Category: Suicide and Self-Injury
Nonsuicidal self-injury (NSSI) is a prevalent, highly maladaptive behavior that frequently co-occurs with other forms of self-injury behavior that are more indirect, such as disordered eating (DE; Cucchi et al., 2016; Swannell et al., 2014). Understanding relations among these related psychopathologies is important, as they suggest the possibility of common risk factors. Although there is a growing research base on NSSI among high income countries (HIC) such as the United States, research in low and middle-income countries (LMIC) where the majority of the world’s population lives is limited. The generalizability of findings from HIC to LMIC is unclear, given that social processes such as peer modeling may be serve as risk factors for self-injury behavior and the substantial cultural differences between HIC and LMIC.
The purpose of the present study was to examine longitudinal relations between NSSI, DE, and general psychopathology among high students in the Asian LMIC of Vietnam. Participants included 1,439 adolescents (50.4% female, M age = 15.81, SD = 0.71) from Danang and Ho Chi Minh City, Vietnam. Participants completed self-report measures of NSSI and DE at baseline as well as the Youth Self-Report (YSR; Achenbach, 2009) to assess general psychopathology, with 557 reassessed three months later. Because of potential socio-cultural influences on gender roles, we tested separate path models for males and females, assessing the extent to which each behavior demonstrated stability and whether general psychopathology predicted change in NSSI and DE at Time 2. Among males, YSR at Time 1 did not significantly predict either change in NSSI or DE behavior at Time 2. DE at Time 1 significantly predicted both DE and change in NSSI at Time 2. Baseline NSSI did not predict either itself or DE at Time 2 after controlling for all measures at Time 1. In females, YSR at Time 1 predicted itself and change in NSSI and DE at Time 2. Baseline NSSI and DE in females predicted themselves but not the other behavior at Time 2 (after controlling for all measures at Time 1).
As in research from HIC, results in this sample of Vietnamese high school students suggest some co-occurrence among self-harm behaviors and general psychopathology. However, results also suggest potentially distinct pathways from general psychopathology to self-harm behaviors among males versus females. Results and implications are discussed.
Rachel Zelkowitz– PhD candidate, Vanderbilt University, Nashville, Tennessee
Anna Skubel– Vanderbilt University
Andrew Porter– Vanderbilt University
David Cole– Professor, Vanderbilt University
Lam T. Trung– Danang Psychiatric Hospital, Vietnam
Anna Lau– Professor, University of California, Los Angeles
Victoria Ngo– RAND Corporation
Bahr Weiss– Vanderbilt University