Retrospective Analysis of Social Factors and Nonsuicidal Self-Injury

Among Young Adults

Nancy L. Heath, Shana Ross, Jessica R. Toste, Alison Charlebois, and Tatiana Nedecheva

McGill University

Retrospective reports of social influences in nonsuicidal self-injury (NSSI) with regard to initiation,
disclosure, methods, and motivations for engaging in the behaviour were examined in 23 (2 male, 21
female) self-injuring university students. Parent and peer social support was compared between the NSSI
group and a comparison group that did not engage in NSSI. Lifetime frequency of NSSI and social
support were evaluated. NSSI behaviours were found to be highly socially influenced in several ways,
with 65% reporting that they talk to their friends about self-injury, 58.8% indicating that a friend had been
the first to engage in self-injury, and 17.4% had self-injured in front of friends. Almost all participants
endorsed emotional motivations for engaging in NSSI (91%); however, social motivations were also
common (65.2%). Social support from peers was less for the NSSI group than the non-NSSI group,
although social support was not found to be related to lifetime frequency of NSSI. The implications for
understanding NSSI as a socially influenced behaviour are discussed.

Keywords: young adults, college, nonsuicidal self-injury, deliberate self-harm, social influence, social
support

Nonsuicidal self-injury (NSSI) is a topic that has been gaining

widespread attention both in the popular culture and media, with a
notable surge of interest in this behaviour over the past 10 to 15
years (Derouin & Bravender, 2004). Self-injury has been refer-
enced in popular songs, television shows, movies, books, and
magazines. There has also been a proliferation of chat rooms and
Internet sites dedicated to the topic (Rodham, Gavin, & Miles,
2007; Whitlock, Powers, & Eckenrode, 2006). As such, greater
focus by the media and the Internet may increase awareness and
subsequent use of NSSI (Whitlock, Powers, et al., 2006). Conse-
quently, it has been posited that NSSI is being viewed as a more
normative and acceptable behaviour within mainstream culture
(Adler & Adler, 2007).

The notion that NSSI may occur in part because of social or

cultural factors is in contrast to earlier theories related to this
behaviour. For decades, self-injury was viewed as occurring pri-
marily among individuals with emotional disturbance, and most of
the research has focused on clinical populations for that reason
(Dulit, Fryer, Leon, Brodsky, & Frances, 1994; Pattison & Kahan,
1983; Simeon et al., 1992; van der Kolk, Perry, & Herman, 1991).
However, within the past decade, there has been a shift in per-
spective as researchers and clinicians began to observe high rates
of NSSI among community samples of youth and young adults.
Prevalence estimates centre around 15%–20% (Heath, Toste,
Nedecheva, & Charlebois, 2008; Laye-Gindhu & Schonert-Reichl,

2005; Ross & Heath, 2002; Whitlock, Eckendrode, & Silverman,
2006), with some studies reporting rates of up to 39% (Gratz,
Conrad, & Roemer, 2002; Lloyd-Richardson, Perrine, Dierker, &
Kelley, 2007). Although emotional dysregulation continues to be
central to most theories of NSSI, the elevated rates being reported
among nonclinical samples suggest that there may be other factors
related to the occurrence of this behaviour. Of particular interest,
researchers have noted that individuals frequently report engaging
in NSSI for both emotional and social reasons (Lloyd-Richardson
et al., 2007; Nock & Prinstein, 2004, 2005). Past research suggests
that dispositional factors, such as poor emotional functioning, can
increase one’s vulnerability for imitation (Berman & Walley,
2003). In extending this hypothesis to NSSI, it may be that indi-
viduals who are most likely to self-injure are those with poor
emotion regulation skills who hear about the behaviour from
outside sources (Nock & Prinstein, 2005). However, there has been
an absence of research investigating the extent to which social
factors may be related to self-injury.

Although little research has assessed social influence related to

NSSI in the community, there is preliminary evidence to suggest
that the role of social factors warrants further examination. A
number of researchers have found that friends’ risk behaviour
(including suicidality and self-injury) is related to adolescents’
own risk behaviour (e.g., Hawton, Haw, Houston, & Townsend,
2002; Prinstein, Boergers, & Spirito, 2001; Yip, Ngan, & Lam,
2002). In addition, it has been reported that those who self-injure
are more likely than their non–self-injuring peers to report having
a friend who also engages in NSSI (e.g., Hawton et al., 2002;
Hodgson, 2004; Nock & Prinstein, 2005). It has been suggested
that friends’ behaviours may increase an adolescent’s access to
self-injury through “priming” or as a means of accomplishing
social contingencies (Nock & Prinstein, 2005; Yip et al., 2002).
Overall, results indicate that individuals who engage in NSSI

Nancy L. Heath, Shana Ross, Jessica R. Toste, Alison Charlebois, and

Tatiana Nedecheva, Department of Educational and Counselling Psycho-
logy, Faculty of Education, McGill University, Montreal, QC, Canada.

Correspondence concerning this article should be addressed to Nancy L.

