Closing in on Crisis: Informing Clinical Practice Regarding Nonsuicidal Self-Injury in Youth

J Pediatr Health Care. 2017 May-Jun;31(3):334-341. doi: 10.1016/j.pedhc.2016.10.005. Epub 2016 Nov 2.

Abstract

Nonsuicidal self-injury (NSSI) in youth is a major public health concern. A retrospective chart review was conducted within a hospital system to examine (a) youth self-reports of reasons for engaging in NSSI and (b) additional contextual circumstances that may contribute to youth NSSI. Detailed history, physical examination, and treatment/discharge data were extracted by thoroughly reviewing all electronic documents in each medical record. The final sample (N = 135) were predominantly female (71.1%), and well over half (63.8%) reported Medicaid or uninsured status. Qualitative content analysis of youth self-reports and hospital progress notes showed that NSSI served as an emotional and functional coping mechanism. Five primary themes characterized the contextual influences on youth engaging in NSSI: (1) Personal Emotions, (2) Trauma, (3) Relationship Quality, (4) Sense of Loss, and (5) Risk Behaviors. Practical clinical practice suggestions for working with youth are discussed using these themes as a template for assessing risk and protective factors.

Keywords: Nonsuicidal self-injury; risk factors; youth.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Child
  • Child Abuse / psychology*
  • Child Abuse / statistics & numerical data
  • Depression / epidemiology
  • Depression / psychology*
  • Emotions
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Practice Guidelines as Topic
  • Qualitative Research
  • Retrospective Studies
  • Risk Factors
  • Self Concept
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology*
  • Self-Injurious Behavior / therapy
  • Social Environment
  • Suicidal Ideation
  • United States / epidemiology