatment, and substance use: Examining correlates of deliberate self-harm among university students. Canadian Journal of Behavioural Science, 41, 241–251. https://doi.org/10.1037/a0014847.
Gonzales, A. H., & Bergstrom, L. (2013). Adolescent non-suicidal self-injury (NSSI) interventions. Journal of Child and Adolescent Psychiatric Nursing, 26, 124–130. https://doi.org/10.1111/jcap.12035.
Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on deliberate self-harm inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253–263. https://doi.org/10.1023/A:1012779403943.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self‐harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192–205. https://doi.org/10.1093/clipsy.bpg022.
Gratz, K. L., & Chapman, A. L. (2007). The role of emotional responding and childhood maltreatment in the development and maintenance of deliberate self-harm among male undergraduates. Psychology of Men and Masculinity, 8, 1–14. https://doi.org/10.1037/1524-9220.8.1.1.
Guerreiro, D. F., Cruz, D., Frasquilho, D., Santos, J. C., Figueira, M. L., & Sampaio, D. (2013). Association between deliberate self-harm and coping in adolescents: A critical review of the last 10 years’ literature. Archives of Suicide Research, 17, 91–105. https://doi.org/10.1080/13811118.2013.776439.
Haw, C., Hawton, K., Houston, K., & Townsend, E. (2001). Psychiatric and personality disorders in deliberate self-harm patients. British Journal of Psychiatry, 178, 48–54. https://doi.org/10.1192/bjp.178.1.48.
Hawton, K., & Harriss, L. (2008). Deliberate self-harm by under-15-year-olds: Characteristics, trends and outcome. Journal of Child Psychology and Psychiatry, 49, 441–448. https://doi.org/10.1111/j.1469-7610.2007.01852.x.
Hawton, K., Saunders, K. E., & O’Connor, R. C. (2012). Self-harm and suicide in adolescents. Lancet, 379, 2373–2382. https://doi.org/10.1016/S0140-6736(12)60322-5.
Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008). An examination of nonsuicidal self-injury among college students. Journal of Mental Health Counseling, 30, 137–156.
Heerde, J. A., Toumbourou, J. W., Hemphill, S. A., Herrenkohl, T. I., Patton, G. C., & Catalano, R. F. (2015). Incidence and course of adolescent deliberate self-harm in Victoria, Australia, and Washington State. Journal of Adolescent Health, 57, 537–544. https://doi.org/10.1016/j.jadohealth.2015.07.017.
Hilt, L. M., Nock, M. K., Lloyd-Richardson, E. E., & Prinstein, M. J. (2008). Longitudinal study of nonsuicidal self-injury among young adolescents: Rates, correlates, and preliminary test of an interpersonal model. Journal of Early Adolescence, 28, 455–469. https://doi.org/10.1177/0272431608316604.
Jutengren, G., Kerr, M., & Stattin, H. (2011). Adolescents’ deliberate self-harm, interpersonal stress, and the moderating effects of self-regulation: A two-wave longitudinal analysis. Journal of School Psychology, 49, 249–264. https://doi.org/10.1016/j.jsp.2010.11.001.
Kerig, P. K., Vanderzee, K. L., Becker, S. P., & Ward, R. M. (2012). Deconstructing PTSD: Traumatic experiences, posttraumatic symptom clusters, and mental health problems among delinquent youth. Journal of Child and Adolescent Trauma, 5, 129–144. https://doi.org/10.1080/19361521.2012.671796.
Kiekens, G., Hasking, P., Bruffaerts, R., Claes, L., Baetens, I., Boyes, M., & Whitlock, J. (2017). What predicts ongoing nonsuicidal self-injury?: A comparison between persistent and ceased self-injury in emerging adults. Journal of Nervous and Mental Disease, 205, 762–770. https://doi.org/10.1097/NMD.0000000000000726.
Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226–239. https://doi.org/10.1016/j.cpr.2006.08.002.
Klonsky, E. D., Glenn, C. R., Styer, D. M., Olino, T. M., & Washburn, J. J. (2015). The functions of nonsuicidal self-injury: Converging evidence for a two-factor structure. Child and Adolescent Psychiatry and Mental Health, 9, 44 https://doi.org/10.1186/s13034-015-0073-4.
Klonsky, E. D., & Muehlenkamp, J. J. (2007). Self-injury: A research review for the practitioner. Journal of Clinical Psychology, 63, 1045–1056. https://doi.org/10.1002/jclp.20412.
Kortge, R., Meade, T., & Tennant, A. (2013). Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the Inventory of Statements About Self-Injury (ISAS) scale. Behaviour Change, 30, 24–35. https://doi.org/10.1017/bec.2013.3.
Lewis, S. P., & Santor, D. A. (2010). Self-harm reasons, goal achievement, and prediction of future self-harm intent. Journal of Nervous and Mental Disease, 198, 362–369. https://doi.org/10.1097/NMD.0b013e3181da8500.
Madge, N., Hewitt, A., Hawton, K., Wilde, E. J. D., Corcoran, P., Fekete, S., & Ystgaard, M. (2008). Deliberate self-harm within an international community sample of young people: Comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. Journal of Child Psychology and Psychiatry, 49, 667–677. https://doi.org/10.1111/j.1469-7610.2008.01879.x.
McMahon, E. M., Corcoran, P., McAuliffe, C., Keeley, H., Perry, I. J., & Arensman, E. (2013). Mediating effects of coping style on associations between mental health factors and self-harm among adolescents. Crisis, 34, 242–250. https://doi.org/10.1027/0227-5910/a000188.
