Nonsuicidal Self-Injury in a College Sample: Risk Factors, Pathways, and Diagnostic Correlates

Abstract

As research on nonsuicidal self-injury (NSSI) is in its beginning stages, relatively little is known about the variables that confer risk for this class of behaviors. Although recent work has implicated the role of childhood maltreatment in the development of NSSI, this body of literature is hampered by several important limitations. These limitations include either grouping together all forms of maltreatment (i.e., emotional, physical, and sexual abuse) or focusing on only one form of maltreatment. In addition, there is a paucity of research exploring the mechanisms by which maltreatment experiences relate to NSSI. Furthermore, although a great deal of attention has focused on the relation between self-harm (both suicidal and nonsuicidal) and specific psychological diagnoses, particularly borderline personality disorder (BPD), the vast majority of this research has been conducted with severe clinical samples. As a result, there is a dearth of knowledge about the risk factors, pathways, and diagnostic correlates of NSSI in non-clinical samples. Given that recent research has suggested that NSSI is increasingly common in college samples, the current study aimed to address these limitations in a diverse sample of 1,819 college students. Participants completed assessments of childhood maltreatment experiences, NSSI, as well as two potential mediators, emotion dysregulation and cognitive vulnerability, and one potential moderator, impulsivity. In addition, a subset of participants (n = 140) were administered diagnostic interviews for BPD and depression. Results provided support for the role of childhood maltreatment in the development in NSSI. Controlling for other forms of maltreatment, emotional maltreatment was most predictive of NSSI. Both emotion dysregulation and negative cognitive style partially mediated the relationship between childhood maltreatment and NSSI. In contrast, impulsivity did not significantly moderate the childhood maltreatment - NSSI relation. As expected, borderline personality features significantly predicted NSSI. However, contrary to expectations, impulsivity and affective instability were not the strongest borderline criteria in the prediction of NSSI. Treatment implications of these results, strengths and limitations, as well as areas of future research are discussed.