Prevalence and Help Seeking Behavior for Non-Suicidal Self-Injury on College Students 10.55131/jphd/2023/210219

Main Article Content

Farida Hidayati
Mohammad Fanani
Sri Mulyani

Abstract

The high prevalence of NSSI has become a widespread health issue in various countries. Unfortunately, NSSI studies in Eastern countries are not as many as in Western countries. This study aims to explore the self-injury behavior of students in Indonesia. Crowdsourcing approach is used by distributing questionnaires through Google Form. A total of 909 students aged 18-25 years (mean age = 20.3, SD = 1,329, 75.4% female) participants completed the Inventory of Statements About Self-injury (ISAS) self-report scale to comprehensively assess non suicidal self-injury (NSSI). Participants were recruited during June 2022–July 2022. The results shows 30% of students were involved in NSSI behavior. The mean age of onset was 15.5 years. As many as 55% of subjects reported having committed more than 50 acts of self-injury. The reported NSSI methods included slashing (78% hair pulling, hitting 74%, biting 57.1%, interfering wound healing 46.9%, carving 26.7%, pinching 66%, scratching 63.3%, stabbing 25.2%, and ingesting a hazardous substance 7.3%. It was reported that 88.3% used more than one method, 17.2% did not feel pain while doing self-injury. In conclusion, the prevalence of NSSI among students in Indonesia is not different from other countries. Prevention and management actions need to be developed to help people who self-injure to have strategies in dealing with problems adaptively and avoiding risky behavior.

Article Details

How to Cite
1.
Hidayati F, Fanani M, Mulyani S. Prevalence and Help Seeking Behavior for Non-Suicidal Self-Injury on College Students: 10.55131/jphd/2023/210219. J Public Hlth Dev [Internet]. 2023 May 16 [cited 2024 May 3];21(2):223-40. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/261103
Section
Original Articles
Author Biographies

Farida Hidayati, Doctoral Program of Public Health, Faculty of Medicine, Sebelas Maret University, Surakarta 57126, Indonesia

Doctoral Program of Public Health, Faculty of Medicine, Sebelas Maret University, Surakarta 57126, Indonesia

Mohammad Fanani, Department of Psychiatry, Faculty of Medicine, Sebelas Maret University, Surakarta 57126, Indonesia

Department of Psychiatry, Faculty of Medicine, Sebelas Maret University, Surakarta 57126, Indonesia

Sri Mulyani, Department of Occupational Safety and Health, Vocational School, Sebelas Maret University, Surakarta 57126, Indonesia

Department of Occupational Safety and Health, Vocational School, Sebelas Maret University, Surakarta 57126, Indonesia

References

Brossard B. Why do we hurt ourselves? 1st ed. Alma, editor. Indiana: Indiana University Press; 2018.

Hamza CA, Willoughby T. Nonsuicidal self-injury and suicidal risk among emerging adults. J Adolesc Heal. 2016;59(4):411–5.

Mars B, Heron J, Klonsky ED, Moran P, O’Connor RC, Tilling K, et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. The Lancet Psychiatry. 2019;6(4):327–37.

Grandclerc S, De Labrouhe D, Spodenkiewicz M, Lachal J, Moro MR. Relations between nonsuicidal self-injury and suicidal behavior in adolescence: A systematic review. PLoS One. 2016;11(4):1–15.

Poudel A, Lamichhane A, Magar KR, Khanal GP. Non suicidal self injury and suicidal behavior among adolescents : co-occurrence and associated risk factors. BMC Psychiatry. 2022;22(96):1–12.

Cipriano A, Cella S, Cotrufo P. Non-suicidal self-injury among italian adolescents: the role of parental rejection, self-concept, anger expression, and body investment. Clin Neuropsychiatry. 2020;17(6):330–8.

Klonsky ED, Victor SE, Saffer BY. Nonsuicidal self-injury: What we know, and what we need to know. Can J Psychiatry. 2014;59(11):565–8.

Taylor, Jomar K, Dhingra K, Forrester R, Shahmalak U, Dickson JM. A meta-analysis of the prevalence of different functions of non-suicidal self-injury. J Affect Disord. 2018;227:759–69.

Sim L, Adrian M, Zeman J, Cassano M, Friedrich WN. Adolescent deliberate self-harm: Linkages to emotion regulation and family emotional climate. J Res Adolesc. 2009;19(1):75–91.

In-Albon T, Bürli M, Ruf C, Schmid M. Non-suicidal self-injury and emotion regulation: a review on facial emotion recognition and facial mimicry. Child Adolesc Psychiatry Ment Health. 2013;7(5).

Laporte N, Klein Tuente S, Ozolins A, Westrin Å, Westling S, Wallinius M. Emotion regulation and self-harm among forensic psychiatric patients. Front Psychol. 2021;12.

