Citation

Denton EG, Álvarez K. JAMA Netw. Open 2024; 7(6): e2415406.

Copyright

(Copyright © 2024, American Medical Association)

DOI

10.1001/jamanetworkopen.2024.15406

PMID

38874928

Abstract

Since the early 2000s, research has advanced observation and conceptual distinction of nonsuicidal self-injury (NSSI), which is a strong predictor of later death by suicide. Now a Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (Text Revision) category, detection of NSSI, has implications for preventing and intervening on suicidal behaviors. Elsewhere in JAMA Network Open, Moloney et al1 define NSSI as "deliberate self-inflicted destruction of body tissue that results in immediate damage, for purposes not culturally sanctioned and without suicidal intent." Findings summarize a pooled NSSI prevalence of 17.7% (21.4% among female adolescents and 13.7% among male adolescents) for adolescents aged 10 to 19 years and from 17 different countries in North America, Australia, Europe, and Asia. The main findings replicate previous systematic reviews and global meta-analyses that similarly conclude that adolescent NSSI prevalence ranges between 11.5% and 33.8%2: Gillies et al3 report 16.9%, Swannell et al4 report 17.2%, and Muehlenkamp et al5 report 18.0%. The present study1 advances the literature in several ways: (1) replicating gender differences--female adolescents being at higher risk for NSSI compared with male adolescents (21.4% vs 13.7%),3 (2) reporting relatively higher NSSI prevalence in Asia (among male adolescents) relative to North America2 and Europe; and (3) framing the scientific narrative to address developmentally informed public health prevention and intervention. We focus the remainder of our commentary on the latter.

In the past 2 decades, media exposure has become a part of everyday life and even more so a developmentally normative part of life for adolescents. Media and social media have also exponentiated opportunity for shared exposures to self-harm imagery worldwide. Moloney et al1 allude to mitigating NSSI risk across cultures and regional boundaries by managing the portrayal of NSSI in the media and preventing consequences of contagion. They also posit that higher rates of self-harm may be linked to being exposed to self-harm imagery involving women more often than men. Indeed, in a systematic review and meta-analysis, Nesi and colleagues6 found associations between several social media-related exposures and self-injurious thoughts and behaviors (SITBs), including NSSI; these included cyberbullying, social media use related to SITBs, and problematic social media use. ...

Language: en

Keywords

Humans; Female; Male; Adolescent; Prevalence; *Global Health/statistics & numerical data; *Self-Injurious Behavior/epidemiology/psychology