Non-suicidal Self-Injury in Adolescence

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Abstract

Purpose of Review

Non-suicidal self-injury (NSSI) is a common mental health threat among adolescents. This review aims to present the current literature on epidemiology, etiology, and therapeutic approaches with a focus on the period of adolescence.

Recent Findings

NSSI is widespread among adolescents both in community as well as in clinical settings with lifetime prevalence rates between 17 and 60% in recent studies. It is influenced by multiple factors including social contagion, interpersonal stressors, neurobiological background, as well as emotional dysregulation and adverse experiences in childhood.

Summary

There is still a lack of studies regarding the psychotherapeutic as well as the psychopharmacological treatment of NSSI in adolescence. Furthermore, sufficient evidence for prevention programs is missing.

Related collections

Most cited references 54

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The adolescent brain.

Todd A. Hare, B. J. Casey, Rebecca Jones (2008)

Adolescence is a developmental period characterized by suboptimal decisions and actions that are associated with an increased incidence of unintentional injuries, violence, substance abuse, unintended pregnancy, and sexually transmitted diseases. Traditional neurobiological and cognitive explanations for adolescent behavior have failed to account for the nonlinear changes in behavior observed during adolescence, relative to both childhood and adulthood. This review provides a biologically plausible model of the neural mechanisms underlying these nonlinear changes in behavior. We provide evidence from recent human brain imaging and animal studies that there is a heightened responsiveness to incentives and socioemotional contexts during this time, when impulse control is still relatively immature. These findings suggest differential development of bottom-up limbic systems, implicated in incentive and emotional processing, to top-down control systems during adolescence as compared to childhood and adulthood. This developmental pattern may be exacerbated in those adolescents prone to emotional reactivity, increasing the likelihood of poor outcomes.

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Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression.

Sarah V Swannell, Graham Martin, Andrew Page … (2014)

Published prevalence estimates of nonsuicidal self-injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired. © 2014 The American Association of Suicidology.

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A functional approach to the assessment of self-mutilative behavior.

Matthew Nock, Mitchell J. Prinstein (2004)

This study applied a functional approach to the assessment of self-mutilative behavior (SMB) among adolescent psychiatric inpatients. On the basis of past conceptualizations of different forms of self-injurious behavior, the authors hypothesized that SMB is performed because of the automatically reinforcing (i.e., reinforced by oneself; e.g., emotion regulation) and/or socially reinforcing (i.e., reinforced by others; e.g., attention, avoidance-escape) properties associated with such behaviors. Data were collected from 108 adolescent psychiatric inpatients referred for self-injurious thoughts or behaviors. Adolescents reported engaging in SMB frequently, using multiple methods, and having an early age of onset. Moreover, the results supported the structural validity and reliability of the hypothesized functional model of SMB. Most adolescents engaged in SMB for automatic reinforcement, although a sizable portion endorsed social reinforcement functions as well. These findings have direct implications for the understanding, assessment, and treatment of SMB.

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Author and article information

Contributors

Paul L. Plener: +49 731 500 61765 , paul.plener@uniklinik-ulm.de

Journal

Journal ID (nlm-ta): Curr Psychiatry Rep

Journal ID (iso-abbrev): Curr Psychiatry Rep

Title: Current Psychiatry Reports

Publisher: Springer US (New York )

ISSN (Print): 1523-3812

ISSN (Electronic): 1535-1645

Publication date (Electronic): 17 March 2017

Publication date PMC-release: 17 March 2017

Publication date (Print): 2017

Volume: 19

Issue: 3

Electronic Location Identifier: 20

Affiliations

ISNI 0000 0004 1936 9748, GRID grid.6582.9, Department of Child and Adolescent Psychiatry and Psychotherapy, , University of Ulm, ; Steinhoevelstr. 5, 89075 Ulm, Germany

Article

Publisher ID: 767

DOI: 10.1007/s11920-017-0767-9

PMC ID: 5357256

PubMed ID: 28315191

SO-VID: 35b692ff-4943-4a39-8bfd-532587648980

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.