Body Image in Adolescents with Suicidal and Non-Suicidal Self-Harm Behavior: Satisfaction with Their Own Bodies

The aim of the study was to examine the features of body image perception in adolescents with self-harming, suicidal and normative behavior in terms of satisfaction with their own bodies. A theoretical review of the phenomena of suicidal and self-harming behavior and current studies of body image in non-clinical and clinical samples was conducted. The description and results of the first part of the empirical study of body image, devoted to the study of satisfaction with one's own body, are presented. The study was conducted on three groups of adolescents: those with suicidal behavior (n=30, M_age=15.10, SD_age=0.97, 26.7% of males), self-injurious behavior (n=27, M_age=15.48, SD_age=1.10, 11.1% of males) and normative behavior (control group: n=30, M_age=15.40, SD_age=0.96, 50% of males). The first group was distinguished on the basis of anamnestic data (suicide attempts in the last year or current hospitalization due to high suicide risk), the second group was distinguished on the basis of the Self-Harming Behavior Reason Scale (N.A. Polskaya, 2017): repeated cuts, punctures, and/or self-burns in the last year. The following methods were used: Self-Harming Behavior Reason Scale (N.A. Polskaya, 2017), Body Focus Questionnaire (Fisher, 1970), adapted by E.T. Sokolova (1985) and a questionnaire to collect socio-demographic data (gender, age, presence of psychiatric diagnoses, suicide attempts). The results suggest that self-harm is determined by an adolescent's need to reduce psychoemotional tension and gain control over emotions, and these determinants are stronger in the main groups than in the control groups, but no differences were found between the main groups. Satisfaction with one's own body is lower in the main groups compared to controls, but no differences were found between the main groups.

1. Avdunina N.A. Obraz tela kak komponent samosoznaniya v yunosheskom vozraste [Development of body image in adolescence]. Vestnik assotsiatsii vuzov turizma i servisa = Universities for Tourism and Service Association Bulletin, 2016, no. 2. URL: https://cyberleninka.ru/article/n/obraz-tela-kak-komponent-samosoznaniya-v-yunosheskom-vozraste (Accessed: 19.06.2023). (In Russ., abstr. in Engl.).
2. Ambrumova A.G., Tikhonenko V.A. Diagnostika suitsidal'nogo povedeniya: metodicheskie rekomendatsii. [Diagnosis of suicidal behavior: guidelines]. Moscow: Minister of Health of the RSFSR, 1980. 55 p. (in Russ.).
3. Barylnik S.N. Vliyanie sovremennogo ehtalona fizicheskoi privlekatel'nosti na psikhicheskoe zdorov'e podrostkov s uchetom gendernykh osobennostei [The influence of the modern standard of physical attractiveness on the mental health of adolescents, taking into account gender characteristics]. Byulleten' meditsinskikh internet-konferentsii = Bulletin of Medical Internet Conferences, 2018, no. 11. URL: https://cyberleninka.ru/article/n/ vliyanie-sovremennogo-etalona-fizicheskoy-privlekatelnosti-na-psihicheskoe-zdorovie-podrostkov-s-uchetom-gendernyh-osobennostey (Accessed: 19.06.2023). (In Russ.).
4. World Health Organization. One in 100 deaths is by suicide / News release. June, 17. 2021. URL: https://www.who.int/ru/news/item/17-06-2021-one-in-100-deaths-is-by-suicide (Accessed: 19.06.2023).
5. Gelda A.P. Prichinnye faktory i motivatsiya suitsidal'nogo povedeniya v detsko-podrostkovom vozraste [Causative factors and motivation for chifdren and adofescents' suicidaf behavior]. Voprosy organizatsii i informatizatsii zdravookhraneniya = Problems of Public Health Organization and Informatization, 2019, no. 2, pp. 10–21. (In Russ., abstr. in Engl.).
6. Gorbatov S.V., Arbuzova E.N., Shaboltas A.V. et al. Osobennosti YA-kontseptsii devochek podrostkov s nesuitsidal'nym samopovrezhdayushchim povedeniem [Features of self-concept of female adolescents with non-suicidal self-harming behavior]. Suitsidologiya = Suicidology, 11., no. 1 (38), pp. 53–69. DOI: 10.32878/suiciderus.20-11-01(38)-53-69 (In Russ., abstr. in Engl.).
