Self-injurious behavior in a community sample of young women: Relationship with childhood abuse and other types of self-damaging behaviors

Objective: The prevalence of self-injurious behavior (SIB) in the general population is unknown. The present study aims to assess the prevalence and dimensionality of a large spectrum of SIBs in a community sample of young women. Method: A cohort of female subjects aged 18 through 25 years resident in 2 areas of a large city was involved in the study, which was conducted from December 1996 to August 1998. Subjects (N=934) underwent a clinical interview to assess the presence of SIBs, childhood sexual and physical abuse, suicidality, use of illicit drugs, alcohol abuse, and DSM-IV lifetime eating disorder diagnosis. Results: About 24% of the sample reported some type of SIB. The factor analysis revealed that the different types of SIBs tend to group into 4 dimensions: 2 characterized by impulsive features and the other 2 by compulsive features. Body image disturbance (p<.01), emotional distress (p<.001), alcohol/substance misuse (p<.05), and suicide attempts (p<.01) were significantly associated with both compulsive and impulsive SIBs. In addition, the presence of impulsive SIBs was significantly predicted by a lower level of education (p<.05), lifetime eating disorders (p<.01), and childhood abuse (p<.05), whereas skin picking/self-biting was predicted by childhood sexual molestation (p<.04) and childhood rape (p<.005). Conclusion: Self-injurious behaviors are common among young women. There is a significant association between SIBs and other forms of direct and indirect self-damaging behaviors, including alcohol abuse, use of illicit substances, suicidality, and eating disorders. Further research is needed to better understand the nosology of this spectrum of behaviors.