Heath, Department of Educational and Counselling Psychology, McGill
University, 3700 McTavish Street, Montreal, Quebec, H3A 1Y2, Canada.
E-mail: [e-mail]

Canadian Journal of Behavioural Science

© 2009 Canadian Psychological Association

2009, Vol. 41, No. 3, 180 –186

0008-400X/09/$12.00

DOI: 10.1037/a0015732

180

report a degree of social interaction around the behaviour, which is
surprising as NSSI has often been thought to be a private act.

A second area of research that supports the notion that NSSI

may be socially influenced is the study of contagion effects.
Contagion of self-injury has been investigated in clinical popula-
tions and observed in more normative populations. This phenom-
enon has been defined as two or more acts of self-injury that
involve two or more individuals and that occur on the same day or
consecutive days (Rosen & Walsh, 1989). Episodes of contagion
of self-injury have been documented among psychiatric inpatients
and incarcerated youth (Taiminen, Kallio-Soukainen, Nokso-
Koivisto, Kaljonen, & Helenius, 1998; Walsh & Rosen, 1985). In
these settings, it was found that self-injury occurred in distinct
clusters across participants, but that other behaviours such as
aggression, suicidal talk, and substance abuse did not. Contagion
has also been noted in high school students (Fennig, Carlson, &
Fennig, 1995; Stone, 1998) where an outbreak of NSSI followed
an initial public episode of self-injury. The authors speculated that
contagion might be more frequent in schools than reported, per-
haps because of reluctance to deal with the behaviour openly.
Thus, there is evidence from a variety of settings that social
influences may result in a spread of self-injury.

A final area of research that provides support for the social

element of NSSI is the investigation of the function of self-injury.
Recent literature has suggested that although there is strong sup-
port for the emotion regulation function of NSSI, there is also
support for the social function (Klonsky, 2007; Nock, 2008). The
social function theory of self-injury suggests that NSSI is used to
communicate, influence, or connect with other people. For exam-
ple, in response to questions about what purpose the behaviour
serves for the individual, a number of recent studies have demon-
strated that youth and young adults will respond that it serves a
social function (e.g., Laye-Gindhu & Schonert-Reichl, 2005;
Nock, 2008; Nock & Prinstein, 2004). Specifically, more than 30%
of adolescent self-injurers from a community sample indicated as
a reason for the behaviour, “I wanted other people to see how
desperate I was” (Laye-Gindhu & Schonert-Reichl, 2005), and in
an inpatient adolescent sample, approximately 15% of participants
endorsed social reasons such as “to control a situation” or “to try
to get a reaction from someone” (Nock & Prinstein, 2004). Thus,
social reasons appear to play a small but important part in the
self-reported function of NSSI.

In summary, although it has been clearly demonstrated that there

are social factors related to the occurrence, spreading or increase,
and function of NSSI, this social element of self-injury has not
been fully explored. Nock (2008) presents an elaborated social
theory of NSSI and reviews evidence to suggest that NSSI is
maintained by social reinforcement from peers or family in a
“substantial minority of instances” (p. 159). In addition, it is
argued that NSSI serves as a form of communication to others
when alternative and less extreme forms of communication are
perceived as being ineffective. This elaborated social theory is
premised on the idea that those who engage in NSSI will perceive
themselves as having less family or peer support; as such, the act
of NSSI serves the specific purpose of strengthening affiliations
and a sense of group belonging. This is consistent with the liter-
ature documenting that those who engage in NSSI are more likely
to have difficult family environments (Gratz, 2003; Heath et al.,
2008; Yates, Tracey, & Luthar, 2007), although no one has actu-

ally examined perceptions of family and peer support directly.
Thus, in the present study, we sought to systematically examine
university students’ retrospective reports of NSSI and potential
social influences related to this behaviour. The use of retrospective
reports was necessary to tap the initiation and engagement in NSSI
through the entire span of adolescence.

Research Objectives

The first objective was to investigate reports of social interac-

tions around NSSI. Specifically, information was collected con-
cerning social elements such as initiation of self-injury, ongoing
occurrence, disclosure to others, and shared methods of self-injury
within the peer group. The second objective of the study was to
assess the reported motivations for engaging in NSSI. The third
objective of the study was to compare peer and parent social
support between individuals who do and do not engage in NSSI.
Lastly, the relationship between social support and lifetime fre-
quency of NSSI was examined.

Method

Participants

The participants in this study were recruited as part of a larger

project examining the prevalence and correlates of NSSI in a
university sample of young adults (Heath et al., 2008). From a
sample of 728 first-year undergraduate students (160 men, 568
women) ranging between 18 to 35 years of age (M

⫽ 20.64 years,

SD

⫽ 3.46), 11.68% of students (n ⫽ 85; 15 men, 70 women)

reported that they had engaged in NSSI to deal with stress at least
once in their lifetime.

