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Deprecated function: Return type of DatabaseStatementEmpty::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
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Evidence-Based Reviews
Risk factors for nonsuicidal self-injury: A review of the evidence
Current Psychiatry. 2022 August;21(8):15-25 | doi: 10.12788/cp.0251
Radhika J. Kothadia, MD PGY-3 General Psychiatry Resident Prisma Health/University of South Carolina School of Medicine Columbia, South Carolina
Kaustubh G. Joshi, MD Associate Professor of Clinical Psychiatry Associate Program Director, Forensic Psychiatry Fellowship Department of Neuropsychiatry and Behavioral Science University of South Carolina School of Medicine Columbia, South Carolina
Richard L. Frierson, MD Alexander G. Donald Professor of Clinical Psychiatry Vice Chair for Academic Affairs Program Director, Forensic Psychiatry Fellowship Department of Neuropsychiatry and Behavioral Science University of South Carolina School of Medicine Columbia, South Carolina
Disclosures The authors report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
Emotional dysregulation (EDR)—defined as difficulty understanding, recognizing, and managing one’s emotions—has been researched extensively in relation to NSSI.62 A recent review that included studies of both adolescents and adults reported a significant association between EDR and NSSI, with an OR of 2.40 (95% CI, 2.01 to 2.86).62 A larger effect size was observed between EDR and lifetime NSSI (OR 3.21; 95% CI, 2.63 to 3.91) compared to past-year NSSI (OR 2.32; 95% CI, 1.84 to 2.92).62 Patient age, sex, and sample type (clinical vs community) were not significant moderators of strength between the reported associations.62
Studies examining intimate partner violence (IPV) and NSSI have found that young adults who engage in IPV (both as victims and as perpetrators) are more likely to report NSSI.63-65 Researchers have proposed that anxiety over abandonment may explain this relationship.64 A recent study found that individuals with bidirectional IPV (ie, both victimization and perpetration) engaged in NSSI at a higher prevalence than those engaging in unidirectional IPV or no IPV.65 This suggests that relationship violence in general (rather than just being a victim of IPV) may be a risk factor for NSSI.65
Finally, studies suggest that adolescents and adults who have sleep problems (insomnia, short sleep duration, long sleep onset latency, waking after sleep onset, and poor quality sleep) are more likely to report self-harm or NSSI than those without sleep problems.42,66 In adults, this relationship is partially mediated by depressive symptoms, EDR, and PTSD.66 In adolescents, depressive symptoms are a mediator for this relationship.42
Bottom Line
Nonsuicidal self-injury (NSSI) is a significant health concern due to its association with suicide attempts. Although there are similarities in NSSI risk factors between adolescents and adults, there are also important differences. Understanding these differences is necessary to develop appropriate treatment plans.