7. Davidouski S.V., Igumnov S.A. Nesuitsidal'noe samopovrezhdayushchee povedenie u podrostkov [Non-suicidal self-harming behavior in adolescents]. Voprosy psikhicheskogo zdorov'ya detei i podrostkov = Mental Health of Children and Adolescent, 2021, vol. 21, no. 1, pp. 90–101 (In Russ., abstr. in Engl.).
8. Durkheim E. Samoubiistvo: sotsial'nyi ehtyud [Suicide: a social study]. Moscow: Pedagogika, 1994. 216 p. (In Russ.).
9. Zinchuk MS, Avedisova AS, Guekht AB. Nesuitsidal'noe samopovrezhdayushchee povedenie pri psikhicheskikh rasstroistvakh nepsikhoticheskogo urovnya: ehpidemiologiya, sotsial'nye i klinicheskie faktory riska [Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = The Korsakov’s Journal of Neurology and Psychiatry, 2019, vol. 119, no. 3, pp. 108–119. DOI: 10.17116/jnevro2019119031108 (In Russ., abstr. In Engl.).
10. Kaminskaya N.A., Ailamazyan A.M. Issledovaniya obraza fizicheskogo «Ya» v razlichnykh psikhologicheskikh shkolakh [Studies of the body image in various psychological approaches]. Natsional'nyi psikhologicheskii zhurnal = National Psychological Journal, 2015, vol. 19, no. 3, pp. 45–55. DOI: 10.11621/npj.2015.0305 (In Russ., abstr. in Engl.).
11. Komolov D.A. Osobennosti affektivnykh i kognitivnykh komponentov v strukture reprezentatsii tela u detei i podrostkov s razlichnymi gruppami zdorov'ya: dis. … kand. psikhol. nauk [Peculiarities of affective and cognitive components in the structure of body representation in children and adolescents with different health groups. PhD (Psychology) Dissertation]. Tomsk, 2019. 189 p. (In Russ.).
12. Kon I.S. V poiskakh sebya: lichnost' i ee samosoznanie [In search of oneself: Personality and its self-consciousness]. Moscow: Politizdat, 1984. 335 p. (In Russ.).
13. Krylova E.S., Beburishvili A.A., Kaleda V.G. Nesuitsidal'nye samopovrezhdeniya pri rasstroistve lichnosti v yunosheskom vozraste i otsenka ikh vzaimosvyazi s suitsidal'nym povedeniem [Non-suicidal self-injury and its relation to suicidal behavior in youth patients with personality disorders]. Suitsidologiya = Suicidology, 2019, no. 1 (34). URL: https://cyberleninka.ru/article/n/nesuitsidalnye-samopovrezhdeniya-pri-rasstroystve-lichnosti-v-yunosheskom-vozraste-i-otsenka-ih-vzaimosvyazi-s-suitsidalnym-povedeniem (Accessed: 19.06.2023) (In Russ., abstr. in Engl.).
14. Kulikov A.V. Suitsidal'noe povedenie detei i podrostkov pri endogennykh zabolevaniyakh [Suicidal behavior in children and adolescents with endogenous psychiatric disorders]. Psikhiatriya = Psychiatry, 2013, no. 4, pp. 22–26. (In Russ., abstr. in Engl.)
15. Lukashuk A.V., Merinov A.V. Samopovrezhdeniya u podrostkov: podkhody k terapii [Self-harm in adolescents: Approaches to therapy]. Nauka molodykh = Eruditio Juvenium, 2016, no. 2. URL: https://cyberleninka.ru/article/n/samopovrezhdeniya-u-podrostkov-podhody-k-terapii (Accessed: 19.06.2023). (In Russ., abstr. in Engl.).
16. Menninger K. Voina s samim soboi [War with oneself]. Moscow: EKSMO-Press, 2000. 480 p. (In Russ.).
17. Meshkova T.A. Kontseptsiya pozitivnogo obraza tela v sovremennoi zarubezhnoi psikhologii [The concept of a positive body image in modern foreign psychology]. Sovremennaya zarubezhnaya psikhologiya = Journal of Modern Foreign Psychology, 2021, vol. 10, no. 2, pp. 55–69. DOI: 10.17759/jmfp.2021100206. (In Russ., а in Engl.)
