Academic journal article Journal of Mental Health Counseling

Features of Psychopathology in Self-Injuring Female College Students

Academic journal article Journal of Mental Health Counseling

Features of Psychopathology in Self-Injuring Female College Students

Article excerpt

Although research on nonsuicidal self-injury (NSSI) is accumulating, there is as yet little data on psychopathological features associated with NSSI in nonclinical samples. College students may be particularly susceptible to engaging in NSSI and NSSI may be phenomenologically and etiologically different for males and females. This archival study examined differences between college student women with (n = 34) and without (n = 32) a history of NSSI in scores on the clinical scales and subscales of the Personality Assessment Inventory (PAI). Multivariate analyses revealed significantly higher levels of depression, anxiety, borderline personality features, suicidality, and certain psychotic features in self-injurers. Follow-up analysis identified four symptom themes associated with NSSI across diagnostic categories: emotional distress, physiological distress, cognitive distortion, and interpersonal difficulties. This study confirms previous findings of higher levels of affective symptoms in self-injurers. Unique findings of this study included significantly higher scores for self-injurers on the PAI Thought Disorder, Psychotic Experiences, and Hypervigilance subscales. This suggests a need to expand the conceptualization of the clinical correlates of NSSI to encompass a broader array of symptomatology. Implications for clinical practice are discussed

INTRODUCTION

Nonsuicidal self-injury (NSSI) covers any behavior that results or is highly likely to result in immediate tissue damage without conscious intent to cause death, such as laceration, burning, scratching, and hitting oneself (Klonsky & Muehlenkamp, 2007; Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007). Silverman and colleagues have conceptualized NSSI as including self-harmful behaviors with the intent to cause damage but not death that may or may not actually produce physical damage to the individual. Rates of NSSI are posited to be increasing, especially among young adults (Hawton, Fagg, Simkin, Bale, & Bond, 1997; Whitlock, Eells, Cummings, & Purington, 2007). Previous research has documented substantially higher rates of NSSI (11-38%) in college populations (Gratz, 2001; Whitlock, Eckenrode, & Silverman, 2006) than in nonclinical adult populations, where rates of 4% have been reported (Briere & Gil, 1998; Klonsky, Oltmanns, & Turkheimer, 2003). Despite the higher rates among college student populations, there is a paucity of research pertaining to this age group.

Identification of risk factors is a primary goal for much of the current research into NSSI (see Klonsky & Muehlenkamp, 2007; Muehlenkamp, 2005). Among the risk factors identified are impulsivity (Simeon & Favazza, 2001); insecure parental attachment (Gratz, Conrad, & Roemer, 2002); and childhood physical and sexual abuse (Gratz et al.; Weiderman, Sansone, & Sansone, 1999). Psychopathologies such as borderline personality disorder (BPD; Brown, Comtois, & Linehan, 2002; Lieb, Zanarini, Schmahl, Linehan, & Bohus, 2004); mood disorders (Haw, Houston, Townsend, & Hawton, 2002); anorexia and bulimia nervosa (Claes, Vandereycken, & Vertommen, 2001); posttraumatic stress disorder (PTSD); and substance abuse (Zlotnick, Mattia, & Zimmerman, 2001) have also been documented as significant correlates of NSSI for both inpatients and outpatients. Yet there is still a dearth of data on specific psychopathological features of NSSI in community and college student populations. Bridging this gap is important for a more complete understanding of the emotional and psychological factors associated with NSSI.

The relationship between NSSI and BPD has received the most attention. There is clear evidence that in clinical settings a considerable number of individuals with BPD engage in NSSI, at rates as high as 80.7%--more than quadruple the rate found in those with other Axis II disorders (Zanarini, Frankenburg, Hennen, & Silk, 2003). …

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