Imke Baetens

The association between family functioning and NSSI in adolescence: the mediating role of depressive symptoms

Non-suicidal self-injury (NSSI) refers to socially unacceptable behavior causing intentional and direct injury to one’s own body tissue without conscious suicidal intent. Recent literature has highlighted the importance of examining the interaction between intrapersonal (e.g. coping, psychopathology) and interpersonal risk factors (e.g. psychopathology in family, family abuse, parenting), for enhancing our understanding of NSSI. The present study adds to this by investigating the association between NSSI, adolescent depressive feelings, and perceived family functioning. A sample of 358 adolescents was assessed by means of self-report measures for (1) NSSI behavior (NSSI-AT), (2) depressive symptoms (CDI-NL), and (3) perceived family functioning (FAD-NL). The prevalence rate of NSSI was 14.29%. Data suggest that general dysfunction of the family as a whole, poor affective involvement, and excessive behavioral control uniquely distinguished between adolescents engaging in NSSI and adolescents not engaging in NSSI. The association between family functioning and NSSI was partially mediated by depressive symptoms. The implications of the findings for further research, prevention, and intervention of NSSI are discussed.

Helping schools support caregivers of youth who self-injure: Considerations and recommendations:

Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged.

“I Do Want to Stop, At Least I Think I Do”: An International Comparison of Recovery From Nonsuicidal Self-Injury Among Young People:

Phenomenological and cultural understandings of recovery from the perspective of individuals who engage in nonsuicidal self-injury (NSSI) are rare. The primary study objective was to understand similarities across three samples in (a) how young people define recovery from NSSI and (b) what they consider helpful approaches taken by parents and professionals to assist their recovery. Using a cross-national sample of young people (n = 98) from Australia (n = 48), Belgium (n = 25) and the United States (n = 25), we assessed their perspectives on NSSI. Consistent across all samples, young people defined recovery as no longer having the urge to self-injure when distressed, often displayed ambivalence about recovery, and reported it was helpful when parents and professionals were calm and understanding. Acceptance of recovery as a process involving relapses may need to be emphasized in NSSI treatment, to ease the pressure young people often place on themselves to stop the behavior outright.

Attachment and non-suicidal self-injury among young adolescents: The indirect role of behavioral problems

Non-suicidal self-injury (NSSI) often occurs before age 15, yet the majority of research on risk factors for this dangerous behavior has focused on samples of older participants. Insecure attachment has been previously identified as a risk factor for both NSSI and behavioral problems, and behavioral problems appear to be particularly associated with NSSI among young populations. Redressing the lack of young adolescent NSSI research, the present study uses longitudinal data from a sample of young adolescents to test a model in which insecure attachment acts as a prospective risk factor for NSSI via emotional and behavioral problems. Data on NSSI, child-mother attachment, and emotional and behavioral problems were collected from 559 (41.1% male) Flemish adolescents when they were 13 years old (M = 12.71, SD =0.32), and again 1 year later. Insecure attachment was measured using maternal items on the Experiences in Close Relationships—Revised Child scale. Psychological adjustment was assessed with the Strengths and Difficulties Questionnaire. We found that anxious and avoidant attachment were indirectly associated with NSSI through behavioral problems but not through emotional problems. Findings highlight the role of behavioral problems as a risk factor for NSSI in early adolescence, a rarely studied developmental period during which NSSI often first starts. Findings suggest that one possible pathway for the attachment-NSSI association among young adolescents is through behavioral problems. Therapies that improve child-parent attachment may reduce NSSI among young adolescents both directly, and indirectly by improving behavioral problems.