18. Motovilin O.G. Razvitie predstavlenii o sobstvennom tele u detei v usloviyakh sem'i i internata: dis. ... kand. psikhol. nauk [Development of ideas about one's own body in children in a family and boarding school. PhD (Psychology) Dissertation]. Moscow, 2001. 188 p. (In Russ.).
19. Nalchadzhyan A.A. Ya-kontseptsiya [I-concept] In D.Ya. Raygorodsky (ed.), Psikhologiya samosoznaniya. Khrestomatiya = Psychology of Self-Consciousness. Reader. Samara: Bakhrakh-M, 2000. Pp. 333–393. (In Russ.).
20. Polozhy B.S. Suitsidy sredi nesovershennoletnikh (Ehpidemiologicheskii aspekt) [Suicides among minors (Epidemiological aspect)]. Suitsidologiya = Suicidology, 2019, vol. 10 (1), pp. 21–26. DOI: 10.32878/suiciderus.19-10-01(34)-21-2 (In Russ).
21. Polskaya N.A. Prichiny samopovrezhdeniya v yunosheskom vozraste (na osnove shkaly samootcheta) [The reasons of self-injurious behavior in youth (based on a self-report scale)]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2014, vol. 22, no. 2, pp. 140–152. (In Russ., аbstr. in Engl.)
22. Polskaya N.A. Faktory riska i napravleniya profilaktiki samopovrezhdayushchego povedeniya podrostkov [Risk factors and approaches to preventing self-injurious behavior in adolescents]. Klinicheskaya i spetsial'naya psikhologiya = Clinical and Special Psychology, 2018, vol. 7, no. 2, pp. 1–20. DOI: 10.17759/psyclin.2018070201 (In Russ., аbstr. in Engl.)
23. Polskaya N.A. Fenomenologiya i funktsii samopovrezhdayushchego povedeniya pri normativnom i narushennom psikhicheskom razvitii (Doctoral (Psychology) dissertation). Moscow, 2017. 423 p. (In Russ.)
24. Popov Yu.V., Pichikov A.A. Suitsidal'noe povedenie u podrostkov. Мoscow: Litres, 2018. 367 p. (In Russ.)
25. Rozhkov S.N., Voronova S.Z., Sazonova T.A. et al. Osobennosti motivatsii suitsidal'nogo povedeniya u podrostkov pri zavershennykh suitsidakh. Omskii psikhiatricheskii zhurnal=Omsk Journal of Psychiatry, 2016, № 4 (10). URL: https:// cyberleninka.ru/article/n/osobennosti-motivatsii-suitsidalnogo-povedeniya-u-podrostkov-pri-zavershennyh-suitsidah (Accessed: 19.06.2023). (In Russ.)
26. Ruzhenkov V.A., Ruzhenkova V.V. Nekotorye aspekty terminologii i klassifikatsii autoagressivnogo povedeniya [Some aspects of terminology and classification of self-injurious behavior]. Suitsidologiya = Suicidology, 2014, no. 1 (14). URL: https:// ru/article/n/nekotorye-aspekty-terminologii-i-klassifikatsii-autoagressivnogo-povedeniya (Accessed: 19.06.2023) (In Russ., abstr. in Engl.).
27. Sokolova E.T., Dorozhevets A.N. Issledovaniya «obraza tela» v zarubezhnoi psikhologii. Vestnik Moskovskogo universiteta. Seriya 14: Psikhologiya = Moscow University Psychology Bulletin, 1985, no. 4, pp. 39–49. (In Russ.)
28. Sultanov A.A. K voprosu o suitsidal'nom povedenii prakticheski zdorovykh lits molodogo vozrasta. In V.V. Kovalev (ed.), Nauchnye i organizatsionnye problemy suitsidologii: sb. nauch. tr. Moscow: Publ. of Moscow Research Institute of Psychiatry of the RSFSR Ministry of Health, 1983, pp. 94–97. (In Russ.)
29. Filippova E.V., Bulygina M.V., Koval' O.V. et al. Otnoshenie k sobstvennomu telu kak faktor psihologicheskogo blagopoluchija sovremennyh podrostkov. Vozmozhnosti i riski cifrovoj sredy: Sbornik materialov VII Vserossijskoj nauchno-prakticheskoj konferencii po psihologii razvitija (chtenija pamjati L.F. Obuhovoj) (pp. 429–432). Vol. 1. Moscow: Publ. of MSUPE, 2019. (In Russ.)
