Closing in on Crisis: Informing Clinical Practice Regarding Nonsuicidal Self-Injury in Youth [2017]

Nonsuicidal self-injury (NSSI) in youth is a major public health concern. A retrospective chart review was conducted within a hospital system to examine (a) youth self-reports of reasons for engaging in NSSI and (b) additional contextual circumstances that may contribute to youth NSSI. Detailed history, physical examination, and treatment/discharge data were extracted by thoroughly reviewing all electronic documents in each medical record. The final sample (N = 135) were predominantly female (71.1%), and well over half (63.8%) reported Medicaid or uninsured status. Qualitative content analysis of youth self-reports and hospital progress notes showed that NSSI served as an emotional and functional coping mechanism. Five primary themes characterized the contextual influences on youth engaging in NSSI: (1) Personal Emotions, (2) Trauma, (3) Relationship Quality, (4) Sense of Loss, and (5) Risk Behaviors. Practical clinical practice suggestions for working with youth are discussed using these themes as a template for assessing risk and protective factors.

Cara C. Young, PhD, RN, FNP-C, Amanda J. Simonton, BSN, RN, Stephanie Key, RN, MSN, CPNP-PC, Amanda N. Barczyk, PhD, MSW, Karla A. Lawson, PhD, MPH

Journal of Pediatric Health Care, May–June, 2017, Volume 31, Issue 3