Non-suicidal self-injury (NSSI) among emerging adults - Sub-group profiles and their clinical relevance

Sep 21, 2026

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High prevalence and pattern variability in non-suicidal self-injury (NSSI) among emerging adults require identifying distinct self-injury sub-groups. This study aims to derive homogeneous NSSI profiles in a community-based sample of emerging adults. A cross-sectional survey of 1,574 participants (18–25) used multi-stage sampling, followed by k-medoid cluster analysis on 353 self-injurers. Five clusters were found and differed by gender, severity, frequency, diversification, onset age, and NSSI functions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

NSSI distinctiveness and prevalence

Prior links between NSSI features and psychopathology

Need for sub-group identification

Psychiatry Research 300 (2021) 113877 Contents lists available at ScienceDirect Psychiatry Research journal [homepage:](homepage: www.elsevier.com/locate/psychres)[ www.elsevier.com/locate/psychres](homepage: www.elsevier.com/locate/psychres) | Non-suicidal self-injury (NSSI) among emerging adults: Sub-group profiles and their clinical relevance
Nupur Singhala, Poornima Bhola a, *, Venkata Senthil Kumar Reddib, Binukumar Bhaskarapillai c, Smitha Joseph d
a Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India b Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India c Department of Biostatistics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India d Department of Biostatistics, St. John’s National Academy of Health Sciences, Bengaluru, India | | | | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | Keywords:
Non-suicidal self-injury Emerging adults
Sub-groups Cluster analysis Prevalence
Emotion regulation, Diversification
Severity Frequency Diversification NSSI onset Experimental NSSI Male NSSI Female NSSI Multimethod NSSI
Indian young adults K-medoid partitioning | | Background: High prevalence rates and variations in patterns of non-suicidal self-injury (NSSI) necessitate the identification of profiles of distinct sub-groups of self-injurers. Aim: To identify homogenous sub-groups of NSSI in a community-based sample of emerging adults. Method: Data was collected using a cross-sectional survey design from a sample of 1,574 emerging adults aged 18-25 years, via multi-stage sampling. Cluster analysis using the k-medoid partitioning method was used to identify homogenous sub-groups in the sub-sample of 353 selfinjurers. Follow-up analysis was conducted on measures of self-criticism, brooding-rumination, emotion regulation difficulties, experiential avoidance, psychological distress, attachment style and perceived social support to explore the validity of the clusters. Results: Five homogenous sub-groups were identified; Multimethod, Exclusively Severe, Female Minor, Male Minor and Experimental NSSI. The sub-groups showed distinct patterns of NSSI behaviour, differing on the basis of gender, severity, frequency, diversification, age of onset and functions of NSSI. The Multimethod and Exclusively severe NSSI group members showed significantly higher psychological distress and emotion regulation difficulties. Conclusion: Identification of distinct sub-groups highlights the heterogeneity in NSSI behaviour. This has implications for comprehensive assessment frameworks, early identification of more vulnerable groups of self-injurers, and planning of targeted interventions. | 1. Introduction Research in the past two decades has demonstrated the uniqueness of non-suicidal self-injury (NSSI) from other forms of suicidal behaviours, placing it in the DSM V as a condition requiring further study (American Psychiatric Association, 2013). Emergent data underscores high NSSI rates among emerging adults in the community (pooled prevalence: 18.5 - 24.0%; Swannell, et al., 2014), necessitating identification of indicators of higher vulnerability. Existing literature indicates that certain NSSI characteristics, such as severity and diversification ofthe NSSI methods used (Nock, et al., 2006; Whitlock et al., 2008, 2011) and frequency (Andover & Gibb, 2010; You, et al., 2011), are associated with greater psychopathology and risk for suicidal attempts. Similarly, age of onset of NSSI has been found associated with NSSI frequency, severity and more NSSI related hospital visits (Ammerman, et al., 2018; Bhola et al., 2017; Somer et al., 2015). The gendered manifestation of NSSI is seen in its association with NSSI frequency, severity and type of NSSI method used (Bresin & Schoenleber, 2015). These findings indicate characteristics of NSSI that may he

FAQs

What is the main objective of the study?

To identify homogeneous sub-groups of non-suicidal self-injury (NSSI) among emerging adults and examine their clinical relevance.

How were the NSSI sub-groups identified?

Using a cross-sectional survey and k-medoid partitioning cluster analysis on a sub-sample of self-injurers (n=353).

What did the study find regarding psychological outcomes across sub-groups?

The Multimethod and Exclusively Severe clusters showed significantly higher psychological distress and emotion regulation difficulties.

Sep 21, 2026

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