Citation

Cramer RJ, Cacace S, Coffey A, Hazlett E, Kaniuka AR, Robertson R, Peiper LJ. Int. J. Law Psychiatry 2024; 93: e101967.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.ijlp.2024.101967

PMID

38401176

Abstract

Self-directed violence (SDV), including both suicide and non-suicidal self-injury, represents a major challenge for carceral systems. Persistent self-injury (PSI) is an understudied SDV subtype, especially within the carceral context. The present study addressed three research questions: (a) do naturally occurring SDV subgroups occur within a carceral population (e.g., PSI versus other classes); (b) how SDV groups may be differentiated by verbal or behavioral SDV; and (c) whether demographic, mental health, and incarceration-related factors are associated with SDV subgroups. We conducted a secondary analysis of existing data from a statewide carceral electronic medical record (N = 3527). Latent class analysis supports two SDV subtypes: episodic and persistent self-injury. The PSI class was characterized by significantly greater verbal expressions and behavioral acts of SDV compared to the episodic group. Correlates of the PSI subtype included older age, male sex, prior SDV, and lower depressive symptoms.

FINDINGS are discussed with respect to the proposed Diagnostic and Statistical Manual self-injury focused disorder, influential factors on SDV in carceral settings, and recommendations for future research and practice.

Language: en

Keywords

Incarceration; Latent class analysis; Persistent self-injury; Self-directed violence; Suicide