Department of Psychiatry, University of Cambridge, UK; The Mental Health Foundation, London, UK.
Department of Psychiatry, Faculty of Medicine, University of Southampton, UK and Southern Health NHS Foundation Trust, Southampton, UK.
J Affect Disord. 2024 Dec 15;367:496-506. doi: 10.1016/j.jad.2024.08.224. Epub 2024 Sep 2.
Non-suicidal self-injury (NSSI) can be motivated by a broad range of functions and many individuals report multiple reasons for self-injuring. Most NSSI research has involved predominantly female samples and few studies have examined gender similarities and differences in function endorsement.
We characterise the prevalence and versatility of NSSI functions within a gender-diverse online sample of cisgender women (cis-women; n = 280), cisgender men (cis-men; n = 176), and transgender, non-binary, and other gender non-conforming young adults (TGNC; n = 80) age 18-30 (M = 23.73, SD = 3.55). The Ottawa Self-Injury Inventory (OSI-F) assessed 24 intrapersonal and social functions across nine domains: affect regulation, self-punishment, anti-dissociation, anti-suicide, sensation seeking, sexuality, interpersonal influence, and body image.
TGNC participants and cis-women were significantly more likely to report intrapersonally motivated NSSI and greater function versatility than cis-men. Low mood, emotional distress, suicidality, and trauma symptomology appeared to contribute to gender differences in function endorsement. Gender similarities also emerged; across groups, intrapersonal functions were substantially more common than social functions, and the most endorsed domains were affect regulation and self-punishment. No domains were gender specific.
The OSI-F was developed from majority female samples and may not adequately capture the experiences of other gender groups.
Interventions which reduce distress and strengthen emotion regulation are likely to benefit individuals who self-injure regardless of gender. However, most individuals report multiple NSSI functions and person-centred interventions which address this complexity are needed. Future research should develop gender-informed treatment models which consider the unique experiences of TGNC individuals and cis-men who self-injure.
非自杀性自伤（NSSI）的动机可能多种多样，许多人报告了多种自伤的原因。大多数 NSSI 研究都涉及主要为女性的样本，很少有研究检查性别在功能认同方面的相似性和差异。
我们在一个跨性别、非二元和其他性别不符合传统观念的年轻人（TGNC；n=80）的性别多样化在线样本中，描述了 NSSI 功能的普遍性和多样性，这些人年龄在 18 至 30 岁之间（M=23.73，SD=3.55）。渥太华自伤清单（OSI-F）评估了 24 种内在和社会功能，涵盖九个领域：情绪调节、自我惩罚、反分离、反自杀、寻求刺激、性、人际影响和身体形象。
TGNC 参与者和 cis-women 比 cis-men 更有可能报告内在动机的 NSSI 和更多样化的功能。情绪低落、情绪困扰、自杀意念和创伤症状似乎导致了功能认同方面的性别差异。性别相似性也出现了；在所有群体中，内在功能比社会功能更常见，最被认可的领域是情绪调节和自我惩罚。没有特定于性别的领域。
OSI-F 是从多数为女性的样本中开发出来的，可能无法充分捕捉其他性别群体的经验。
减少痛苦和增强情绪调节的干预措施可能会使那些有自伤行为的人受益，无论其性别如何。然而，大多数人报告了多种 NSSI 功能，需要针对这种复杂性的以个人为中心的干预措施。未来的研究应该开发性别敏感的治疗模式，考虑到 TGNC 个体和 cis-men 的独特经历。
