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Identifying Associations with Nonsuicidal Self-Injury in Preadolescents

November 2, 2023

Editor’s Note: Elizabeth Zeichner (she/her) is a former high school teacher and fourth-year medical student at Emory University School of Medicine. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics

Nonsuicidal self-injury (NSSI) is the “deliberate, self-directed damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned.” A common example of NSSI is cutting. While it is well-known that NSSI is associated with risk for negative future outcomes, there has been little research dedicated to understanding sociodemographic and diagnostic predictors of NSSI in preadolescents.

This week, Pediatrics is early releasing “Nonsuicidal Self-Injury in Preadolescents,” by Taylor A. Burke PhD at Massachusetts General Hospital and Harvard Medical School and colleagues at Vanderbilt University, Temple University, and the University of Delaware (10.1542/peds.2023-063918). In this study, the authors analyzed data from 11,875 9–10-year-old youth who participated in the Adolescent Brain and Cognitive Development (ABCD) Study to identify sociodemographic characteristics, diagnostic factors, and suicidal ideation associated with lifetime NSSI history. The data collection process included both parent- and child-reported data.

The authors found that 9.2% of preadolescents have a lifetime NSSI history, and 4.24% have a past two-week history of NSSI. Sociodemographic factors that correlate to higher odds of lifetime NSSI include:

  • Male sex
  • Identifying as a sexual minority
  • Having a family income of <$25,000
  • Having unmarried parents

The authors also identified multiple psychiatric diagnoses that are significantly associated with lifetime NSSI:

  • The diagnosis of any psychiatric diagnosis increased the odds of lifetime NSSI
  • The diagnosis of multiple disorders resulted in an increased odds of lifetime NSSI in a “dose-dependent manner,” meaning the more diagnoses, the higher the odds of lifetime NSSI.
  • A history of suicidal ideation significantly predicted elevated odds of lifetime NSSI or subsequent NSSI onset.

While we know that NSSI is common, this article highlights how common it is and how early it can start. Additionally, this article explores many more important details that elucidate key predictors and risks associated with NSSI. These considerations have crucial clinical implications and possibilities for interventions with preadolescents. Having a better understanding of contributing sociodemographic and diagnostic factors associated with NSSI risk can help us engage preadolescents and their families and connect them with the appropriate resources.

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