Arinda OD, Mansoer WWD. NSSI (nonsuicidal self-injury) pada dewasa muda di Jakarta: Studi fenomenologi interpretatif. J Psikol Ulayat. 2020;

Hidayati F, Fanani M, Mulyani S. Prevalensi dan fungsi melukai diri sendiri pada mahasiswa. In: Tantangan Pembelajaran Komprehensif untuk Mengembangkan Karakter peserta didik : Berdasarkan Pendekatan Psikologi Positif. Malang: Universitas Negeri Malang; 2021. p. 172–9.

Li X, Chen F, Lin Y, Jia Z, Tucker W, He J, et al. Research on the relationships between psychological problems and school bullying and non-suicidal self-injury among rural primary and middle school students in developing areas of China. Int J Environ Res Public Health. 2020;17(10).

Glenn CR, Klonsky ED. Non-suicidal self-injury disorder: An empirical investigation in adolescent psychiatric patients catherine. J Clin Child Adolesc Psychol. 2013;42(4):496–507.

Cerutti, Manca M, Presaghi F, Gratz KL. Prevalence and clinical correlates of deliberate self-harm among a community sample of Italian adolescents. J Adolesc. 2011;34(2):337–47.

Calvete E, Orue I, Aizpuru L, Brotherton H. Prevalence and functions of non-suicidal self-injury in Spanish adolescents. Psicothema. 2015;27(3):223–8.

Swannell S V., Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide Life-Threatening Behav. 2014;44(3):273–303.

Whitlock J, Muehlenkamp J, Purington A, Eckenrode J, Barreira P, Baral Abrams G, et al. Nonsuicidal self-injury in a college population: General trends and sex differences. J Am Coll Heal. 2011;59(8):691–8.

Kiekens G, Hasking P, Claes L, Boyes M, Mortier P, Auerbach RP, et al. Predicting the incidence of non-suicidal self-injury in college students. Eur Psychiatry. 2019;59:44–51.

Cipriano A, Cella S, Cotrufo P. Nonsuicidal self-injury: A systematic review. Front Psychol. 2017;8(8):1–14.

Naidoo S. The prevalence, nature, and functions of non-suicidal self-injury (NSSI) in a South African student sample. South African J Educ. 2019;39(3).

Laye-Gindhu A, Schonert-Reichl KA. Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. J Youth Adolesc. 2005;34(5):447–57.

Nemati H, Sahebihagh MH, Mahmoodi M, Ghiasi A, Ebrahimi H, Atri SB, et al. Non-suicidal self-injury and its relationship with family psychological function and perceived social support among Iranian high school students. J Res Health Sci. 2020;20(1).

Ystgaard M, Arensman E, Hawton K, Madge N, van Heeringen K, Hewitt A, et al. Deliberate self-harm in adolescents: Comparison between those who receive help following self-harm and those who do not. J Adolesc. 2009;32(4):875–91.

Rowe SL, French RS, Henderson C, Ougrin D, Slade M, Moran P. Help-seeking behaviour and adolescent self-harm: A systematic review. Aust N Z J Psychiatry. 2014;48(12):1083–95.

Long M, Manktelow R, Tracey A. The healing journey: Help seeking for self-injury among a community population. Qual Health Res. 2015;25(7):932–44.

Baetens I, Claes L, Muehlenkamp J, Grietens H, Onghena P. Non-suicidal and suicidal self-injurious behavior among flemish adolescents: A web-survey. Arch Suicide Res. 2011;15(1):56–67.

Doyle L, Treacy MP, Sheridan A. Self-harm in young people: Prevalence, associated factors, and help-seeking in school-going adolescents. Int J Ment Health Nurs. 2015;24(6):485–94.

Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet. 2007;370(9590):841–50.

Gholamrezaei M, De Stefano J, Heath NL. Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. Int J Psychol. 2015;52(4):1–11.

Tresno F, Ito Y, Mearns J. Self-injurious behavior and suicide attempts among indonesian college students. Death Stud. 2012;36(7):627–39.

Wiguna T, Minayati K, Kaligis F, Ismail RI, Wijaya E, Murtani BJ, et al. The effect of cyberbullying, abuse, and screen time on non-suicidal self-injury among adolescents during the pandemic: A perspective from the mediating role of stress. Front Psychiatry. 2021;12.

Thippaiah MS, Shankarapura Nanjappa M, Gude JG, Voyiaziakis E, Patwa S, Birur B, et al. Non-suicidal self-injury in developing countries: A review. Int J Soc Psychiatry. 2021;67(5):472–82.

Klonsky ED. The functions of deliberate self-injury: A review of the evidence. Clin Psychol Rev. 2007;27(2):226–39.

Bildik T, Somer O, Kabukçu Başay B, Başay Ö, Özbaran B. The validity and reliability of the turkish version of the inventory of statements about self-injury. Turk Psikiyatr Derg. 2013;24(1):41–9.

Klonsky ED, Olino TM. Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis. J Consult Clin Psychol. 2008;76(1):22–7.

Kortge R, Meade T, Tennant A. Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the inventory of statements about self-injury (ISAS) scale. Behav Chang. 2013;30(1):24–5.

