Understanding Non-Suicidal Self-Injury on a Child Inpatient Unit: a Mixed-Methods Study

Non-suicidal self-injury (NSSI) is the direct, deliberate destruction of body tissue without suicidal intent (Nock & Favazza, 2009). Age of onset, based primarily on retrospective reports, commonly occurs between twelve and fourteen years old (e.g., Jacobson & Gould, 2007). Recent efforts have examined NSSI among children directly (Barrocas et al., 2012; Esposito-Smythers et al., 2010). The current study, a mixed-methods approach, examined NSSI among a sample of children treated on a psychiatric inpatient unit. Archival chart reviews assessed current/lifetime NSSI behaviors, demographic data, current/lifetime suicidal ideation and attempts, and self-reported clinical rating scales. Semi-structured interviews with self- injuring children assessed phenomenology (e.g., age of onset, discovery of NSSI, emotions/thoughts, triggers) and the functions of NSSI. NSSI was highly prevalent in this sample; 63.9% (n = 78; 47 boys, 31 girls) of inpatient children, age nine to twelve years old, had past or current NSSI documented in their medical charts. NSSI+ participants were found to report significantly higher depressive scores and significantly higher anger scores compared to NSSI- participants (ps \u3c .05). Similarly, among the interviewed children (n = 7), they reported mostly internal (e.g., affect regulation) reasons for engaging in NSSI as well as bullying and family stressors triggering their NSSI behaviors. These findings indicate that NSSI is evident among psychiatrically impaired children as young as nine years old. In addition, depression and anger may play a role in the onset or maintenance of NSSI behavior among youth. Findings show many similarities between children and adolescents engaging in NSSI. Recognizing that NSSI may occur much earlier than previously thought and understanding how psychiatric distress (i.e., depression, anger) contributes to NSSI will inform better prevention and intervention treatments targeting NSSI. This study highlights that children are engaging in NSSI at much younger ages than previously thought, and are just as psychiatrically impaired as adolescents

Sexual Orientation and Non-Suicidal Self-Injury: A Meta-Analytic Review

The aim of this study was to conduct the first meta-analysis comparing risk for NSSI between sexual minority and heterosexual persons. Eleven published and 4 unpublished studies were reviewed, describing associations between sexual orientation and NSSI in 7,147 sexual minority and 61,701 heterosexual participants. The overall weighted effect size for the relationship between sexual orientation and NSSI using a random-effects model was OR = 3.00 (95% CI = 2.46–3.66), indicating a medium-to-large effect. Sexual minority adolescents and bisexuals were found to be at particularly high-risk. These findings highlight the need to examine mechanisms linking sexual orientation and NSSI in future research. Building on these findings can add to understanding the associations between sexual orientation, NSSI, and suicidality, as well as prevention/intervention

Motivation for and use of social networking sites: Comparisons Among College Students With and Without Histories of Non-Suicidal Self-Injury

Objective: This research examines potential differences in social network use and motivation for social network use by non-suicidal self-injury (NSSI) status. Participants: 367 (73% women; Mage = 20.60) college students were recruited in November–December 2011. Methods: A random sample of 2,500 students was accessed through a university registrar to recruit students interested in an online survey assessing NSSI and various health-related behaviors. Results: Social network use and motivations for social networks did not differ by NSSI status. Conclusions: Results suggest that it is not patterns of use or motivation to use social networks that could lead to concern about online behavior (i.e., behavior increasing risk of future NSSI) among those with NSSI history. Rather, future preventive and intervention efforts should address the NSSI-related content that is available online, since this is unregulated, often explicit, and commonly includes “pro-NSSI” content that may be problematic and increase risk among vulnerable individuals