Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Rachel L Zelkowitz; Tate F Halverson; Tapan A Patel; Jean C Beckham; Patrick S Calhoun; Mary Jo Pugh; Nathan A Kimbrel

doi:10.1016/j.psychres.2023.115558

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Psychiatry Res. 2023 Nov:329:115558. doi: 10.1016/j.psychres.2023.115558. Epub 2023 Oct 22.

Authors

Rachel L Zelkowitz¹, Tate F Halverson², Tapan A Patel³, Jean C Beckham⁴, Patrick S Calhoun⁵, Mary Jo Pugh⁶, Nathan A Kimbrel⁵

Affiliations

¹ Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston Chobanian & Avedisian School of Medicine, Boston, MA, USA. Electronic address: rachel.zelkowitz@va.gov.
² Durham Veterans Affairs Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA.
³ Department of Psychology, Florida State University, Tallahassee, FL, USA.
⁴ Durham Veterans Affairs Health Care System, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.
⁵ Durham Veterans Affairs Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.
⁶ VA Salt Lake City Healthcare System, Salt Lake City, UT, USA; Department of Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.

PMID: 37890405
DOI: 10.1016/j.psychres.2023.115558

Abstract

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.

Keywords: Depression; Functioning; PTSD; Suicide.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Female
Humans
Latent Class Analysis
Male
Military Personnel* / psychology
Risk Factors
Self-Injurious Behavior* / psychology
Suicidal Ideation
Veterans* / psychology