Master of Arts
Rodger, Susan C.
Non-Suicidal Self-Injury (NSSI) involves deliberate damage to the body without suicidal intent. St. Germain and Hooley (2012) classify two forms of NSSI: direct and indirect. Direct NSSI is expressed through behaviours with immediate results (e.g. cutting), whereas indirect NSSI is expressed through means that are damaging to the body without immediate injury (e.g. promiscuity, substance abuse, risk behaviours, etc.). Research supports that NSSI behaviours occur in youth with histories of childhood maltreatment (CM; Trocmé et al., 2010); however, no study has examined if experiences of CM influence NSSI expression. Utilizing the InterRAI Child and Youth Mental Health tool (N= 4,616), an association between childhood maltreatment and NSSI expression (direct-only, indirect-only, and direct and indirect) was determined, with over half of participants reported experiencing polyvictimization. Engagement in NSSI was most commonly presented in older youth (16-18) and exhibited more frequently in females (vs. males); however, no gender differences were identified in those who engage in indirect-only NSSI. Of those youth who experienced maltreatment, they most commonly engaged in behaviours associated with indirect-only forms of NSSI expression (e.g. substance use, eating disorder symptomatology, risky behaviours, and sexual promiscuity). In relation to polyvictimization, a significant association was found between the three dimensions of NSSI expression, with polyvictimization significantly predicting engagement in indirect-only NSSI behaviours. Implications for targeted prevention within clinical practice and directions from future research are discussed.
Summary for Lay Audience
Non-Suicidal Self-Injury (NSSI) involves deliberate damage to the body without suicidal intent. Two forms of NSSI have been classified: direct and indirect. Direct NSSI is expressed through behaviours that have an immediate impact on the body (e.g. cutting), whereas indirect NSSI is expressed through behaviours that are damaging to the body, but do not result in immediate injury (e.g. promiscuity, substance abuse, risky behaviours, etc.). Past research supports a strong relationship between adolescents who have experienced childhood maltreatment (e.g. CM; neglect, physical abuse, sexual abuse, emotional abuse, witnessing domestic violence) and their engagement in NSSI. However, no current research had investigated whether adolescents who have experienced CM, including polyvictimization (2+ experiences of CM), express their NSSI in direct-only, indirect-only, or a combination of both forms. In order to explore this question, data was derived from the interRAI Child and Youth Mental Health Assessment tool. A total of 4,616 youth were found to have experienced CM, with results suggesting a strong relationship between CM and NSSI expression (e.g. direct-only, indirect-only, and direct and indirect). Of those youth with histories of CM, engagement in NSSI behaviours in all three forms of expression were most common across older youth (16-18). Moreover, female youth with histories of CM (vs. males) were found to engage in direct-only and both direct and indirect NSSI more often; however, male and female engagement in indirect-only NSSI expression was similar. Of those youth who experienced CM, emotional abuse was the most commonly reported form, with results suggesting that the most common behaviours associated with NSSI were related to indirect-only forms of expression. Finally, the present study determined a strong association between each of the three different domains of NSSI expression and youth with a history of polyvictimization. In particular, polyvictimization was found to predict engagement in indirect-only NSSI expression in youth. The present study recognizes that NSSI behaviours can be expressed in a number of ways across youth who have experienced CM, and as a result, should be taken into consideration both in clinical practice and in the development of future research.
Truffyn, Emma, "Direct and Indirect Non-Suicidal Self-Injury (NSSI) Expression: An Investigation into the Nature of NSSI and Childhood Maltreatment" (2020). Electronic Thesis and Dissertation Repository. 6875.
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