Psychosocial Determinants of the Acts and Functions of Nonsuicidal Self-Injury

Nonsuicidal self-injury (NSSI) is a significant physical and mental health concern in society today. Whilst research efforts have made considerable headway in developing an understanding of NSSI, there is still much we do not understand about this paradoxical phenomenon, particularly regarding its aetiology, the functions it serves, and how these are interrelated. The current study examined the impact of the psychosocial determinants of gender, sexual orientation, self-esteem, coping, attachment, mental illness, trauma and body modifications on NSSI. A sample of 1292 adults, ranging in age from 18 to 76 years (1110 females, 182 males), recruited from 29 different countries, completed an online self-report survey. Of the total sample, 67.9% reported a history of NSSI (801 females, 76 males). Female participants identifying as bisexual or lesbian were 5.95 and 4.80 times, respectively, more likely to self-injure than their heterosexual, gay or bisexual male counterparts. Self-injurers in the present study had more body modifications; lower self-esteem; higher incidences of mental illness; and poorer perceived relationship quality with their fathers, mothers, and peers. They had also experienced more aggregated personal trauma and demonstrated a nonproductive coping style, in comparison to non-injurers. Self-injurers who also disclosed a self-reported history of mental illness faired considerably poorer across the range of psychosocial determinants than self-injurers with no history of mental illness. This group also self-injured more frequently, used more methods, endorsed a greater number of functions, and had obtained more medical treatment for their wounds. Whilst each of the psychosocial variables were found to be an individual risk factor for NSSI, the combination of gender, familial and individual history of mental illness, aggregated personal trauma, tattoos, paternal and maternal attachment, low self-esteem and coping strategies, accounted for nearly half of the variance of NSSI in the present study