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Characteristics and functions of non-suicidal self-injury in a community sample of adolescents

  • DOI:
  • Published online: 12 March 2007

Few studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This study assessed the prevalence, associated clinical characteristics, and functions of NSSI in a community sample of adolescents.


A total of 633 adolescents completed anonymous surveys. NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM).


Some form of NSSI was endorsed by 46·5% (n=293) of the adolescents within the past year, most frequently biting self, cutting/carving skin, hitting self on purpose, and burning skin. Sixty per cent of these, or 28% of the overall sample, endorsed moderate/severe forms of NSSI. Self-injurers reported an average of 12·9 (s.d.=29·4) incidents in the past 12 months, with an average of 2·4 (s.d.=1·7) types of NSSI used. Moderate/severe self-injurers were more likely than minor self-injurers, who in turn were more likely than non-injurers, to have a history of psychiatric treatment, hospitalization and suicide attempt, as well as current suicide ideation. A four-factor model of NSSI functions was indicated, with self-injurers likely to endorse both reasons of automatic reinforcement and social reinforcement. The most common reasons for NSSI were ‘to try to get a reaction from someone’, ‘to get control of a situation’, and ‘to stop bad feelings’.


Community adolescents reported high rates of NSSI, engaged in to influence behaviors of others and to manage internal emotions. Intervention efforts should be tailored to reducing individual issues that contribute to NSSI and building alternative skills for positive coping, communication, stress management, and strong social support.

Corresponding author
*Address for correspondence: Dr E. E. Lloyd-Richardson, The Miriam Hospital, Brown Medical School, 196 Richmond Street, Providence, RI 02903, USA. (Email:
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J. Briere & E. Gil (1998). Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. American Journal of Orthopsychiatry 68, 609620.

G. D. Chowanec , A. M. Josephson , C. Coleman & H. Davis (1991). Self-harming behavior in incarcerated male delinquent adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 30, 202207.

C. Esposito , A. Spirito , J. Boergers & D. Donaldson (2003). Affective, behavioral and cognitive functioning in adolescents with multiple suicide attempts. Suicide and Life-Threatening Behavior 33, 389399.

A. R. Favazza (1998). The coming of age of self-mutilation. Journal of Nervous and Mental Disease 186, 259268.

K. L. Gratz , S. D. Conrad & L. Roemer (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry 72, 128140.

T. Guertin , E. Lloyd-Richardson , A. Spirito , D. Donaldson & J. Boergers (2001). Self-mutilative behavior in adolescents who attempt suicide by overdose. Journal of the American Academy of Child and Adolescent Psychiatry 40, 10621069.

K. Hawton , S. Hall , S. Simkin , L. Bale , A. Bond , S. Codd & A. Stewart (2003). Deliberate self-harm in adolescents: a study of characteristics and trends in Oxford, 1990–2000. Journal of Child Psychology and Psychiatry 44, 1191.

K. Hawton , K. Rodham , E. Evans & R. Weatherall (2002). Deliberate self-harm in adolescents: self-report survey in schools in England. British Medical Journal 325, 12071211.

T. E. Joiner , Y. Conwell , K. K. Fitzpatrick , T. K. Witte , N. B. Schmidt , M. T. Berlim , M. P. A. Fleck & D. M. Rudd (2005). Four studies on how past and current suicidality relate even when ‘Everything but the kitchen sink’ is covaried. Journal of Abnormal Psychology 114, 291303.

E. D. Klonsky , T. F. Oltmanns & E. Turkheimer (2003). Deliberate self-harm in a nonclinical population. Prevalence and psychological correlates. American Journal of Psychiatry 160, 15011508.

A. Laye-Gindhu & K. A. Schonert-Reichl (2005). Nonsuicidal self-harm among community adolescents: understanding the ‘whats’ and ‘whys’ of self-harm. Journal of Youth and Adolescence 34, 447457.

J. J. Muehlenkamp & P. M. Gutierrez (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior 34, 1223.

M. K. Nock & M. J. Prinstein (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology 72, 885890.

M. K. Nock & M. J. Prinstein (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology 114, 140146.

G. C. Patton , R. Harris , J. B. Carlin , M. E. Hibbert , C. Coffey , M. Schwart & G. Bowes (1997). Adolescent suicidal behaviors: a population-based study of risk. Psychological Medicine 27, 715724.

J. Penn , C. Esposito , L. Schaeffer , G. Fritz & A. Spirito (2003). Suicide attempts and self-mutilative behavior in a juvenile correctional facility. Journal of the American Academy of Child and Adolescent Psychiatry 42, 762769.

K. Rodham , K. Hawton & E. Evans (2004). Reasons for deliberate self-harm: comparison of self-poisoners and self-cutters in a community sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 43, 8087.

S. Ross & N. Heath (2002). A study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence 31, 6777.

K. L. Suyemoto (1998). The functions of self-mutilation. Clinical Psychology Review 18, 531554.

R. F. Valois , K. J. Zullig , S. Huebner & J. W. Drane (2004). Life satisfaction and suicide among high school students. Social Indicators Research 66, 81105.

C. Zlotnick , J. I. Mattia & M. Zimmerman (1999). Clinical correlates of self-mutilation in a sample of general psychiatric patients. Journal of Nervous and Mental Disease 187, 296301.

S. S. Zoroglu , U. Tuzun , V. Sar , H. Tutkun , H. A. Savas , M. Ozturk , B. Alyanak & M. E. Kora (2003). Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry and Clinical Neurosciences 57, 119126.

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