Skip to main content
SpringerLink
Log in

Prevalence of non-suicidal self-injury and distinct groups of self-injurers in a community sample of adolescents

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Adolescence is an important developmental period for the first onset of non-suicidal self-injury (NSSI), a behavior known to be associated with elevated suicide risk. Little is currently known, however, about NSSI among adolescents. The primary objectives of this research were to establish the prevalence of non-suicidal self-injury (NSSI) in a representative sample of Turkish high school students and to identify and describe distinct subgroups of self-injurers.

Methods

A total of 1656 of 1676 eligible students (98.8 % participation rate) from 18 schools were surveyed during the 2010–2011 academic year. Questionnaires were administered that assessed prior engagement in a variety of self-injurious behaviors, current psychiatric symptoms, suicide-related risk factors, and participation in health-risk behaviors. Latent class analysis (LCA) methods were used to identify distinct groups of self-injurers.

Results

Almost one-third of the sample (N = 519) endorsed some previous engagement in NSSI behaviors. In LCA analyses restricted to youth with prior histories of NSSI, four distinct classes were identified characterized by: (1) low rates of NSSI behaviors (29 %); (2) high rates of self-battery (32 %); (3) high rates of self-cutting (19 %); and (4) high rates of multiple NSSI behaviors (19 %). These classes were further distinguished by current psychiatric symptoms, suicide risk factors, and other health-risk behaviors.

Conclusions

Findings from the present study indicate that NSSI is a common form of behavior among adolescent youth. There is, however, considerable heterogeneity among those with NSSI histories, with about 40 % at particularly high risk for ongoing distress, future acts of intentional self-harm, and suicidal behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  2. Giletta M, Scholte RH, Engels RC, Ciairano S, Prinstein MJ (2012) Adolescent non-suicidal self-injury: a cross-national study of community samples from Italy, the Netherlands and the United States. Psychiatry Res 197:66–72

    Article  PubMed Central  PubMed  Google Scholar 

  3. Plener PL, Libal G, Keller F, Fegert JM, Muehlenkamp JJ (2009) An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: germany and the USA. Psychol Med 39:1549–1558

    Article  CAS  PubMed  Google Scholar 

  4. Muehlenkamp JJ, Claes L, Havertape L, Plener PL (2012) International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child Adolesc Psychiatry Ment Health 6:10

    Article  PubMed Central  PubMed  Google Scholar 

  5. Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, Wasserman D (2014) Life‐time prevalence and psychosocial correlates of adolescent direct self‐injurious behavior: a comparative study of findings in 11 European countries. J Child Psychol Psychiatry 55:337–348

  6. Nock MK (2010) Self-injury. Annu Rev Clin Psychol 6:339–363

    Article  PubMed  Google Scholar 

  7. Claassen CA, Trivedi M, Shimizu I, Stewart S, Larkin GL, Litovitz T (2006) Epidemiology of nonfatal deliberate self-harm in the United States as described in three medical databases. Suicide Life Threat 36:192–212

    Article  Google Scholar 

  8. Laye-Gindhu A, Schonert-Reichl K (2005) Nonsuicidal self-harm among community adolescents: understanding the “whats” and “whys” of self-harm. J Youth Adolesc 34:447–457

    Article  Google Scholar 

  9. Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML (2007) Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med 37:1183–1192

    Article  PubMed Central  PubMed  Google Scholar 

  10. Jacobson CM, Gould M (2007) The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: a critical review of the literature. Arch Suicide Res 11:129–147

    Article  PubMed  Google Scholar 

  11. Nock MK, Joiner TE Jr, Gordon KH, Lloyd-Richardson E, Prinstein MJ (2006) Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res 144:65–72

    Article  PubMed  Google Scholar 

  12. Hintikka J, Tolmunen T, Rissanen ML, Honkalampi K, Kylmä J, Laukkanen E (2009) Mental disorders in self-cutting adolescents. J Adolesc Health 44:464–467

    Article  PubMed  Google Scholar 

  13. Klonsky ED, Olino TM (2008) Identifying clinically distinct subgroups of self-injurers among young adults: a latent class analysis. J Consult Clin Psychol 76:22–27

    Article  PubMed  Google Scholar 

  14. Bracken-Minor KL, McDevitt-Murphy ME, Parra GR (2012) Profiles of non-suicidal self-injurers and associated patterns of alcohol use. J Psychopathol Behav 34:552–563

    Article  Google Scholar 

  15. Whitlock J, Muehlenkamp J, Eckenrode J (2008) Variation in nonsuicidal self-injury: identification and features of latent classes in a college population of emerging adults. J Clin Child Adolesc Psychol 37:725–735

