A Psychosocial Approach to Predicting Self-Harm in Heterogeneous Populations

Previous studies have demonstrated relationships between deliberate self-harm and psychological distress and social functioning (for a review see Nock, 2010). However, few studies have examined psychological distress and social functioning at the same time in order to compare these predictors of deliberate self-harm. Using a more comprehensive, psychosocial approach may allow more accurate predictions of deliberate self-harm. Accurate predictions could aid in the intervention and treatment of individuals who engage in deliberate self-harm, regardless of their population; that is, whether they are seeking treatment for symptoms of Borderline Personality Disorder, or if they are a member of the community. In the current study, we used a sample of individuals with Borderline Personality Disorder (N = 60) and a community sample of undergraduate college students (N = 116), all of whom reported engaging in deliberate self-harm at least once in the past year. Participants completed measures of deliberate self-harm (outcome variable), psychological distress (specifically depression, anxiety, obsessive-compulsion, and interpersonal sensitivity; predictor variables), and social functioning (positive support and negative interactions with family members, friends, and a romantic partner; predictor variables). We found that the population (or sample type) was the strongest predictor of deliberate self-harm, with individuals with Borderline Personality Disorder engaging in more deliberate self-harm than students. Additionally, anxiety predicted deliberate self-harm for individuals with Borderline Personality Disorder. No social functioning variables predicted deliberate self-harm. Explanations for findings and treatment implications are discussed. Keywords: self-harm, distress, social support, Borderline Personality Disorder, student health