Psychosocial Factors Associated with Non-Suicidal Self Injury Among Youth

Purpose

Suicide ranks third in adolescent mortality (CDC), necessitating intervention. Healthy People 2030 noted 14.1 suicides and 146.6 self-harm injuries per 100,000. Nonsuicidal self-injury (NSSI) can precede suicide, involving deliberate harm without suicidal intent by cutting, burning, scratching, and various atypical behaviors. Previous studies indicate NSSI is most common in the adolescent and young adult populations. Further, previous studies suggest peer socialization and emotion regulation as explanations for NSSI behavior. The purpose of this study is to explore the potential risk factors associated with NSSI among youth.

Methods

A secondary analysis of the PRIDE (Parents’ Resource Institute for Drug Education) was conducted on a large sample of youth participating in 133 local schools in Cincinnati. The response rate for the survey was 85.9%.Our outcome, past month NSSI, was assessed by the following question: “Did you engage in NSSI in the past 30 days?” Options were binary (1 = “Yes”, 0 = “No”). Past thirty day depression, stress, bullying, and anxiety were used as psychosocial risk factors. Participants’ age, biological sex (female/male), race/ethnicity (Non-Hispanic White, Non-Hispanic African American, Hispanic, and other) were used as covariates. Here, “other” is a combination of Pacific Islander, Native American, and Mixed race; we created this category given the small sample sizes. Frequencies and bivariate statistics were estimated to capture relationships between independent variables and our outcome of interest. Logistic regression models were built to determine conditional associations. Analyses took place in SAS v.9.4, and the level of significance was set at p <.05.

Results

The final analytic sample was 34,410 youth 12-17 years old. An estimated 6.1% (n= 2,249) of youth reported past-month NSSI. Girls were less likely to engage in NSSI when compared to boys (aOR: 0.69, 95% CI 0.62, 0.76). Compared to 12-13 year olds, 16-17 year olds were at higher risk for NSSI (aOR: 1.44, 95% CI 1.27, 1.64). Compared to White youth, every racial group was less likely to engage in NSSI. Youth who experienced past-30 day anxiety (aOR: 2.00), depression (aOR: 14.2), bullying (aOR: 3.92), and/or stress (aOR: 1.70) were all at higher risk for engaging in NSSI.

Conclusion

The present study indicated that NSSI was found to occur more frequently in males than females. Moreover, older adolescents (16-17 years old) exhibited higher NSSI rates than younger peers (12-13 years old). Importantly, NSSI was strongly associated with depression, anxiety, stress, and bullying experiences. Given the perilous link between NSSI and suicide, the study underscores the urgency of comprehensive prevention methods. This research prompts a collaborative effort from medical professionals, parents, and school to screen risk factors, tailor mental health programs, and increase access to counseling services.