Zade ZN, Mojtabaie M. Effectiveness of Self-Compassion Focused Therapy on reducing of function of self-harm behaviors in Juvenile offenders of Tehran Juvenile Correction and Rehabilitation Center. Int J Appl Behav Sci. 2016;3(3):30–8.

Jeong JY, Kim DH. Gender differences in the prevalence of and factors related to non-suicidal self-injury among middle and high school students in south korea. Int J Environ Res Public Health. 2021;18(11).

Kim S, Kim Y, Hur JW. Nonsuicidal self-injury among korean young adults: A validation of the korean version of the inventory of statements about self-injury (Psychiatry Investig 2019, 16(4), 270-278). Psychiatry Investig. 2021;18(6):589–90.

Gandhi A, Luyckx K, Adhikari A, Parmar D, De Sousa A, Shah N, et al. Nonsuicidal self-injury and identity formation in Indian clinical and nonclinical samples: A comparative study. Int J Soc Psychiatry. 2021;67(3):219–26.

Kharsati N, Bhola P. Patterns of non-suicidal self-injurious behaviours among college students in India. Int J Soc Psychiatry. 2015;61(1):39–49.

Tang J, Ma Y, Lewis SP, Chen R, Clifford A, Ammerman BA, et al. Association of internet addiction with nonsuicidal self-injury among adolescents in China. JAMA Netw Open. 2020;3(6):1–14.

Wang L, Liu J, Yang Y, Zou H. Prevalence and risk factors for non-suicidal self-injury among patients with depression or bipolar disorder in China. BMC Psychiatry. 2021;21(1):1–12.

Muehlenkamp J., Xhunga N, Brausch AM. Self-injury age of onset: A risk factor for nssi severity and suicidal behavior. Arch suicide res. 2019;23(4):551–63.

Son Y, Kim S, Lee JS. Self‐injurious behavior in community youth. Int J Environ Res Public Health. 2021;18(4):1–16.

Lutz NM, Neufeld SAS, Hook RW, Jones PB, Bullmore ET, Goodyer IM, et al. Why is non-suicidal self-injury more common in women? Mediation and moderation analyses of psychological distress, emotion dysregulation, and impulsivity. Arch Suicide Res. 2022;1–29.

Wilkinson PO, Qiu T, Jesmont C, Neufeld SAS, Kaur SP, Jones PB, et al. Age and gender effects on non-suicidal self-injury, and their interplay with psychological distress. J Affect Disord. 2022;306:240–5.

Swannell S V., Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide Life-Threatening Behav. 2014;44(3):273–303.

Bresin K, Schoenleber M. Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clin Psychol Rev. 2015;38:55–64.

Yang X, Feldman MW. A reversed gender pattern? A meta-analysis of gender differences in the prevalence of non-suicidal self-injurious behaviour among Chinese adolescents. BMC Public Health. 2018;18(66):1–7.

Lodebo BT, Möller J, Larsson JO, Engström K. Socioeconomic position and self-harm among adolescents: A population-based cohort study in Stockholm, Sweden. Child Adolesc Psychiatry Ment Health. 2017;11(46):1–9.

Wu J, Liu H. Features of nonsuicidal self-injury and relationships with coping methods among college students. Iran J Public Health. 2019;48(2):270–7.

Zetterqvist M, Lundh LG, Dahlström Ö, Svedin CG. Prevalence and function of non-suicidal self-injury (NSSI) in a community sample of adolescents, using suggested DSM-5 criteria for a potential NSSI disorder. J Abnorm Child Psychol. 2013;41:759–73.

Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Front Psychiatry. 2022;13:1–16.

Nock MK, Joiner TE, Gordon KH, Lloyd-Richardson E, Prinstein MJ. Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006;144(1):65–72.

Nock MK, Prinstein MJ. Contextual features and behavioral functions of self-mutilation among adolescents. J Abnorm Psychol. 2005;114(1):140–6.

Reinhardt M, Kökönyei G, Rice KG, Drubina B, Urbán R. Functions of nonsuicidal self-injury in a Hungarian community adolescent sample: a psychometric investigation. BMC Psychiatry. 2021;21(1):1–14.

Kostić J, Žikić O, Stankovic M, Nikolić G. Nonsuicidal self-injury among adolescents in south-east Serbia. Int J Pediatr Adolesc Med. 2019;6(4):131–4.

Glenn CR, Klonsky ED. Social context during non-suicidal self-injury indicates suicide risk. Pers Individ Dif. 2009;46(1):25–9.

Fortune S, Sinclair J, Hawton K. Help-seeking before and after episodes of self-harm: A descriptive study in school pupils in England. BMC Public Health. 2008;8:1–13.

Xin M, Yang X, Liu K, Boke BN, Bastien L. Impact of negative life events and social support on nonsuicidal self-injury among Chinese middle school students. Am J Men’s Heal. 2020;14(4).

Wang, Ang H, Liu X. Loneliness, non-suicidal self-injury, and friendship quality among Chinese left-behind adolescents: The role of parent-child cohesion. J Affect Disord. 2020;271:193–200.