Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder
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Previous prevalence rates of non-suicidal self-injury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15–17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ 2 (1, N = 3046) = 94.08, p < 0.001, cOR = 5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein’s (Journal of Consulting and Clinical Psychology 72:885–890, 2004, Journal of Abnormal Psychology 114:140–146, 2005) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.
KeywordsNon-suicidal self-injury disorder DSM-5 Prevalence Function Adolescents
This study was supported by grants to Maria Zetterqvist from Clas Groschinsky’s Memorial Foundation, Sven Jerring Foundation and Östergötland County Council research support for licensed employees in professional healthcare. Medical student Hanna Högberg provided valuable assistance during the data collection.
Conflict of Interest
The authors declare that they have no conflict of interest.
- American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association (2012, 1 May). Suggested criteria for DSM-5 Non-suicidal self-injury disorder, Retrieved from http://www.dsm5.org/Pages/Default.aspx. Accessed 7 November 2012.
- Brown, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park: Sage.Google Scholar
- Crowell, S. E., Beauchaine, T. P., Hsiao, R. C., Vasilev, C. A., Yaptangco, M., Linehan, M. M., & McCauley, E. (2012). Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development. Journal of Abnormal Child Psychology, 40, 45–57.PubMedCrossRefGoogle Scholar
- Favazza, A. R. (1996). Bodies under siege: self-mutilation and body modification in culture and psychiatry (2nd ed.). Baltimore: John Hopkins University Press.Google Scholar
- Franklin, J. C., Hessel, E. T., Aaron, R. V., Arthur, M. S., Heilbron, N., & Prinstein, M. J. (2010). The functions of nonsuicidal self-injury: support for cognitive-affective regulation and opponent processes from a novel psychophysiological paradigm. Journal of Abnormal Psychology, 119, 850–862.PubMedCrossRefGoogle Scholar
- Haahr, M. (2010). Random.org: True random number service. Web resource, retrieved from http://www.random.org. Accessed on 29 December 2010.
- Heath, N. L., Schaub, K., Holly, S., & Nixon, M. K. (2009). Self-injury today. Review of population and clinical studies in adolescents. In M. K. Nixon & N. L. Heath (Eds.), Self-injury in youth. The essential guide to assessment and intervention (pp. 9–27). New York: Routledge.Google Scholar
- Jöreskog, K. G., & Sörbom, D. (1984). LISREL-VI user’s guide (3rd ed.). Mooresville: Scientific Software.Google Scholar
- Lloyd, E. E., Kelley, M. L., & Hope, T. (1997). Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates. Poster session at the annual meeting of the Society for Behavioral Medicine; New Orleans, LA.Google Scholar
- Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012). International prevalence of non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 6. doi: 10.1186/1753-2000-6-10.
- Plener, P. L., Kapusta, N. D., Kölch, M. G., Kaess, M., & Brunner, R. (2012). Non-suicidal self-injury as autonomous diagnosis—implications for research and clinic of the DSM-5 proposal to establish the diagnosis of Non-Suicidal Self-Injury in adolescents. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychoterapie, 40, 113–120.CrossRefGoogle Scholar
- Shaffer, D., & Jacobson, C. (2009, December 1). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder. American Psychiatric Association. Retrieved from http://www.dsm5.org/Pages/Default.aspx. Accessed 4 November 2010.Google Scholar
- Statistics Sweden (2011). Retrieved from http://www.ssd.scb.se/databaser/makro/start.asp. Accessed on 8 February 2012.
- Swedish Association of Local Authorities and Regions (2011). Retrieved from http://www.skl.se/kommuner_och_landsting/om_kommuner/kommungruppsindelning. Accessed 8 February 2012.
- The Ethical Review Act. (2003). The Act concerning the Ethical Review of Research Involving Humans (SFS 2003:460). The Swedish Ministry of Education and Cultural Affairs.Google Scholar
- The National Agency for Education (2010). Retrieved from http://www.skolverket.se/statistik-och-analys/2.1862/2.4391/2.4392. Accessed 29 December 2012.