Reinhardt Melinda, Rice Kenneth G, Cho Hunggu, Horváth Zsolt
Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
14th District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary.
BMC Psychiatry. 2025 Jul 1;25(1):601. doi: 10.1186/s12888-025-07045-2.
An important indicator of self-harm severity is the co-occurrence of different nonsuicidal self-injurious (NSSI) behaviors. However, there is little research on how different self-injurious behaviors (e.g., cutting, biting, burning, carving) are related. In contrast to person-centred approaches, variable-centred network analysis helps to identify the most meaningful associations between different forms of NSSI behavior, thus allowing the identification of structural patterns in different NSSI methods. Based on network analysis, it will be possible to examine which NSSI methods are the most central and which are most closely linked to other methods.
We used network analysis to investigate interconnections between 12 different self-harm methods. The Inventory of Statements About Self-Injury [24] was utilized to assess the types and frequency of NSSI in a community adult sample.
More than one-third (39.7%; n = 744) of 1873 adults reported at least one episode of NSSI in their lifetime. Most (77%) of those engaged in NSSI used more than one NSSI method. The most frequently used NSSI methods were hitting self, interfering with wound healing, pinching, biting, and severe scratching. In the NSSI methods network analysis, severe scratching, cutting, and pinching had the highest rates of interrelationship with other NSSI behaviors. Moreover, the interconnectedness of certain specific NSSI-methods (i.e., cutting with burning and carving; severe scratching with pinching, biting and hitting self) have a greater risk of co-occurrence (versatility).
Although different NSSI methods occurred as distinct entities, some play a more central role in the network. Our results suggest that the NSSI methods identified as central should be given more attention in clinical settings as these behaviors may indicate the severity of the condition. Specifically, when assessing and treating those who engage in self-harm, clinicians may find it useful to create a detailed map of the person-specific NSSI-methods to inform risk assessment and treatment.
自我伤害严重程度的一个重要指标是不同的非自杀性自我伤害（NSSI）行为同时出现。然而，关于不同的自我伤害行为（如割伤、咬伤、烧伤、刻划）之间如何关联的研究很少。与以人为主的方法不同，以变量为中心的网络分析有助于识别不同形式的NSSI行为之间最有意义的关联，从而能够识别不同NSSI方法中的结构模式。基于网络分析，将有可能研究哪些NSSI方法是最核心的，以及哪些与其他方法联系最紧密。
我们使用网络分析来研究12种不同自我伤害方法之间的相互联系。利用自我伤害陈述量表[24]对社区成年样本中的NSSI类型和频率进行评估。
1873名成年人中，超过三分之一（39.7%；n = 744）报告在其一生中至少有一次NSSI发作。大多数（77%）参与NSSI的人使用了不止一种NSSI方法。最常用的NSSI方法是击打自己、妨碍伤口愈合、捏、咬和严重抓挠。在NSSI方法网络分析中，严重抓挠、割伤和捏与其他NSSI行为的相互关系率最高。此外，某些特定的NSSI方法（即割伤与烧伤和刻划；严重抓挠与捏、咬和击打自己）同时出现（多功能性）的风险更大。
尽管不同的NSSI方法作为不同的实体出现，但有些在网络中发挥着更核心的作用。我们的结果表明，在临床环境中，被确定为核心的NSSI方法应得到更多关注，因为这些行为可能表明病情的严重程度。具体而言，在评估和治疗那些自我伤害的人时，临床医生可能会发现创建一份针对个人的NSSI方法详细地图以指导风险评估和治疗是有用的。
