Association of Non-Suicidal Self-Harm with Anxiety, Depression and Aggressive Behavior in Young Men of Military Age

Background: suicidal behavior, intentional self-harm and non-suicidal self-harm are important precursors of suicide in children and adolescents. The objective: to determine the prevalence and structure of non-suicidal self-harm, as well as the relationship of non-suicidal self-harming behavior with aggression, anxiety and depression in a non-clinical group of young men of military age. Participants and methods: the object of the study was 507 young men (from 18 to 27 years old). The average age of the examined was 19.32 years (± 2.35). Assessment of non-suicidal self-harm was carried out using a clinical interview and the scale of self-harming behavior (Polskaya N.A., 2014). The analysis of patterns of aggressive behavior was carried out with the Buss-Perry Aggression Questionnaire (BPAQ) to identify the propensity to aggression, the assessment of anxiety and depression level was assessed on Beck Anxiety and Depression Scales (BAI; BDI). Results: the study showed a high prevalence of non-suicidal selfharm in the non-clinical population of young people (33.9%). Instrumental self-harm was committed at least once in a lifetime by 14.7% of the surveyed, somatic — 19.2%. The most common acts of instrumental self-harm are blows with a fist, foot, head or body body on hard surfaces and cuts with cutting objects. From somatic — biting nails and lips, biting cheeks and tongue, combing the skin and creating obstacles to wound healing were the most frequent. As a result of the correlation analysis of the links of acts of self-harm with the domains of the scale of propensity to aggression from instrumental self-harm, a significant positive correlation was found in relation to self-burns. Punching your body and pulling out your hair turned out to be associated with all domains of the aggression scale. Self-harming was accompanied by depressive symptoms. Symptoms of anxiety correlate with somatic self-harm — punching your body, scratching your skin and biting your cheeks or tongue. Conclusion: non-suicidal self-harm showed positive correlations with manifestations of aggression, anxiety and depression. Effective and evidence-based prevention programs can be implemented at the population, subpopulation and individual levels to timely identify self-harming behavior. At the stage of psychiatric examination of young people, it is advisable to include in the complex of psychodiagnostic methods scales aimed at identifying self-harm, anxiety, depression and aggressive behavior.

1. Suicide worldwide in 2019: global health estimates. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

2. Aggarwal S, Patton G, Reavley N, Sreenivasan SA, Berk M. Youth self-harm in low- and middle-income countries: Systematic review of the risk and protective factors. Int J Soc Psychiatry. 2017;63(4):359-375. doi: 10.1177/0020764017700175

3. Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, Tan W, Ho CS, Ho RC. Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(22):4581. doi: 10.3390/ijerph16224581

4. Wilkinson P, Kelvin R, Roberts C, Dubicka B, Goodyer I. Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Am J Psychiatry. 2011;168(5):495-501. doi: 10.1176/appi.ajp.2010.10050718

5. Evseev VD, Peshkovskaya AG, Matsuta VV, Mandel AI. Non-Suicidal SelfInjuries (NSSI) and online Social Networks. Academic Journal of West Siberia. 2020;16(3):38-40. (In Russ.).

6. Evseev VD, Peshkovskaya AG, Matsuta VV, Mandel AI, Bokhan NA. Interconnection of digital markers of online activity and socio-demographic characteristics of young males with non-suicidal forms of selfharming behaviour. Suicidology. 2020;11(3):72-83. (In Russ.). doi: 10.32878/suiciderus.20-11-03(40)-72-83

7. Evseev VD, Peshkovskaya AG, Bokhan NA, Mandel AI. A screening study of non-suicidal forms self-injuri ous behavior in persons of draft age. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2021;121(8):54-60. (In Russ.). doi: 10.17116/jnevro202112108154

8. Lyubov EB, Zotov PB. Adolescents non-suicidal self-injury: general and particular. Part I. Suicidology. 2020;11(3):44-71. (In Russ.). doi: 10.32878/suiciderus.20-11-03(40)-44-71

9. Bohan NA, Evseev VD, Mandel AI. Structure and prevalence of mental and behavioral disorders in persons of military age in the Tomsk region in 2016-2018. Siberian Herald of Psychiatry and Addiction Psychiatry. 2019;4(105):26-33. (In Russ.). doi: 10.26617/1810-3111-2019-4(105)-26-33

10. Buelens T, Luyckx K, Kiekens G, Gandhi A, Muehlenkamp JJ, Claes L. Investigating the DSM-5 criteria for non-suicidal self-injury disorder in a community sample of adolescents. J Affect Disord. 2020;260:314-322. doi: 10.1016/j.jad.2019.09.009 Epub 2019 Sep 3. PMID: 31521868

11. Crowe M. From expression to symptom to disorder: the psychiatric evolution of self-harm in the DSM. J Psychiatr Ment Health Nurs. 2014;21:857-858. doi: 10.1111/jpm.12183

12. Liu X., Liu ZZ, Jia CX. Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors. Soc Psychiatry Psychiatr Epidemiol. 2021;56(11):1979-1992. doi: 10.1007/s00127-021-02085-x

13. Gámez-Guadix M, Mateos E, Wachs S, Blanco M. SelfHarm on the Internet Among Adolescents: Prevalence and Association With Depression, Anxiety, Family Cohesion, and Social Resources. Psicothema. 2022;34(2):233-239. doi: 10.7334/psicothema2021.328 PMID: 35485536

14. Hu Z, Yu H, Zou J, Zhang Y, Lu Z, Hu M. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury. Brain Behav. 2021;11(12):e2419. doi: 10.1002/brb3.2419

15. Kuznetsova SO, Takmakova MV. Personal traits of young men with self-injurious behavior and with subclinical depression. Vestnik Permskogo universiteta. Filosofia. Psihologia. Sociologia/Perm university herald. Philosophy. Psychology. Sociology. 2021;3:454-465. (In Russ.). doi: 10.17072/20787898/2021-3-454-465

16. Lee JY, Kim H, Kim SY, Kim JM, Shin IS, Kim SW. Non-suicidal self-injury is associated with psychotic like experiences, depression, and bullying in Korean adolescents. Early Interv Psychiatry. 2021;15(6):1696-1704. doi: 10.1111/eip.13115

17. Richmond-Rakerd LS, Caspi A, Arseneault L, Baldwin JR, Danese A, Houts RM, Matthews T, Wertz J, Moffitt TE. Adolescents Who Self-Harm and Commit Violent Crime: Testing Early-Life Predictors of Dual Harm in a Longitudinal Cohort Study. Am J Psychiatry. 2019;176(3):186-195. doi: 10.1176/appi.ajp.2018.18060740

18. Polskaya NA. Causes of self-harm in youth (based on the self-report scale). Counseling psychology and psychotherapy. 2014;2(81):140-152. (In Russ.).

19. Liu X, Liu ZZ, Jia CX. Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors. Soc Psychiatry Psychiatr Epidemiol. 2021;56(11):1979-1992. doi: 10.1007/s00127-021-02085-x Epub 2021 Apr 16. PMID: 33861354

20. Zubrick SR, Hafekost J, Johnson SE, Sawyer MG, Patton G, Lawrence D. The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12-17. J Affect Disord. 2017;220:49-56. doi: 10.1016/j.jad.2017.05.050