30. Chistopol'skaya K.A., Enikolopov S.N. Osobennosti molodykh lyudei s samopovrezhdeniyami i predshestvuyushchimi popytkami v ostrom suitsidal'nom krizise [Characteristics of young people in acute suicidal crisis with and without non-suicidal self-harm and suicide attempts]. Suitsidologiya = Suicidology (Russia), 2019, vol. 10, no. 4 (37), pp. 47–64. DOI: 10.32878/suiciderus.19-10-04(37)-47-64 (In Russ., abstr. in Engl.).
31. Shakura K.V., Zaitsev D.V. Own body satisfactoriness is the investigation object in life and perception of modern young adults. XLI International Scientific and Practical Conference: International Scientific Review of the Problems and Prospects of Modern Science and Education (pp. 166–168). Boston, MA: Problems of Science, 2018.
32. Brunner R., Kaess M., Parzer P. Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 2014, no. 55 (4), pp. 337–348. DOI: 10.1111/jcpp.12166
33. Ceja M., Aguiar-Vasquez S. Body image role on non-suicidal self-injury. Electronic Theses, Projects, and Dissertations, 2020, p. 989. URL: https://scholarworks.lib.csusb. edu/etd/989/ (Accessed: 19.06.2023).
34. Del Bello V., Verdolini N., Pauselli L. et al. Personality and psychotic symptoms as predictors of self-harm and attempted suicide. Psychiatria Danubina, 2015, no. 27 (1), pp. 285–291.
35. Du N., Ouyang Y., Ouyang Y.J. et al. Psychosocial factors associated with increased adolescent non-suicidal self-injury during the COVID-19 pandemic. Frontiers in Psychiatry, 2021, no. 12, article 743526. DOI: 10.3389/fpsyt.2021.743526
36. Fisher S. Body experience in fantasy and behavior. New York: Appleton-Century-Crofts, 1970. 676 p.
37. Furnham A., Calnan A. Eating disturbance, self-esteem, reasons for exercising and body /*weight dissatisfaction in adolescent males. European Eating Disorders Review, 1998, no. 6 (1), pp. 58–72.
38. Gibbons R.D., Perraillon M.C., Hur K. et al. Antidepressant treatment and suicide attempts and self-inflicted injury in children and adolescents. Pharmacoepidemiology and Drug Safety, 2015, vol. 24, no. 2, pp. 208–214. DOI: 10.1002/pds.3713
39. Grandclerc S., De Labrouhe D., Spodenkiewicz M. et al. Relations between nonsuicidal self-injury and suicidal behavior in adolescence: A systematic review. PLoS ONE, 2016, no. 11 (4), e0153760. DOI: 10.1371/journal.pone.0153760
40. Hamza C.A., Stewart S.L., Willoughby T. Examining the link between nonsuicidal self-injury and suicidal behavior: A review of the literature and an integrated model. Clinical Psychology Review, 2012, no. 32 (6), pp. 482–495. DOI: 10.1016/j.cpr.2012.05.003
41. Hawton K., Kingsbury S., Steinhardt K. et al. Repetition of deliberate self-harm by adolescents: The role of psychological factors. Journal of Adolescence, 1999, no. 22 (3), 369–378. DOI: 10.1006/jado.1999.0228
42. Hawton K., Saunders K., O’Connor R.C. Self-harm and suicide in adolescents. Lancet, 2012, vol. 379 (9834), pp. 2373–2382. DOI: 10.1016/S0140-6736(12)60322-5
43. King A.J.C., Boyce W.F., King M.A. Trends in the health of Canadian youth. Ottawa, ON: Health Canada, 1999. 110
44. Leeb R.T., Bitsko R.H., Radhakrishnan L. et al. Mental health–related emergency department visits among children aged <18 years during the COVID-19 pandemic. United States, January 1–October 17, 2020. Morbidity and mortality weekly report, 2020, vol. 69 (45), pp. 1675–1680. DOI: 10.15585/mmwr.mm6945a3
45. Muehlenkamp J.J., Claes L., Havertape L. et al. International prevalence of adolescent nonsuicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 2012, vol. 6 (1). DOI: 10.1186/1753-2000-6-10
46. Nock M.K., Borges G., Bromet E.J. et al. Cross-national prevalence and risk factors for suicidal ideation, plans, and attempts. The British Journal of Psychiatry: The Journal of Mental Science, 2008, vol. 192 (2), pp. 98–105. DOI: 10.1192/bjp.bp.107.040113
