Direct and indirect forms of non-suicidal self-injury: Evidence for a distinction

Abstract Non-suicidal self-injury (NSSI) involves deliberate acts (such as cutting) that directly damage the body but occur without suicidal intent. However, other non-suicidal behaviors that involve people mistreating or abusing themselves but that do not deliberately and directly damage bodily tis...

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Bibliographic Details
Published in:Psychiatry research 2012-05, Vol.197 (1), p.78-84
Main Authors: St. Germain, Sarah A, Hooley, Jill M
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adolescent
Adult
Alcoholism - psychology
Analysis of Variance
Borderline personality disorder
Deliberate self-harm
Depression - psychology
DSM-5
Feeding and Eating Disorders - psychology
Female
Humans
Impulsive Behavior
Male
Non-suicidal self-injury (NSSI)
Personality Inventory
Psychiatric Status Rating Scales
Psychiatry
Self Report
Self-criticism
Self-Injurious Behavior - classification
Self-Injurious Behavior - diagnosis
Self-Injurious Behavior - psychology
Suicide
Surveys and Questionnaires
Young Adult
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Summary:Abstract Non-suicidal self-injury (NSSI) involves deliberate acts (such as cutting) that directly damage the body but occur without suicidal intent. However, other non-suicidal behaviors that involve people mistreating or abusing themselves but that do not deliberately and directly damage bodily tissue may have much in common with NSSI. Such ‘indirect’ methods of self-injury might include involvement in abusive relationships, substance abuse, risky or reckless behavior, or eating disordered behavior. Using a community sample ( N = 156) we compared individuals engaging in NSSI ( n = 50), indirect (non-suicidal) self-injurers ( n = 38), and healthy controls ( n = 68) on a range of clinical and personality characteristics. As predicted, non-suicidal self-injurers and indirect self-injurers showed more pathology than healthy controls on all measures. Comparisons of the NSSI and the Indirect self-injury groups revealed no significant differences on measures of dissociation, aggression, impulsivity, self-esteem, negative temperament, depressive symptoms, and borderline personality disorder. However, compared to people who engaged only in indirect forms of self-injury, those who engaged in NSSI were more self-critical, had higher scores on a measure of suicide proneness, and had a history of more suicide attempts. The findings suggest that NSSI and indirect self-injury are best viewed as separate and distinct clinical phenomena.
ISSN:0165-1781
1872-7123
DOI:10.1016/j.psychres.2011.12.050