Category: Suicide and Self-Injury
Nonsuicidal self-injury (NSSI) is a worrying phenomenon for several reasons: it is quite common, affecting approximately 10-20% of adolescents (Swannell, Martin, Page, Hasking, & St. John, 2014), it can cause direct bodily harm, and it is strongly associated with future suicide attempts (Ribeiro et al., 2016). Although the last 10 to 15 years have seen a large body of research on NSSI, many questions remain about why some people engage in NSSI and others do not (Klonsky, Victor, & Saffer, 2014; Nock, 2009). Moreover, certain groups, such as sexual and gender minorities (SGMs), are at higher risk of engaging in NSSI and other self-injurious thoughts and behaviors (SITBs) than are heterosexual people (Arcelus, Claes, Witcomb, Marshall, & Bouman, 2016). Although this increased risk has been described in relation to minority stress theory (Meyer, 2003), further questions remain regarding the nature of the specific relationship between SGM status and NSSI engagement.
The minority stress model describes factors such as concealment of one’s sexual or gender identity and internalized stigma, which may affect the relationship between sexual orientation, gender identity, and NSSI. However, to our knowledge there have been no prospective studies to empirically test the role of the minority stress model in teen SGMs. The present study examined the relationship between minority stress and variables related to NSSI in SGM youth and heterosexual females. 345 adolescents completed a series of questionnaires and computer-based tasks to assess various dimensions of the minority stress model. SGM participants reported higher NSSI prevalence and self-criticism than cisgender heterosexual participants at baseline (MSGM = 37.82, MC/H = 29.56, U = 6593.5, two-tailed p < .001); however, the difference in self-criticism between SGM and cisgneder heterosexual participants persisted even among those participants with no NSSI histories (MSGM = 34.67, MC/H = 25.59, U = 1724.5, two-tailed p < .001). Importantly, of the eight variables we tested that were specifically designed to capture minority stress factors, none were significantly associated with a history of NSSI. However, body image and experiences of discrimination were significantly associated with NSSI engagement at baseline.
Participants who indicated consent to a follow-up study will complete a brief assessment 6 months later, measuring their engagement in SITBs. Data collection for this follow-up assessment is ongoing (current n = 38; estimated n by October = 160). The prospective relationship between self-criticism, body image and discrimination at baseline and NSSI engagement at 6 months will be examined. If factors such as self-criticism, body image, and discrimination predict NSSI engagement, then it is possible that higher levels of these variables in SGMs may predispose them toward NSSI.