The impact of restrictiveness of living environment on self-injurious behavior in youth

The purpose of this quantitative study was to explore the factors related to self-injurious behavior (SIB) in youth between the ages of 12 and 18, who called into a 24/7 mental health crisis hotline for an emergency psychological evaluation. Independent variables were restrictiveness of living environment, severity of problems in the 30 days prior to the assessment, and DSM-IV diagnoses. A linear regression and an ANCOVA were conducted in order to determine which variable had the most significant effect on the dependent variable, which was self-injurious behavior (SIB). For the purpose of this study, self-injurious behavior was defined as an intentional, self-effected, low-lethality, bodily harm of a socially unacceptable nature, performed to reduce psychological stress (Walsh, 2006), and is not conducted with suicidal intent or in adherence to religious or cultural customs (Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006). Examples included but were not limited to: cutting, burning, or scratching skin, or banging the head against a hard surface. Archival data was obtained from the 24/7 mental health crisis hotline of a Southern California nonprofit agency. The instrument used to gather the data was the Ventura County Outcome System (VCOS), which is based on the Ohio Youth Problem, Functioning and Satisfaction Scales (Ohio scales), developed by Ogles, Melendez, Davis, and Lunnen in 1999. Hypotheses included the following: (1) The higher level of restrictiveness of care that the youth had prior to the assessment, the higher the frequency of SIB. (2) The higher reported problem severity, the higher the frequency of SIB. (3) DSM-IV depressive disorders would predict higher frequency of SIB than other DSM-IV diagnoses. After analyses concluded, the only significant predictors of SIB of all independent variables reviewed were older age of the youth and reported problem severity. These findings conclude that there may be additional factors unrelated to higher restrictiveness of living environments, such as attachment and the quality of relationship with caregivers that may affect SIB. Also, the finding that older age predicts higher frequency of SIB may be useful in the development of preventative community mental health programs targeting younger youth