Academic journal article Journal of Mental Health Counseling

An Examination of Nonsuicidal Self-Injury among College Students

Academic journal article Journal of Mental Health Counseling

An Examination of Nonsuicidal Self-Injury among College Students

Article excerpt

This study examines characteristics (i.e., prevalence, method, age of onset, frequency) of nonsuicidal self-injury (NSSI) and associated risk factors in a college student sample. Results revealed 11.68% admitted to engaging in NSSI at least once and no significant gender difference in occurrence of NSSI. Even in this college sample, those who self-injure differed substantially from non-self-injurers with regard to emotion regulation, but were not found to differ significantly on either early attachment or childhood trauma and abuse. Importance of understanding NSSI as an emerging behavior among college students is discussed.


The occurrence of nonsuicidal self-injury (NSSI) amongst college students has increasingly come to the attention of the mental health professionals (Whitlock, Purington, Eells, & Cummings, 2006). In a recent survey of school counselors' experiences with NSSI, the major concern expressed was a lack of training in this area and the need to be informed about the occurrence and characteristics of NSSI (Heath, Toste, & Beettam, 2007). The present paper provides information on the basic facts and associated risk factors of NSSI in college students.

Defining the exact parameters of NSSI behavior has not been straightforward and interpreting the research in the field can be challenging due to differences in the operationalization of the definition. In response to these concerns, the International Network for the Study of Self-injury (ISSS) was established in 2006 by leading researchers in the field of self-injury to work towards a consensus regarding key issues. One year later, in June 2007, the ISSS agreed on the following definition of NSSI:

   The deliberate, self-inflicted destruction of body tissue resulting
   in immediate damage, without suicidal intent and for purposes not
   socially sanctioned. As such, this behavior is distinguished from:
   suicidal behaviors involving an intent to die, drug overdoses, and
   other forms of self-injurious behaviors, including
   culturally-sanctioned behaviors performed for display or aesthetic
   purposes; repetitive, stereotypical forms found among individuals
   with developmental disorders and cognitive disabilities, and severe
   forms (e.g., self-immolation and auto-castration) found among
   individuals with psychosis. (ISSS, 2007)

However, NSSI can be understood as a subset of the larger range of self-harming behaviors. Deliberate self-harm, as defined by the Child and Adolescent Self-harm (CASE) group in Europe, is an act with a nonfatal outcome in which an individual deliberately does one or more of the following: initiated behavior (e.g., self-cutting, jumping from a height) intended to cause self-harm; ingested a substance in excess of the prescribed or generally recognized therapeutic dose; ingested a recreational or illicit drug that was an act that the person regarded as self-harm; or ingested a non-ingestible substance or object, irrespective of suicidal intent (Hawton, Rodham, Evans, & Weatherall, 2002; Hawton et al., 2003). More recently, Hawton and colleagues have sought to change the term from deliberate self-harm to self-harm (Hawton & James, 2005).

Clearly, self-harm is a broader construct than NSSI and critical readers of the literature should be aware that NSSI, while subsumed under the self-harm definition, cannot be equated with other self-harming behaviors. In their classification of suicide-related behaviors, Silverman et al. (2007) categorize each behavior on the basis of suicidal intent (e.g., none, undetermined, some) and outcome (e.g., fatal injury, non-fatal injury, no injury). Silverman and colleagues emphasize the importance of determining the suicidal intent or motivation behind the behavior. Thus, while in the past deliberate self-harm as studied in Europe has largely not evaluated suicidal intent, Silverman et al. insist that in the future, behaviors that differ in suicidal intent cannot be equated. …

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