The distinction between exclusivity and comorbidity within NSSI.

Abstract

Based on notions posited by problem behavior theory, the primary goal of the current study was to examine the possibility that adolescents who engage in NSSI are not a homogeneous group but are rather divided into 2 subgroups: (a) adolescents who exclusively engage in NSSI, and (b) adolescents who are involved in NSSI alongside other problem behaviors (e.g., drug abuse, unprotected sexual intercourse). Participants were a school sample of 436 adolescents from 6 high schools across Israel, who completed self-report questionnaires during school hours on engagement in NSSI and other problem behaviors, self-esteem, self-criticism, ego clarity, coping strategies, self-efficacy to regulate affect, and sociodemographic information. Findings indicated that 22% of the sample reported engaging in NSSI. Adolescents who reported engaging in NSSI had higher prevalence rates of involvement in other problem behaviors compared to those who did not report engaging in NSSI. However, a comparison between those who exclusively engaged in NSSI and those who were involved in NSSI alongside other problem behaviors indicated that lower ego clarity, lower self-esteem, and poorer self-efficacy to regulate affect, alongside higher self-criticism and greater use of disengagement coping mechanisms characterized exclusive engagement in NSSI. Distinct theoretical models are needed to characterize different forms of NSSI: NSSI, which is an exclusive and singular phenomenon, for which problems related to the self are prominent, versus NSSI, which is accompanied by other problem behaviors. Accordingly, the implications related to school psychologists' work in the assessment, treatment, and prevention of NSSI are suggested. (PsycINFO Database Record

Understanding the self in nonsuicidal self-injury: A conceptual review and framework for future research

“…Relatively few studies have examined self-efficacy in people with NSSI. Research that does exist indicates that NSSI is associated with low self-efficacy regarding one's ability to cope in a healthy manner (Goldberg & Israelashvili, 2017;Hasking, Boyes, & Greves, 2018;Heath, Joly, & Carsley, 2016;Midkiff, Lindsey, & Meadows, 2018;Nock & Mendes, 2008). For example, compared to those without NSSI, adolescents with NSSI report reduced self-efficacy to identify adaptive solutions in response to fictitious social scenarios (Nock & Mendes, 2008).…”

“…Furthermore, self-concept clarity fully accounted for the variance explained by emotion dysregulation in NSSI versatility, suggesting that self-concept clarity plays a separate and potentially interactive role in NSSI. Additional work examining NSSI in an Israeli sample found that adolescents who engage in NSSI exclusively, compared with those who engage in NSSI alongside other problematic behaviors (e.g., substance abuse, disordered eating), reported lower self-concept clarity (Goldberg & Israelashvili, 2017).…”

Gender differences in self-harm and drinking behaviors among high school students in Beijing, China

“…Moreover, drinking is not only a prevalent behavior in adolescents but also an observable behavior. Numerous studies have reported the positive association between self-harm and drinking (or alcohol abuse) [3,7,8,10,12,15,[29][30][31][32][33][34][35][36] . Ness et al conducted an epidemiological and longitudinal study and found that alcohol was involved in 58.4% of self-harm episodes [36].…”

Gender differences in self-harm and drinking behaviors among middle school students in Beijing, China

“…Drinking is such an observable behavior. Numerous researches have reported the positive association between self-harm (or self-injury) and drinking (or alcohol abuse) [1,7,8,10,11,13,[17][18][19][20][21][22][23][24] . Ness et al conducted an epidemiological and longitudinal study and found that alcohol was involved in 58.4% of self-harm episodes [24].…”