intrapersonal and interpersonal underpinnings: kealagh robinson youth wellbeing study understanding...

Intrapersonal and Interpersonal Underpinnings:

Kealagh RobinsonYouth Wellbeing Study

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

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)

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

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

Intrapersonal Functions

Affect Regulation

Marking Distress

Self-Punishment

Feeling Generation

Anti-Suicide

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

Interpersonal Functions

Peer Bonding

Sensation Seeking

Toughness

Interpersonal Boundaries

Self-Care

Autonomy

Interpersonal Influence

Revenge

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

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)

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

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

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)

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

Overall Wellbeing

Intrapersonal Functions

Interpersonal Functions

Depression .67 .31

Anxiety .51 .31

Self-Esteem -.56 ns

Emotion Regulation -.49 -.22

Resilience -.29 ns

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

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?