Inside out – do adverse childhood experiences predict nonsuicidal self-injury?

Abstract

Non-suicidal self-injury (NSSI) is defined as behavior that is self-directed and deliberate, resulting in injury or potential injury to oneself without suicidal intent, although it consistently correlates with suicidality. Common forms of NSSI include cutting, burning, scratching, banging, hitting, biting etc. Meta-analysis showed that overall childhood maltreatment is associated with NSSI, especially in the case of childhood emotional neglect or emotional abuse. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The NSSI questionnaire designed for this study was based on several questionnaires such as Deliberate Self-Harm Inventory (DSHI), Inventory of Statements About Self-Injury (ISAS), Ottawa Self-Injury Inventory (OSI) and Self-Harm Behaviour Questionnaire (SHBQ). The NSSI used in this survey contains 12 items with joint binary (yes or no) and numeric (how many times) scales. On all items, respondents provided answers with respect to two time periods: before and after the age of 18 (laws in Serbia restrict rights of persons under the age of 18 and some of those are related to potentially risky behaviors such as rights regarding alcohol purchase). Overall, approximately 4% of respondents reported NSSI at least once in lifetime, out of which 3.6% reported NSSI at least once before the age of 18 and 1.8% at least once after the age of 18. Since this is a form of behaviour is typical for younger adolescents, as expected, the NSSI is more prevalent before the age of 18 (2 = 17.225, p < .01). The correlation between the frequency of NSSI before and after the age of 18 is r = 0.73 (p < .01), while the correlation between suicide attempts and NSSI was Φ = 0.25 (p < .01). When it comes to the prediction of NSSI that occurred after the age of 18, ACE scores were not significant predictors. However, regression analysis showed about 9% of the variance of the NSSI before the age of 18 can be related to ACEs. Specifically, three types of ACEs were significant predictors of NSSI: sexual abuse (β = 0.16, p < .01), incarceration of a family member (β = 0.11, p = 0.051) and abuse of father by the partner (β = 0.15, p = 0.012). Available data suggest that at least one part of the variance can be ascribed to the ACEs. Therefore, emphasis should be put on fostering coping strategies in adolescents that would lead to diminishing negative consequences of ACEs.