Nonsuicidal self-injury among adolescents and young adults with prolonged exposure to violence: The effect of post-traumatic stress symptoms.

Less is known about nonsuicidal self-injury (NSSI) among adolescents and young adults living in areas under prolonged political violence. This study aims to explore the frequencies of NSSI as well as the severity of post-traumatic stress symptoms (PTSS), depression, anxiety, and sleep problems among 889 Palestinian adolescents and young adults. The participants completed self-report questionnaires assessing NSSI, PTSS, depression, anxiety symptoms, and sleep difficulties. The results found that 13.8% of the total sample are frequently engaging in some form of NSSI behavior. Moreover, 43.1% exhibited severe symptoms of PTSD, and almost one-third of the sample reported severe symptoms of depression (30.1%); more than two-thirds of the sample (68.4%) experience sleep difficulties. Those who engage in NSSI were found to be at higher risk for sleep problems, depression, and PTSS. Avoidance/numbing, as well as hyperarousal symptoms clusters of PTSS, were significantly associated with NSSI above and beyond depressive symptoms. These results suggest that NSSI is frequently a sequelae of prolonged exposure to trauma and violence, and highlight the importance of routine assessment of this behavior. It is crucial to be familiar with the association between PTSS, sleep difficulties, and NSSI in a clinical setting to implement programs focusing on preventing these domains.