Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-15T19:22:40.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-suicidal self-injury in United States adults: prevalence, sociodemographics, topography and functions

Published online by Cambridge University Press:  05 January 2011

E. D. Klonsky
E. D. Klonsky*
Affiliation:
Department of Psychology, University of British Columbia, Vancouver, BC, Canada
*
*Address for correspondence: E. D. Klonsky, PhD, Department of Psychology, University of British Columbia, 2329 West Mall, Vancouver, British Columbia V6T 1Z4, Canada. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Non-suicidal self-injury (NSSI) has received increased attention in the mental health literature and has been proposed as a diagnostic entity for DSM-5. However, data on NSSI in the United States adult population are lacking.

Method

The prevalence and nature of NSSI were examined in a random-digit dialing sample of 439 adults in the United States. Participants were recruited during July and August of 2008.

Results

Lifetime prevalence of NSSI was 5.9%, including 2.7% who had self-injured five or more times. The 12-month prevalence was 0.9%. Methods of NSSI reported included cutting/carving, burning, biting, scraping/scratching skin, hitting, interfering with wound healing and skin picking. Half of self-injurers reported multiple methods. The average age of onset was 16 years (median 14 years). Instances of NSSI infrequently co-occurred with suicidal thoughts and with use of alcohol or drugs and rarely required medical treatment. Most injurers reported that NSSI functioned to alleviate negative emotions. Fewer reported that they self-injured to punish themselves, to communicate with others/get attention or to escape a situation or responsibility. NSSI was associated with younger age, being unmarried and a history of mental health treatment, but not with gender, ethnicity, educational history or household income.

Conclusions

Results are largely consistent with previous research in adolescent and young adult samples. Study limitations notwithstanding, this study provides the most definitive and detailed information to date regarding the prevalence and characteristics of NSSI in US adults. In the future, it will be important for large-scale epidemiological studies of psychopathology to include questions about NSSI.

Keywords

Epidemiologyfunctionsnon-suicidal self-injuryself-harmself-mutilation
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1981 - 1986
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychiatric Association: Washington, DC.Google Scholar
APA (2010). DSM-5 Development. (www.dsm5.org). Accessed 2 May 2010.Google Scholar
Andover, MS, Pepper, CM, Ryabchenko, KA, Orrico, EG, Gibb, BE (2005). Self-mutilation and symptoms of depression, anxiety, and borderline personality disorder. Suicide and Life-Threatening Behavior 35, 581–591.CrossRefGoogle ScholarPubMed
Briere, J, Gil, E (1998). Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. American Journal of Orthopsychiatry 68, 609–620.CrossRefGoogle ScholarPubMed
Favazza, AR, Conterio, K (1989). Female habitual self-mutilators. Acta Psychiatrica Scandinavica 79, 282–289.CrossRefGoogle ScholarPubMed
Herpertz, S (1995). Self-injurious behavior: psychopathological and nosological characteristics in subtypes of self-injurers. Acta Psychiatrica Scandinavica 91, 57–68.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Kessler, RC, Borges, G, Walters, EE (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617–626.CrossRefGoogle ScholarPubMed
Klonsky, ED (2007). The functions of deliberate self-injury: a review of the evidence. Clinical Psychology Review 27, 226–239.CrossRefGoogle ScholarPubMed
Klonsky, ED (2009). The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation. Psychiatry Research 166, 260–268.CrossRefGoogle ScholarPubMed
Klonsky, ED, Glenn, CR (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment 31, 215–219.CrossRefGoogle ScholarPubMed
Klonsky, ED, Muehlenkamp, JJ (2007). Self-injury: a research review for the practitioner. Journal of Clinical Psychology/In Session 63, 1045–1056.CrossRefGoogle ScholarPubMed
Klonsky, ED, Olino, TM (2008). Identifying clinically distinct subgroups of self-injurers among young adults: a latent class analysis. Journal of Consulting and Clinical Psychology 76, 22–27.CrossRefGoogle ScholarPubMed
Klonsky, ED, Oltmanns, TF, Turkheimer, E (2003). Deliberate self-harm in a nonclinical population: prevalence and psychological correlates. American Journal of Psychiatry 160, 1501–1508.CrossRefGoogle Scholar
Laye-Gindhu, A, Schonert-Reichl, KA (2005). Nonsuicidal self-harm among community adolescents: understanding the ‘whats’ and ‘whys’ of self-harm. Journal of Youth and Adolescence 34, 447–457.CrossRefGoogle Scholar
Muehlenkamp, JJ (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry 75, 324–333.CrossRefGoogle ScholarPubMed
Nixon, MK, Cloutier, P, Jansson, SM (2008). Nonsuicidal self-harm in youth: a population-based survey. Canadian Medical Association Journal 178, 306–312.CrossRefGoogle ScholarPubMed
Nock, MK (2009). Non-suicidal Self-injury: Origins, Assessment, and Treatment. American Psychological Association Press: Washington, DC.Google Scholar
Nock, MK, Holmberg, EB, Photos, VI, Michel, BD (2007). The Self-Injurious Thoughts and Behaviors Interview: development, reliability, and validity in an adolescent sample. Psychological Assessment 19, 309–317.CrossRefGoogle Scholar
Nock, MK, Joiner, TE, Gordon, KH, Lloyd-Richardson, E, Prinstein, MJ (2006). Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Research 144, 65–72.CrossRefGoogle ScholarPubMed
Nock, MK, Prinstein, MJ (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology 72, 885–890.CrossRefGoogle Scholar
Nock, MK, Prinstein, MJ (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology 114, 140–146.CrossRefGoogle ScholarPubMed
Nock, MK, Prinstein, MJ, Sterba, S (2009). Revealing the form and function of self-injurious thoughts and behaviors: a real-time ecological assessment study among adolescents and young adults. Journal of Abnormal Psychology 118, 816–827.CrossRefGoogle ScholarPubMed
Prinstein, MJ (2008). Introduction to the special section on suicide and non-suicidal self-injury: a review of unique challenges and important directions for self-injury science. Journal of Consulting and Clinical Psychology 76, 1–8.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
Sturgis, P (2006). Surveys and sampling. In Research Methods in Psychology(ed. Breakwell, G. M., Hammond, S., Fife-Schaw, C. and Smith, J. A.), 3rd edn. Sage Publications: London.Google Scholar
Whitlock, J, Eckenrode, J, Silverman, D (2006). Self-injurious behaviors in a college population. Pediatrics 117, 1939–1948.CrossRefGoogle Scholar
Whitlock, J, Muehlenkamp, JJ, Eckenrode, J (2008). Variation in nonsuicidal self-injury: identification and features of latent classes in a college population of emerging adults. Journal of Clinical Child and Adolescent Psychology 37, 725–735.CrossRefGoogle Scholar