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Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury in Young Adolescents

Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

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Page 1: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Intrapersonal and Interpersonal Underpinnings:

Kealagh RobinsonYouth Wellbeing Study

Understanding the Psychological Functions of Non-Suicidal Self Injury in Young Adolescents

Page 2: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Non-Suicidal Self-Injury

Self-inflicted and deliberate destruction of bodily tissue

- absence of suicidal intent- not part of cultural practise (e.g. tattooing)

• Internationally, 18% of adolescents will engage in NSSI at least once

• Linked with depression, anxiety and increased risk of suicide

(Nock & Prinstein, 2004; Muehlenkamp, Claes, Havertape, & Plener, 2012; Tuisku et al., 2009)

Page 3: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Psychological Functions

(YWS: Interviews with Guidance Counsellors [working paper]; Muelenkamp 2006; Klonsky & Olino, 2008)

“…what on earth are they doing this for why would they want to hurt themselves …. [sic] I just don’t get it…”

Understanding of the functions that NSSI serves may aid in:

- understanding the development and trajectory - effective assessment and treatment strategies

- assisting support networks

Page 4: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Inventory of Statements About Self-

Injury (ISAS)

39 items: When I self-harm, I am…

… calming myself down

… showing that I am separate from other people

(Klonsky & Glenn, 2009)

0Not relevant

1Somewhat relevant

2Very relevant

Functions identified through literature review and consultation: Affect Regulation Sensation Seeking Marking Distress

Self-Care Autonomy Self-

Punishment

Feeling Generation Toughness Anti-Suicide

Peer Bonding Interpersonal Boundaries Revenge

Interpersonal Influence

Page 5: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Intrapersonal Functions

Affect Regulation

Marking Distress

Self-Punishment

Feeling Generation

Anti-Suicide

(Klonsky & Glenn, 2009; Illustrations by Ant Sang)

Page 6: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Interpersonal Functions

Peer Bonding

Sensation Seeking

Toughness

Interpersonal Boundaries

Self-Care

Autonomy

Interpersonal Influence

Revenge

(Klonsky & Glenn, 2009; Illustrations by Ant Sang)

Page 7: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Previous LiteratureFunctions established in:University undergrads (M age = 18.5)Members of an international self-injury peer support group (M age = 23.8)

Intrapersonal functions rated higher than Interpersonal functions- Affect Regulation & Self Punishment endorsed most strongly

However...Onset of NSSI begins at 13 to 14 years old

(Klonsky & Olino, 2008; Klonsky & Glenn, 2009; Kortge, Meade & Tennant , 2013)

Page 8: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

15 schools; N = 1006

N = 178

DepressionAnxietyEmotion RegulationSelf EsteemParental Attachment

Deliberate Self-Harm InventoryISAS

M age = 13.4577% ♀ ; 23% ♂

Youth Wellbeing Study

M age = 13.4057% ♀ ; 43% ♂

Wave 1

Page 9: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

NSSI Topography Behaviour Percentage of sample who

report engagement

Cutting 71%      

Scratching 51%      

Carving designs   44%    

Stuck sharp objects in skin   35%    

Punched or banged   35%    

Prevented wounds from healing

  34%    

Biting     18%  

Burning     15%  

Rubbed glass     13%  

Broken bones       7%

Sandpapered skin       6%

Dripped acid       >1%

Used bleach/oven cleaner       >1%

M frequency = 3.27

Page 10: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Function EndorsementFunction Mean (SD)

Affect Regulation 1.11 (0.66)

Self-Punishment 0.93 (0.70)

Anti-Dissociation 0.60 (0.60)

Anti-Suicide 0.51 (0.63)

Marking Distress 0.51 (0.54)

Interpersonal Boundaries 0.36 (0.49)

Toughness 0.35 (0.49)

Self-Care 0.29 (0.40)

Interpersonal Influence 0.24 (0.37)

Autonomy 0.22 (0.41)

Sensation Seeking 0.20 (0.36)

Revenge 0.16 (0.40)

Peer Bonding 0.16 (0.40)

Page 11: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Relationship with Gender

Male Female0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8Intrapersonal

Interpersonal

Gender

Mean

Fu

ncti

on

Rati

ng

Function: p > .001, ηp2 = .34

Sex: ns

Function by Sex:p > .001, ηp

2 = .12

Page 12: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Overall Wellbeing

Intrapersonal Functions

Interpersonal Functions

Depression .67 .31

Anxiety .51 .31

Self-Esteem -.56 ns

Emotion Regulation -.49 -.22

Resilience -.29 ns

Page 13: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Chronic NSSI

Never Once A Few Times

Many Times

0

0.2

0.4

0.6

0.8

1

1.2

Intrapersonal

Interpersonal

NSSI Frequency in Last Year

Mean

Fu

ncti

on

Rati

ng

Function: p < .001, ηp2 = .57

Frequency: p < .001, ηp2

= .17

Function by Frequency:p < .001, ηp

2 = .27

Page 14: Intrapersonal and Interpersonal Underpinnings: Kealagh Robinson Youth Wellbeing Study Understanding the Psychological Functions of Non-Suicidal Self Injury

Conclusions • Young people report many different reasons for

why hurt themselves • Intrapersonal reasons much more likely,

particularly amongst girls• Intrapersonal functions more strongly predicts

both positive and negative outcomes, as well as chronic NSSI

Next: How do these functions develop over time?