    Article  PubMed  Google Scholar 

  16. Nock MK, Prinstein MJ (2005) Contextual features and behavioral functions of self-mutilation among adolescents. J Abnorm Psychol 114:140–146

    Article  PubMed  Google Scholar 

  17. Moffitt TE, Caspi A, Kokaua J, Milne BJ, Polanczyk G, Poulton R (2010) How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychol Med 40:899–909

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Ögel K, Eke C, Taner S, Erol B (2004) İstanbul’da öğrencilerde riskli davranışlar araştırması [Risky behaviors among students in Istanbul]. Yeniden Yayın 6

  19. Zoroğlu SS, Tüzün U, Şar V et al (2003) Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry Clin Neurosci 57:119–126

    Article  PubMed  Google Scholar 

  20. Lemeshow S, Hosmer DW Jr, Klar J, Lwanga SK (1990) Adequacy of Sample Size in Health Studies. Wiley/World Health Organization, Chichester

    Google Scholar 

  21. Klonsky ED, Glenn C (2009) Assessing the functions of non-suicidal self-injury: psychometric properties of the inventory of statements about self-injury (ISAS). J Psychopathol Behav 31:215–221

    Article  Google Scholar 

  22. Bildik T, Somer O, Kabukçu-Başay B, Başay Ö, Özbaran B (2013) The validity and reliability of the Turkish version of the inventory of statements about self-injury. Turkish J Psychiatry 24:49–57

    Google Scholar 

  23. Brislin RW (1980) Translation and content analysis of oral and written material. In: Triandis HC, Berry JW (eds) Handbook of cross-cultural psychology. Allyn & Bacon, Boston, pp 389–444

    Google Scholar 

  24. Şahin NH, Durak A (1994) Brief symptom inventory in Turkish youth. Turkish J Psychol 9:44–56

    Google Scholar 

  25. Derogatis LR (1992) The brief symptom inventory-BSI administration, scoring and procedures manual-II. National Computer System, Minneapolis

    Google Scholar 

  26. Şahin NH, Durak-Batıgün A, Uğurtaş S (2002) Brief symptom inventory: usage for adolescents. Turkish J Psychiatry 13:21–32

    Google Scholar 

  27. Cull JG, Gill WS (1988) Suicide probability scale manual. Western Psychological Services, Los Angeles

    Google Scholar 

  28. Tuğcu H (2006) A study of various factors related to suicide probability. Kriz Dergisi 14:17–21

    Google Scholar 

  29. Atlı Z, Eskin M, Dereboy Ç (2009) Đntihar Olasılığı Ölçeği’nin Klinik Örneklemde Geçerlik ve Güvenirliği [The validity and the reliability of Suicide Probability Scale in a clinical sample]. Klinik Psikiyatri Dergisi 12:111–124

    Google Scholar 

  30. Vermunt JK, Magidson J (2008) Latent GOLD® [computer program]. Version 4.5. Statistical Innovations Inc, Belmont

  31. McCutcheon AL (2002) Basic concepts and procedures in single-and multiple-group latent class analysis. In: Hagenaars JA, McCutcheon AL (eds) Applied latent class analysis. Cambridge University Press, New York, pp 56–89

    Chapter  Google Scholar 

  32. Nylund KL, Asparouhov T, Muthén BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Struct Equ Modeling 2007(14):535–569

    Article  Google Scholar 

  33. Gratz KL (2006) Risk factors for deliberate self-harm among female college students: the role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. Am J Orthopsychiatry 76:238–250

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was funded by the Turkish Association for Child and Adolescent Psychiatry. Correspondence to Richard Farmer, Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon, 97403, USA; E-mail: rfarmer@ori.org.

Conflict of interest

All authors report no potential conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Psychology, Gediz University, Izmir, Turkey

    Oya Somer

  2. Department of Child Psychiatry, School of Medicine, Ege University, Izmir, Turkey

    Tezan Bildik

  3. Doctor Doğan Baran Women’s and Children’s Hospital, Niğde, Turkey

    Bürge Kabukçu-Başay & Ömer Başay

  4. Department of Psychology, İzmir University, Izmir, Turkey

    Duygu Güngör

  5. Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA

    Richard F. Farmer

Authors
  1. Oya Somer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tezan Bildik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bürge Kabukçu-Başay
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Duygu Güngör
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ömer Başay
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Richard F. Farmer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard F. Farmer.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 79 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Somer, O., Bildik, T., Kabukçu-Başay, B. et al. Prevalence of non-suicidal self-injury and distinct groups of self-injurers in a community sample of adolescents. Soc Psychiatry Psychiatr Epidemiol 50, 1163–1171 (2015). https://doi.org/10.1007/s00127-015-1060-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-015-1060-z

Keywords

Search

Navigation