High rates of nonsuicidal self-injury (NSSI; 14%-17%) in adolescents and young adults suggest that some self-injurers may exhibit more or different psychiatric problems than others. In the present study, the authors utilized a latent class analysis to identify clinically distinct subgroups of self-injurers. Participants were 205 young adults with a history of 1 or more NSSI behaviors. Latent classes were identified on the basis of method (e.g., cutting vs. biting vs. burning), descriptive features (e.g., self-injuring alone or with others), and functions (i.e., social vs. automatic). The analysis yielded 4 subgroups of self-injurers, which were then compared on measures of depression, anxiety, borderline personality disorder, and suicidality. Almost 80% of participants belonged to 1 of 2 latent classes characterized by fewer or less severe NSSI behaviors and fewer clinical symptoms. A 3rd class (11% of participants) performed a variety of NSSI behaviors, endorsed both social and automatic functions, and was characterized by high anxiety. A 4th class (11% of participants) cut themselves in private, in the service of automatic functions, and was characterized by high suicidality. Clinical and research implications are discussed.
1 April 2012 in Journal of the American Academy of Child & Adolescent Psychiatry
We aim to provide a starting point toward the development of an evidence-based assessment of depression in children and adolescents. We begin by discussing issues relevant to the diagnosis and clas...
28 September 2015 in Child and Adolescent Psychiatry and Mental Health
Research has identified more than a dozen functions of non-suicidal self-injury (NSI), but the conceptual and empirical overlap among these functions remains unclear. The present study examined the structure of NSI functions in two large samples of patients receiving acute-care treatment for NSI. Two different measures of NSI functions were utilized to maximize generalizability of findings: one sample (n = 946) was administered the Inventory of Statements About Self-injury (ISAS; Klonsky and Glenn in J Psychopathol Behav Assess 31:215–219, 2009), and a second sample (n = 211) was administered the Functional Assessment of Self-Mutilation (FASM; Lloyd et al. in 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, 1997). Exploratory factor analyses revealed that both measures exhibited a robust two-factor structure: one factor represented Intrapersonal functions, such as affect regulation and anti-dissociation, and a second factor represented Social functions, such as interpersonal influence and peer bonding. In support of the two-factor structure’s construct validity, the factors exhibited a pattern of correlations with indicators of NSI severity that was consistent with past research and theory. Findings have important implications for theory, research, and treatment. In particular, the two-factor framework should guide clinical assessment, as well as future research on the implications of NSI functions for course, prognosis, treatment, and suicide risk.