Part 1: Understanding Self-Harm in Students

By Didi Dunin, CEI Intern

Parents and educators may not always recognize that their children or students, who outwardly seem happy and well-balanced, are practicing self-harm, but its prevalence makes it an important issue for adults to understand and address. Many youth turn to self-harm to alleviate the emotional pain they are experiencing. Approximately two million cases of self-injury are reported annually in the U.S., 90% of them beginning during teen or pre-adolescent years (Gluck, 2012).

What is Self-Harming Behavior?

Non-suicidal self-injury (NSSI) is defined as deliberately injuring oneself without suicidal intent, in which the most common types of self-injury behaviors are cutting and burning the skin. Often, youth who practice this behavior do so to alleviate the emotional pain or trauma they are experiencing. School-based prevention of NSSI begins with educational staff obtaining an understanding of self-injury and school leaders determining an appropriate means of intervention.

Unfortunately, many parents and educators hold the common misconception that NSSI is a form of attention-seeking behavior which does not need to be taken seriously. In reality, youth who engage in NSSI can be experiencing diverse psychosocial stressors and significant distress. This may even be occurring behind the scenes for those that are doing well academically or seem popular with their classmates. Read the brave story of the myriad stressors that led this young girl to begin cutting to regain control (Writer, 2019).

Functions

NSSI can function as a coping mechanism for distress in several ways, including affect regulation, self-punishment, and help-seeking behavior.

Affect Regulation

The most commonly reported function of self-injury is the regulation of aversive affective experiences, whereby NSSI is used as a strategy to reduce, manage, or escape intense and intolerable negative emotions (Laye-Gindhu & Schonert-Reichl, 2005).

Self-Punishment

Many of those who engage in self-harm explain that one motivation for NSSI is self-punishment (Nock & Prinstein, 2004). People may use NSSI as a form of self-directed abuse that they have internalized after experiencing repeated abuse or criticism from others (Glassman, Weierich, Hooley, Deliberto, & Nock, 2007). Feelings of low self-worth and/or feelings of guilt can also lead youth to feel that they deserve punishment, thus encouraging them to engage in NSSI.

Communication

Teens and pre-teens may also use NSSI to serve interpersonal functions. For example, youth may escalate to the use of NSSI as a means of communication with adults when less intense strategies (e.g., speaking, yelling) have failed to illicit a response (Nock, 2009). In these cases, young people believe that their actions will speak louder than words. Actively listening to adolescents’ words can prevent these maladaptive actions by allowing them to feel heard and valued.

Risk Factors

Understanding the common risk factors associated with self-injury can better equip educators to understand the underlying difficulties for students at risk of self-injury. Common risk factors include:

1. Child maltreatment (Riggi, Moumne, Heath, & Lewis, 2016)

2. Bullying and victimization (Noble, Sornberger, Toste, Heath, & Mclouth, 2011)

3. Suicide ideation and attempt (Guan, Fox, & Prinstein, 2012)

4. Mental health difficulties, including anxiety, depression, substance abuse and eating disorders (Stewart, Baiden, & Theall-Honey, 2014)

5. Genetic predispositions to high emotion reactivity (Nock, 2009)

6. Low distress tolerance and high rumination (Slabbert, Hasking, & Boyes, 2018)

7. High self-criticism, low self-esteem, disordered eating (Zelkowitz & Cole, 2018)

Fortunately, however, when school staff working with youth who self-injure are aware of the student’s inner distress and interpersonal risk factors, prevention and recovery can be attained.

To learn more about best practices in treatment and prevention of NSSI in students, be sure to read Understanding Self-Harm in Students: Part 2.

References

Glassman, L. H., Weierich, M. R., Hooley, J. M., Deliberto, T. L., & Nock, M. K. (2007). Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism. Behaviour Research and Therapy, 45(10), 2483-2490. Gluck, S. (2012, August 24). Self injury, self harm statistics and facts. HealthyPlace. Retrieved on 2019, August 22. Guan, K., Fox, K. R., & Prinstein, M. J. (2012). Nonsuicidal self-injury as a time-invariant predictor of adolescent suicide ideation and attempts in a diverse community sample. Journal of Consulting and Clinical Psychology, 80(5), 842-849. Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34(5), 447-457.