Cluster Analysis of Functions of NSSI in a Sample of New Zealand Community Adolescents Jessica Garisch, Marc Stewart Wilson, Robyn Langlands, Angelique

Cluster Analysis of Functions of NSSI in a Sample of New Zealand Community

Adolescents

Jessica Garisch, Marc Stewart Wilson, Robyn Langlands, Angelique O’Connell, Lynne Russell, Emma-Jayne Brown & Tahlia Kingi

© Youth Wellbeing Study

Overview• Youth Wellbeing Studyhttp://www.victoria.ac.nz/psyc/research/youth-and-wellbeing-study

• Longitudinal survey design• Self-reported functions of NSSI– Cluster analysis – How functions relate to psychosocial wellbeing

• Preliminary longitudinal information

Youth Wellbeing Study

• 3+ year project on NSSI among New Zealand adolescents and rangatahi.

• Longitudinal survey– 16 schools in wider Wellington region. – Over 1000 participants– Resource development for the community

Functions of NSSI

• Assessed using the Inventory of Statements About Self-Injury (ISAS; Klonsky & Olino, 2008).

• Of over 1000 participants, 206 hx NSSI– Mean age = 13.48– Sex: male: 42

Female : 148Transgender: 1

Functions of NSSI: Cluster analysis

• Cluster analysis of subscales of the ISAS

• Four clusters identified– Two interpersonal

• Peer bonding, interpersonal influence and revenge (other -focused)

• Interpersonal boundaries, toughness, autonomy, sensations seeking and self-care (self-focused)

– Two intrapersonal• Anti-dissociation, anti-suicide, and marking distress

(disconnection)• Affect regulation and self-punishment

YWS Wave 1: Four Clusters(Functions assessed using ISAS (Klonsky & Olino, 2008)

Interpersonal:Other-focused

Interpersonal: self-focused

Intrapersonal: Disconnection

Intrapersonal: Affect & Punish

Clustering participants: pattern of endorsement

• Four clusters– Low level endorsement of all functions (N=81) (most well

adjusted on measures of wellbeing)– Low levels of endorsement of all but affect regulation

and self-punishment (N=75) – Strongest endorsement of interpersonal functions (w/

relatively strong endorsement of intrapersonal functions) (N=13) (second poorest on wellbeing measures)

– Strongest endorsement of both intrapersonal functions, but low endorsement of interpersonal functions (N=25) (poorest on wellbeing measures)

Variation in psychosocial wellbeing

• Clusters significantly differ on..– Suicidality– Depression– Anxiety– Self-esteem – Resilience– Emotion regulation– Parental attachment (no difference for peer attachment)

– With ‘Intrapersonal’ cluster fairing the worst...* Note small sample size in cluster groupings – data is exploratory

Suic

idal

ity

Affec

t Reg

ulati

on &

Sel

f-pun

ishm

ent

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

lSuicidality

Leve

l of F

uncti

on e

ndor

sem

ent

Cluster: Participant groupings Cluster: Subscale groupings

r = .48***

r = .58***

r = .20**

r =.17, ns

Dep

ress

ion

Affec

t reg

ulati

on &

S

elf-p

unis

hmen

t

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

l Depression

Leve

l of F

uncti

on

endo

rsem

ent


r = .54***

r = .59***

r = .32***

r =.11, ns

Anxi

ety

Affec

t reg

ulati

on &

Se

lf-Pu

nish

men

t

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

l


Anxiety

Leve

l of F

uncti

on

endo

rsem

ent

r = .38***

r = .44***

r = .28***

r =.16*

Self-

este

em

Affec

t reg

ulati

on &

se

lf-pu

nish

men

t

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

l Self-esteemLeve

l of F

uncti

on e

ndor

sem

ent


r = -.60***

r = -.47***

r = -.21**

r =.05, ns

Resi

lienc

e

Affec

t reg

ulati

on &

Self-

puni

shm

ent

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

l

Leve

l of F

uncti

on e

ndor

sem

ent

Resilience


r = -.25**

r = -.22**

r = -.11, ns

r =.03, ns

Emoti

on R

egul

ation

Affec

t Reg

ulati

on &

Self-

Puni

shm

ent

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

l

Leve

l of F

uncti

on

endo

rsem

ent

Emotion Regulation


r = -.35***

r = -.36***

r = -.25**

r =-.04, ns

Attac

hmen

ts to

Par

ents

/ W

hāna

u

Affec

t Reg

ulati

on &

Self-

Puni

shm

ent

Low

on

all

Hig

hest

on

Intr

aper

sona

l

Hig

hest

on

Inte

rper

sona

lAttachments to Parents/ Whānau

Leve

l of F

uncti

on

endo

rsem

ent


r = -.35***

r = -.32***

r = -.13. ns

r =.13, ns

Preliminary longitudinal findings• Is NSSI at T1 predictive of later NSSI?

At both T1 and T2 Ps asked whether they have a hx NSSI or have thought about engaging in NSSI (ever), and (at T2) about NSSI between time points.

– Ps who had never thought about NSSI at T1 were less likely than expected by chance to have engaged in NSSI by T2

– If Ps had thought about NSSI at T1 they were no more or less likely to have engaged in NSSI between T1 and T2 than expected by chance

– If Ps indicated a hx of NSSI at T1 they were more likely than chance to have engaged in NSSI btw T1 and T2

– T1 NSSI + Suicidality (ever) predicted NSSI behaviour at T2 (6 – 14 months later). Results suggest NSSI (F (1, 289) = 47.65, p<.001) is a stronger predictor of future NSSI behaviour than suicidality (F(1, 282) = 24.15, p<.001).

ISAS subscales: T1 + T2 scores r?– Subscales correlated over time (possible evidence of some stability

of this function over time): Affect regulation, interpersonal boundaries, Self-punishment, Self-care, Anti-suicide, Sensation seeking, Peer bonding and Interpersonal influence.

– Not significantly correlated T1 + T2 scores: Anti-dissociation, Toughness, Marking distress, Revenge and Autonomy

– Are interpersonal motivations more transitory than intrapersonal ones? (most intrapersonal subscales T1 + T2 scores were correlated, whilst several of the interpersonal subscales were not)

– Please note that the sample size was limited.

Implications (for clinical practice)...o Thoughts of engaging in NSSI do not necessarily indicate increased

risk of this behaviour occurring.o Heterogeneity in functions – wide range between and within

individual cases. o Functions are not necessarily stable over timeo Intrapersonal functions may be more likely to persist over time than

interpersonal functions?o Intrapersonal functions more strongly associated with suicidality

(and other factors related to poor wellbeing) o Different risk and protective factors for NSSI based on participants’

functions??o Failure to have a clear function (i.e. low endorsement of any

function for NSSI) may be a protective factor

Acknowledgements• Participating Wellington secondary schools and students• Health Research Council of New Zealand

Thanks for listening

Documents

Cluster Analysis of Functions of NSSI in a Sample of New Zealand Community Adolescents Jessica Garisch, Marc Stewart Wilson, Robyn Langlands, Angelique