Mikolajczak, M., Petrides, K. V., & Hurry, J. (2009). Adolescents choosing self-harm as an emotion regulation strategy: The protective role of trait emotional intelligence. British Journal of Clinical Psychology, 48, 181–193. https://doi.org/10.1348/014466508X386027.
Moos, R. H. (1993). Coping Responses Inventory Youth Form Manual.. Odessa FL: Psychological Assessment Resources.
Moran, P., Coffey, C., Romaniuk, H., Olsson, C., Borschmann, R., Carlin, J. B., & Patton, G. C. (2012). The natural history of self-harm from adolescence to young adulthood: A population-based cohort study. Lancet, 379, 236–243. https://doi.org/10.1016/S0140-6736(11)61141-0.
Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 6, 10 https://doi.org/10.1186/1753-2000-6-10.
Nobakht, H. N., & Dale, K. Y. (2017). The prevalence of deliberate self-harm and its relationships to trauma and dissociation among Iranian young adults. Journal of Trauma and Dissociation, 18, 610–623. https://doi.org/10.1080/15299732.2016.1246397.
Nock, M. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18, 78–83. https://doi.org/10.1111/j.1467-8721.2009.01613.x.
Nock, M. K., & Mendes, W. B. (2008). Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. Journal of Consulting and Clinical Psychology, 76, 28 https://doi.org/10.1037/0022-006X.76.1.28.
Ougrin, D., Tranah, T., Leigh, E., Taylor, L., & Asarnow, J. R. (2012). Self-harm in adolescents. Journal of Child Psychology and Psychiatry, 53, 337–350. https://doi.org/10.1111/j.1469-7610.2012.02525.x.
Pattison, E. M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867–872.
Paul, E., Tsypes, A., Eidlitz, L., Ernhout, C., & Whitlock, J. (2015). Frequency and functions of non-suicidal self-injury: Associations with suicidal thoughts and behaviors. Psychiatry Research, 225, 276–282. https://doi.org/10.1016/j.psychres.2014.12.026.
Plener, P. L., Schumacher, T. S., Munz, L. M., & Groschwitz, R. C. (2015). The longitudinal course of non-suicidal self-injury and deliberate self-harm: A systematic review of the literature. Borderline Personality Disorder and Emotion Dysregulation, 2, 2 https://doi.org/10.1186/s40479-014-0024-3.
Reynolds, W. M. (1998). Adolescent Psychopathology Scale.. Odessa, FL: Psychological Assessment Resources.
Ross, S., & Heath, N. (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 31, 67–77. https://doi.org/10.1023/A:1014089117419.
Scoliers, G., Portzky, G., Madge, N., Hewitt, A., Hawton, K., De Wilde, E. J., & Van Heeringen, K. (2009). Reasons for adolescent deliberate self-harm: A cry of pain and/or a cry for help? Social Psychiatry and Psychiatric Epidemiology, 44, 601–607. https://doi.org/10.1007/s00127-008-0469-z.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. C. (1998). The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.
Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 44, 273–303. https://doi.org/10.1111/sltb.12070.
Tuisku, V., Kiviruusu, O., Pelkonen, M., Karlsson, L., Strandholm, T., & Marttunen, M. (2014). Depressed adolescents as young adults–predictors of suicide attempt and non-suicidal self-injury during an 8-year follow-up. Journal of Affective Disorders, 152, 313–319. https://doi.org/10.1016/j.jad.2013.09.031.
Victor, S. E., Muehlenkamp, J. J., Hayes, N. A., Lengel, G. J., Styer, D. M., & Washburn, J. J. (2018). Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults. Comprehensive Psychiatry, 82, 53–60. https://doi.org/10.1016/j.comppsych.2018.01.009.
Whitlock, J., Eckenrode, J., & Silverman, D. (2006). Self-injurious behavior in a college population. Pediatrics, 117, 1939–1948. https://doi.org/10.1542/peds.2005-2543.
Whitlock, J., Muehlenkamp, J., Purington, A., Eckenrode, J., Barreira, P., Baral Abrams, G., & Knox (2011). Nonsuicidal self-injury in a college population: General trends and sex differences. Journal of American College Health, 59, 691–698. https://doi.org/10.1080/07448481.2010.529626.
Wilkinson, P., & Goodyer, I. (2011). Non-suicidal self-injury. European Child and Adolescent Psychiatry, 20, 103–108. https://doi.org/10.1007/s00787-010-0156-y.
Author Contributions
J. R. S: co-designed and executed the study, assisted with data analyses, and co-wrote the paper. E. H. R: collaborated with the writing of the study and manuscript preparation. C. A. K: co-designed the study, assisted with data analyses, and co-wrote the paper.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional review board of the University of Nevada, Las Vegas.
Informed Consent
Parents of 99 youth provided consent (and all youth provided assent) and 4 youth aged 18 years provided self-consent for this study.
Additional information
Procedures were in accordance with university and correctional facility policies regarding research with human participants, including IRB approval. All adolescents at the correctional facility were eligible to participate. Parents of 99 youth provided consent (and all youth provided assent) and 4 youth aged 18 years provided self-consent.
Rights and permissions
About this article
Cite this article
Silverman, J.R., Ross, E.H. & Kearney, C.A. Non-Suicidal Self-Injury Among Male Adjudicated Adolescents: Psychosocial Concerns, Coping Responses, Diagnoses, and Functions. J Child Fam Stud 27, 3564–3571 (2018). https://doi.org/10.1007/s10826-018-1172-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-018-1172-7