47. O’Connor R.C., Rasmussen S., Hawton K. Adolescent self-harm: A school-based study in Northern Ireland. Journal of Affective Disorders, 2014, vol. 159, pp. 46–52. DOI: 10.1016/j.jad.2014.02.015
48. Oktan V. Self-harm behaviour in adolescents: Body image and self-esteem. Journal of Psychologists and Counsellors in Schools, 2017, vol. 27 (2), pp. 177–189. DOI: 10.1017/jgc.2017.6
49. Parrado A., León-Jiménez V., León-Jariego J.C. COVID-19 pandemic: Home confinement problems and mental health. SSM Population Health, 2020. DOI: 10.21203/rs.3.rs-49587/v1
50. Plener P.L., Kaess M., Schmahl C. et al. Nonsuicidal self-injury in adolescents. Deutsches Aerzteblatt Online, 2018, vol. 115, pp. 23–30. DOI: 10.3238/arztebl.2018.0023
51. Ramos P., Moreno-Maldonado C., Moreno C. et al. The role of body image in internalizing mental health problems in Spanish adolescents: An analysis according to sex, age, and socioeconomic status. Frontiers in Psychology, 2019, vol. 10, article 1952. DOI: 10.3389/fpsyg.2019.01952
52. Rautio D., Jassi A., Krebs G. et al. Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. European Child & Adolescent Psychiatry, 2020, vol. 31 (1), pp. 133–144. DOI: 10.1007/s00787-020-01677-3
53. Richards C., Oliver C., Nelson L. et al. Self-injurious behaviour in individuals with autism spectrum disorder and intellectual disability. Journal of Intellectual Disability Research: JIDR, 2012, no. 56 (5), pp. 476–489. DOI: 10.1111/j.1365-2788.2012.01537.x
54. Rosenblum G.D., Lewis M. The relations among body image, physical attractiveness, and body mass in adolescence. Child Development, 1999, vol. 70 (1), pp. 50–64. DOI: 10.1111/1467-8624.00005
55. Simms J., McCormack V., Anderson R. et al. Correlates of self-harm behaviour in acutely ill patients with schizophrenia. Psychology and Psychotherapy, 2007, no. 80 (Pt 1), pp. 39–49. DOI: 1348/147608306X99386
56. Skvortsova E., Pechnikova L., Zhuykova E. et al. Body attitudes and experienced early care and attachment relationships in suicidal adolescents. European Psychiatry, 2022, v 65 (S1), S184–S184. DOI: 10.1192/j.eurpsy.2022.486
57. Šmídová S., Švancara J., Andrýsková L. et al. Adolescent body image: results of Czech ELSPAC study. Central European Journal of Public Health, 2018, vol. 26 (1), pp. 60–64. DOI: 10.21101/cejph.a4930
58. Svirko E., Hawton K. Self‐injurious behavior and eating disorders: The extent and nature of the association. Suicide and Life‐Threatening Behavior, 2007, vol. 37 (4), pp. 409–421. DOI: 10.1521/suli.2007.37.4.409
59. Swami V., Horne G., Furnham A. COVID-19-related stress and anxiety are associated with negative body image in adults from the United Kingdom. Personality and Individual Differences, 2021, vol. 170, pp. 110426. DOI: 10.1016/j.paid.2020.110426
60. Winkler P., Formanek T., Mlada K. et al. Increase in prevalence of current mental disorders in the context of COVID-19: Analysis of repeated nationwide cross-sectional surveys. Epidemiology and Psychiatric Sciences, 2020, vol. 29, e173. DOI: 10.1017/S2045796020000888
61. World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. 2020. WHO Reference Number: WHO/2019-nCoV/MentalHealth/2020.1. URL: https://www.who.int/publications/i/item/WHO-2019-nCoV-MentalHealth-2020.1 (дата обращения: 19.06.2023).
62. Yard E., Radhakrishnan L., Ballesteros M.F. et al. Emergency department visits for suspected suicide attempts among persons aged 12–25 years before and during the COVID-19 pandemic—United States, January 2019–May 2021. Morbidity and Mortality Weekly Report, 2021, vol. 70 (24), pp. 888–894. DOI: 10.15585/mmwr.mm7024e1