Risk Factors and Approaches to Preventing Self-Injurious Behavior in Adolescents

The problem of self-injurious behavior from the point of view of the risk factors and prevention in adolescents is considered. Strategies of self-injurious behavior and characteristics of emotional dysregulation in those who self-injure are described. Finding help from peers/online friends and high stigmatizing/self-stigmatizing among self-injuring adolescents should be taken into account in treatment and prevention programs. Methods of preventing of self-injurious behavior are summarized. The following groups of methods are distinguished by purpose: informing about the problem, developing of adaptive self-regulation strategies and psychological and social support. The following prerequisites for developing school-based prevention programs of self-injurious behavior are defined: choosing a target group of adolescents (population, risk group, adolescents in stress-inducing situations), identifying the level of intervention (individual or group work with adolescents, their parents, teachers etc.), assessing the cultural specificity of the group. Programs should be based on current psychological knowledge about the development of self-injurious behavior and implicate the measuring of their efficacy.

1. Bannikov G.S., Fedunina N.Y., Pavlova T.S., Vikhristuk O.V., Letova A.V., Bazhenova M.D. Vedushchie mekhanizmy samopovrezhdayushchego povedeniya u podrostkov: po materialam monitoringa v obrazovatel'nykh organizatsiyakh [Mechanisms of self-harm behavior in non-clinical adolescent population: the results of monitoring in Moscow schools]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016, vol. 24, no. 3, pp. 42–68. doi:10.17759/cpp.2016240304. (In Russ., аbstr. in Engl.)
2. Borisonik E.V., Kholmogorova A.B. Psikhologicheskoe sostoyanie chlenov semei, perezhivshikh raznye formy suitsida blizkogo cheloveka (odnokratnaya popytka, khronicheskaya suitsidal'nost', zavershennyi suitsid) [The Psychological State of Family Members Who Have Experienced Various Forms of Suicide of a Loved One (Single Attempt, Chronic Suicide, Completed Suicide)]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2018, vol. 26, no. 1, pp. 56–75. doi:10.17759/cpp.2018260105. (In Russ., аbstr. in Engl.)
3. Vlasova N.V. Osobennosti regulyatsii emotsii v podrostkovom vozraste (na primere vospitannikov kadetskoi shkoly-internata) [Features of Emotional Regulation in Adolescence (With the Example of Students of Cadet Boarding School)] [Elektronnyi resurs]. Psikhologo-pedagogicheskie issledovaniya [Psychological-Educational Studies], 2017, vol. 9, no. 2, pp. 70–83. URL: http://nbn-resolving.de/urn:nbn:de:0168-ssoar-49252-2 (Accessed 26.05.2018). doi:10.17759/psyedu.2017090207. (In Russ., аbstr. in Engl.)
4. Vygotsky L.S. Sobranie sochinenii: V 6-ti t. T. 4: Detskaya psikhologiya [Collected works: in 6 vol. Vol. 4: Child psychology]. Moscow: Pedagogika, 1984. 433 p.
5. Polskaya N.A. Vzaimosvyaz' pokazatelei shkol'nogo bullinga i samopovrezhdayushchego povedeniya v podrostkovom vozraste [Relationship of indicators of school bullying and self-injurious behavior in adolescence]. Psikhologicheskaya nauka i obrazovanie [Psychological Science and Education], 2013, no. 1, pp. 39–49. (In Russ., аbstr. in Engl.).
6. Polskaya N.A. Modeli korrektsii i profilaktiki samopovrezhdayushchego povedeniya [Models of correction and prevention of self-injurious behavior]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016, vol. 24,
   no. 3, pp. 110–125. doi:10.17759/cpp.2016240307. (In Russ., аbstr. in Engl.).
7. Polskaya N.A. Emotsional'naya regulyatsiya u podrostkov s suitsidal'nymi popytkami i samopovrezhdeniyami [Emotional regulation in adolescents with suicidal attempts and self-injuries].  Voprosy psikhicheskogo zdorov'ya detei i podrostkov [Journal of Mental Health of Children and Adolescent], 2017, no. 2 (Prilozhenie) [Supplement], pp. 191–193.
8. Polskaya N.A. Psikhologiya samopovrezhdayushchego povedeniya [The psychology of self-injurious behavior]. Moscow: Lenand, 2017. 320 p.
9. Polskaya N.A., Razvaliaeva A.Yu. Razrabotka oprosnika emotsional'noi disregulyatsii [The development of the “emotion dysregulation” questionnaire]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2017, vol. 25, no. 4, pp. 71–93. doi:10.17759/cpp.2017250406. (In Russ., аbstr. in Engl.).
10. Syrokvashina K.V., Dozortseva E.G. Psikhologicheskie faktory riska suitsidal'nogo povedeniya u podrostkov [Psychological factors of risk of suicidal behavior in adolescents]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016, vol. 24, no. 3, pp. 8–24. doi:10.17759/cpp.2016240302. (In Russ., аbstr. in Engl.)
11. Fesenko Y.A., Kholmogorova A.B. Sluchai suitsidov sredi podrostkov kak sotsial'naya problema: po sledam V vserossiiskogo foruma «Nashi deti zdorov'e detei i faktory, ego formiruyushchie» [Suicides Among Adolescents as A Social Problem: 5th All-Russian Forum “Our Children. Children’s Health and Its Factors”]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2017, vol. 25,
    no. 2, pp. 188–193. doi:10.17759/cpp.2017250212. (In Russ., аbstr. in Engl.)
12. Kholmogorova A.B., Garanyan N.G. Emotsional'nye rasstroistva i sovremennaya kul'tura [Emotional disorders and modern culture]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 1999, no. 2, pp. 61–90.
13. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013,
    pp. 803–806.
14. Baiden P., Stewart S.L., Fallon B. The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Child Abuse & Neglect, 2017, vol. 69,
    pp. 163–176. doi:10.1016/j.chiabu.2017.04.011
15. Berger E., Hasking P., Martin G. Adolescents’ perspectives of youth non-suicidal self-injury prevention. Youth & Society, 2017, vol. 49, no. 1, pp. 3–22. doi:10.1177/0044118X13520561
16. Crisp S. Explainer: what is self-harm and why do people do it? The Conversation. Available at: https://theconversation.com/profiles/simon-crisp-6225 (Accessed: 15.03.2018).
17. Denov M.S. The Long-Term Effects of Child Sexual Abuse by Female Perpetrators: A Qualitative Study of Male and Female Victims. Journal of Interpersonal Violence, 2004,
    vol. 19, no. 10, pp. 1137–1156. doi:10.1177/0886260504269093
18. Gardner F. Self-Harm: A Psychotherapeutic Approach. Hove, East Sussex: Brunner-Routledge, 2001. 163 p.
19. Geulayov G., Casey D., McDonald, Foster P., Pritchard K., Wells C., Clements C., Kapur N., Ness J., Waters K., Hawton K. Incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England (the iceberg model of self-harm): a retrospective study. The Lancet Psychiatry, 2018, vol. 5, no. 2, pp. 167–174. doi:10.1016/S2215-0366(17)30478-9 
20. Gratz K.L., Chapman A.L. The role of emotional responding and childhood maltreatment in the development and maintenance of deliberate self-harm among male undergraduates. Psychology of Men and Masculinity, 2007, vol. 8, no. 1, pp. 1–14. doi:10.1037/1524-9220.8.1.1
21. Hasking P., Rees C.S., Martin G., Quigley J. What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers.  BMC Public Health, 2015, vol. 15, no. 1. URL: https://bmcpublichealth.biomedcentral.com/track/pdf /10.1186/s12889-015-2383-0 (Accessed 26.05.2018). doi:10.1186/s12889-015-2383-0
22. Heath N.L., Toste J.R., MacPhee S.D. Prevention of Nonsuicidal Self-Injury. In
    M.K. Nock (ed.) The Oxford Handbook of Suicide and Self-Injury. New York, Oxford: Oxford University Press, 2014, pp. 397–408.
23. Klingman А., Hochdorf Z. Coping with distress and self harm: the impact of a primary prevention program among adolescents. Journal of Adolescence, 1993, vol. 16,
    no. 2, pp. 121–140. doi:10.1006/jado.1993.1012
24. Leavell H.R., Clark E.G. Preventive Medicine for the Doctor in His Community: An Epidemiologic Approach. Toronto: McGraw-Hill, 1965. 684 p.
25. Manchester Self-Harm Project (MaSH): Reports. Available at: http://research.bmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/MaSH/reports/ (Accessed: 15.03.2018).
26. Miller I.W., Camargo C.A. Jr, Arias S.A., Sullivan A.F., Allen M.H., Goldstein A.B., Manton A.P., Espinola J.A., Jones R., Hasegawa K., Boudreaux E.D. Suicide prevention in an emergency department population: the ED-SAFE Study. JAMA Psychiatry, 2017, vol. 74,
    no. 6, pp. 563–570. doi:10.1001/jamapsychiatry.2017.0678
27. Morgan H.G., Jones E.M., Owen J.H. Secondary prevention of non-fatal deliberate self-harm: the green card study. The British Journal of Psychiatry, 1993, vol. 163, no. 1,
    pp. 111–112. doi:10.1192/bjp.163.1.111
28. Muehlenkamp J.J., Walsh B.W., McDade M. Preventing non-suicidal self-injury in adolescents: The signs of self-injury program. Journal of Youth and Adolescence, 2010,
    vol. 39, no. 3, pp. 306–314. doi:10.1007/s10964-009-9450-8
29. Nicholson C. More teenage girls are self harming than ever before – here’s why. The Conversation. Available at: https://theconversation.com/more-teenage-girls-are-self-harming-than-ever-before-heres-why-86010 (Accessed: 15.03.2018).
30. Nock M.K., Joiner T. Jr, Gordon K., Lloyd-Richardson E., Prinstein M. Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 2006, vol. 144, no. 1, pp. 65–72. doi:10.1016/j.psychres.2006.05.010
31. Nock M.K. Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 2009, vol. 18, no. 2,
    pp. 78–83. doi:10.1111/j.1467-8721.2009.01613.x
32. Olfson M., Wall M., Wang S., Crystal S., Gerhard T., Blanco C. Suicide following deliberate self-harm. American Journal of Psychiatry, 2017, vol. 174, no. 8, pp. 765–774. doi:10.1176/appi.ajp.2017.16111288
33. Tatnell R., Kelada L., Hasking P., Martin G. Longitudinal analysis of adolescent NSSI: the role of intrapersonal and interpersonal factors. Journal of Abnormal Child Psychology, 2014, vol. 42, no. 6, pp. 885–896. doi:10.1007/s10802-013-9837-6
34. Taylor P.J., Jomar K., Dhingra K., Forrester R., Shahmalak U., Dickson J.M. A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 2018, vol. 227, pp. 759–769. doi:10.1016/j.jad.2017.11.073
35. Walker R.L., Joiner T.E. Jr., Rudd M.D. The course of post-crisis suicidal symptoms: How and for whom is suicide “cathartic”? Suicide and Life Threatening Behavior, 2001,
    vol. 31, no. 2, pp. 144–152. doi:10.1521/suli.31.2.144.21514