Adolescent nonsuicidal self-injury: examining the role of child abuse, comorbidity, and disinhibition

Abstract

The purpose of the study is to examine how several well-known correlates of nonsuicidal self-injury (NSSI) might work together to contribute to the occurrence of this behavior. Specifically, we examined models including child abuse, psychiatric comorbidity, and disinhibition, testing how these factors may work together to lead to NSSI in the past month. Participants (n=194; 144 female; age 13-18 years) were recruited from a short-term, acute adolescent residential unit. Within 48 hours of admission to the hospital participants completed structured clinical interviews assessing mental disorders and patterns of NSSI. Following the interviews, participants completed a self-report questionnaire assessing childhood abuse and a computerized continuous performance task. Consistent with study hypotheses, results revealed that the association between child abuse and NSSI is partially mediated by comorbidity. Although disinhibition is associated with comorbidity, contrary to our hypothesis, disinhibition does not mediate the relation between child abuse and NSSI. Collectively, these findings provide new information about how comorbidity may increase risk for NSSI, and critically, discuss the potential importance of creating targeted programs to reduce the prevalence of child abuse.

Keywords: Child abuse; Comorbidity; Disinhibition; Impulsivity; Nonsuicidal self-injury.

Figure 1

Models of nonsuicidal self-injury Note. (A) Comorbidity as a Mediator of Child Abuse and NSSI, (B) Disinhibition as Mediator between Child Abuse and NSSI