Non-suicidal self-injury among psychiatric outpatient adolescent offspring of Croatian posttraumatic stress disorder male war veterans: Prevalence and psychosocial correlates

Background: The children of male veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk of emotional and behavioral problems. However, no studies have examined non-suicidal self-injury (NSSI) in this population of youth. Aims: To determine the prevalence and psychosocial correlates of lifetime NSSI in a sample of psychiatric outpatient adolescent offspring of Croatian PTSD male veterans. Method: Consecutive outpatient adolescent offspring of Croatian male PTSD veterans, aged 12 to 18 years, were assessed on the Deliberate Self Harm Inventory, the Youth Self-Report, the Family Assessment Device, the Parental Bonding Instrument and the Demographics Questionnaire. Results: Of the whole sample, 52.7% of adolescents reported NSSI at least once during their lifetime. Lifetime NSSI was significantly associated with internalizing symptoms (adjusted odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.04-4.42, p = .040), poor family functioning (adjusted OR = 6.54; 95% CI: 2.02-21.22, p = .002), lower maternal and paternal care (adjusted OR = 0.47; 95% CI: 0.40-0.56, p = .000 and adjusted OR = 0.82; 95% CI: 0.73-0.91, p = .000, respectively) and higher paternal control (adjusted OR = 1.84; 95% CI: 1.59-2.14, p = .000) in multivariate analysis. No association was found between lifetime NSSI and any of the socio-demographic variables. Conclusion: NSSI is a significant clinical problem in outpatient adolescent offspring of PTSD male veterans, which may be influenced by clinical and family factors. Interventions aimed at reducing internalizing symptoms and improving family functioning and parental behaviors are needed in the treatment of adolescent offspring of male PTSD veterans engaging in NSSI.