1. Cluster Analysis of Functions of NSSI in a Sample of New Zealand Community Adolescents Jessica Garisch, Marc Stewart Wilson, Robyn Langlands, Angelique O’Connell, Lynne Russell, Emma-Jayne Brown & Tahlia Kingi © Youth Wellbeing Study

2. Overview Youth Wellbeing Study http://www.victoria.ac.nz/psyc/research/youth-and-wellbeing-study Longitudinal survey design Self-reported functions of NSSI – Cluster analysis – How functions relate to psychosocial wellbeing Preliminary longitudinal information

3. Youth Wellbeing Study 3+ year project on NSSI among New Zealand adolescents and rangatahi. Longitudinal survey – 16 schools in wider Wellington region. – Over 1000 participants – Resource development for the community

4. Functions of NSSI Assessed using the Inventory of Statements About Self-Injury (ISAS; Klonsky & Olino, 2008). Of over 1000 participants, 206 hx NSSI – Mean age = 13.48 – Sex:male: 42 Female : 148 Transgender: 1

5. Functions of NSSI: Cluster analysis Cluster analysis of subscales of the ISAS Four clusters identified – Two interpersonal Peer bonding, interpersonal influence and revenge (other - focused) Interpersonal boundaries, toughness, autonomy, sensations seeking and self-care (self-focused) – Two intrapersonal Anti-dissociation, anti-suicide, and marking distress (disconnection) Affect regulation and self-punishment

6. YWS Wave 1: Four Clusters (Functions assessed using ISAS (Klonsky & Olino, 2008) Interpersonal: Other-focused Interpersonal: self-focused Intrapersonal: Disconnection Intrapersonal: Affect & Punish

7. Clustering participants: pattern of endorsement Four clusters – Low level endorsement of all functions (N=81) (most well adjusted on measures of wellbeing) – Low levels of endorsement of all but affect regulation and self-punishment (N=75) – Strongest endorsement of interpersonal functions (w/ relatively strong endorsement of intrapersonal functions) (N=13) (second poorest on wellbeing measures) – Strongest endorsement of both intrapersonal functions, but low endorsement of interpersonal functions (N=25) (poorest on wellbeing measures)

8. Variation in psychosocial wellbeing Clusters significantly differ on.. – Suicidality – Depression – Anxiety – Self-esteem – Resilience – Emotion regulation – Parental attachment (no difference for peer attachment) – With ‘Intrapersonal’ cluster fairing the worst... * Note small sample size in cluster groupings – data is exploratory

9. Suicidality Affect Regulation & Self-punishment Low on all Highest on Intrapersonal Highest on Interpersonal Suicidality Level of Function endorsement Cluster: Participant groupingsCluster: Subscale groupings r =.48*** r =.58*** r =.20** r =.17, ns

10. Depression Affect regulation & Self-punishment Low on all Highest on Intrapersonal Highest on Interpersonal Depression Level of Function endorsement Cluster: Participant groupingsCluster: Subscale groupings r =.54*** r =.59*** r =.32*** r =.11, ns

11. Anxiety Affect regulation & Self-Punishment Low on all Highest on Intrapersonal Highest on Interpersonal Cluster: Participant groupings Cluster: Subscale groupings Anxiety Level of Function endorsement r =.38*** r =.44*** r =.28*** r =.16*

12. Self-esteem Affect regulation & self-punishment Low on all Highest on Intrapersonal Highest on Interpersonal Self-esteem Level of Function endorsement Cluster: Participant groupingsCluster: Subscale groupings r = -.60*** r = -.47*** r = -.21** r =.05, ns

13. Resilience Affect regulation & Self-punishment Low on all Highest on Intrapersonal Highest on Interpersonal Level of Function endorsement Resilience Cluster: Participant groupingsCluster: Subscale groupings r = -.25** r = -.22** r = -.11, ns r =.03, ns

14. Emotion Regulation Affect Regulation & Self-Punishment Low on all Highest on Intrapersonal Highest on Interpersonal Level of Function endorsement Emotion Regulation Cluster: Participant groupingsCluster: Subscale groupings r = -.35*** r = -.36*** r = -.25** r =-.04, ns

15. Attachments to Parents/ Whānau Affect Regulation & Self-Punishment Low on all Highest on Intrapersonal Highest on Interpersonal Attachments to Parents/ Whānau Level of Function endorsement Cluster: Participant groupingsCluster: Subscale groupings r = -.35*** r = -.32*** r = -.13. ns r =.13, ns

16. Preliminary longitudinal findings Is NSSI at T1 predictive of later NSSI? At both T1 and T2 Ps asked whether they have a hx NSSI or have thought about engaging in NSSI (ever), and (at T2) about NSSI between time points. – Ps who had never thought about NSSI at T1 were less likely than expected by chance to have engaged in NSSI by T2 – If Ps had thought about NSSI at T1 they were no more or less likely to have engaged in NSSI between T1 and T2 than expected by chance – If Ps indicated a hx of NSSI at T1 they were more likely than chance to have engaged in NSSI btw T1 and T2 – T1 NSSI + Suicidality (ever) predicted NSSI behaviour at T2 (6 – 14 months later). Results suggest NSSI (F (1, 289) = 47.65, p<.001) is a stronger predictor of future NSSI behaviour than suicidality (F(1, 282) = 24.15, p<.001).

17. ISAS subscales: T1 + T2 scores r? – Subscales correlated over time (possible evidence of some stability of this function over time): Affect regulation, interpersonal boundaries, Self-punishment, Self-care, Anti- suicide, Sensation seeking, Peer bonding and Interpersonal influence. – Not significantly correlated T1 + T2 scores: Anti-dissociation, Toughness, Marking distress, Revenge and Autonomy – Are interpersonal motivations more transitory than intrapersonal ones? (most intrapersonal subscales T1 + T2 scores were correlated, whilst several of the interpersonal subscales were not) – Please note that the sample size was limited.

18. Implications (for clinical practice)... o Thoughts of engaging in NSSI do not necessarily indicate increased risk of this behaviour occurring. o Heterogeneity in functions – wide range between and within individual cases. o Functions are not necessarily stable over time o Intrapersonal functions may be more likely to persist over time than interpersonal functions? o Intrapersonal functions more strongly associated with suicidality (and other factors related to poor wellbeing) o Different risk and protective factors for NSSI based on participants’ functions?? o Failure to have a clear function (i.e. low endorsement of any function for NSSI) may be a protective factor

19. Acknowledgements Participating Wellington secondary schools and students Health Research Council of New Zealand Thanks for listening