Of these 85 participants, 23 provided their contact information

for follow-up and agreed to participate in the current study. The
participants in the NSSI group (2 men, 21 women) ranged from 18
to 24 years in age (M

⫽ 20.22 years, SD ⫽ 1.76). From the

remaining participants who had provided their contact information
and indicated that they had never engaged in NSSI, we selected a
comparison group for the purpose of analyses examining between-
groups differences on measures of social support. The comparison
group participants (n

⫽ 23; 3 men, 20 women) were, whenever

possible, matched to the NSSI group on the basis of gender, age
(within 1 year), and program of study.

Measures

How I Deal With Stress (HIDS; Ross & Heath, 2002).

This

questionnaire, designed and reported by Ross and Heath (2002),
was employed as a screening measure. Because of concerns about
suggestibility as found with any screening device measuring self-
injury (Hodgson, 2004) and to reduce possible selection bias in
recruiting students, the scale assessed NSSI by using one question
that was embedded in a coping questionnaire. This 24-item self-
report questionnaire presents a list of strategies generated through
a review of the literature that youth and young adults may use to
cope with stress of other difficulties (Ross, 2004). Using a 4-point
scale, participants indicated how often they employed each strat-
egy (frequently, a few times, once, or never). To assess whether
these 24 items formed a reliable scale, we computed Cronbach’s
alpha. The alpha for this measure was .78, which indicates that the

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SOCIAL FACTORS AND NONSUICIDAL SELF-INJURY

items form a scale that has reasonable internal consistency reli-
ability. In addition, with a large sample of college students, the
HIDS was examined through multidimensional scaling analyses,
which supported the construct validity of the measure and the
delineation of active or passive and adaptive or maladaptive cop-
ing strategies (Toste, Grouzet, Heath, & Naeem, 2006). Further
reliability information is currently being collected with both ado-
lescent and young adult community samples.

Follow-up sections were included for those individuals who

indicated that, when feeling stress, they “talk to someone,” “do
risky things,” or “physically hurt myself on purpose.” These sec-
tions asked students to provide more details about their use of
these strategies. Specifically, for those who indicated that they had
hurt themselves on purpose, they were asked to specify the method
(e.g., cutting, burning), frequency of the behaviour, and their
motivations for engaging in self-injury. The questions used in this
section were based on the Deliberate Self-Harm Inventory (Gratz,
2001), which is a behaviourally based measure of NSSI. Within
this follow-up section, two specific provisions were put in place to
ensure that participants met the criteria for the “nonsuicidal”
classification of NSSI. The first question in this section asked
participants to indicate all of the ways in which they had inten-
tionally hurt themselves without suicidal intent. An additional
question directly tapped suicidal intent, “Did you ever hurt your-
self with the intent to die/kill yourself?” (never, sometimes,
always).

Child and Adolescent Social Support Scale (CASSS; Malecki &

Demaray, 2002).

The CASSS provided a measure of perceived

support received from the participants’ parents and friends during
periods when they were engaging in NSSI. This measure allowed
for the retrospective examination of the support received during
the period of adolescence (Favazza & Conterio, 1988; Pattison &
Kahan, 1983; Suyemoto, 1998). The CASSS consists of five
12-item subscales (Parent, Teacher, Classmate, Close Friend, and
School); however, only the Parent and Close Friend subscales were
used in this study. Each item in the measure is a statement of
emotional, informational, appraisal, or instrumental support. For
each statement, the participants rated how often the item happened
on a 5-point scale from never to always. Each subscale score
ranges from a minimum of 12, indicating no social support, to a
maximum of 72, indicating high social support.

The CASSS has been shown to be a reliable indicator of per-

ceived social support. Internal consistency reliability coefficients
have been reported to be .95 for the total scale and to range from
.89 to .94 on the subscales. Test–retest reliability coefficients were
.70 for the total scale and ranged from .60 to .76 on the subscales
over an 8-week interval (Malecki & Demaray, 2002).

Social influence questions.

The researchers developed ques-

tions to tap social influence. These questions asked about the
participants’ NSSI and others’ involvement in the behaviours,
including the following: How did you first think of the idea? Who
knows about it? Do you have friends who do it? Do they do it in
the same way? Who did it first? Have you done it with them or in
front of them? Have you talked to friends about it and if so, how
often? If someone told you they were going to do it, what did you
do? What was your main reason for doing it? What was the main
reason others you know have done it? Aside from the questions
with a “yes” or “no” response format, each question presented a

series of multiple-choice responses and an “other” choice that
allowed participants to leave an open-ended response.

Procedure

The HIDS screening survey was distributed in first-year under-

graduate courses at a large university in an urban centre. Prior to
completion of the survey, participants provided informed consent
after having the study and potential risks described to them (ver-
bally and in writing). Some deception was employed, in that the
study was presented as focusing on “stress and coping in young
adults.” This was necessary in order to screen effectively for NSSI
and to avoid potential contagion effects. Following completion of
the HIDS, the participants were asked to provide their contact
information if they were interested in participating in a follow-up
study.

Those participants who had provided contact information were

sent an invitation via e-mail to participate in the follow-up study.
Before completing the follow-up, participants were informed in
writing of the voluntary and confidential nature of the study and
were asked to give informed consent. The participants completed
an online survey, including the questionnaires described above. On
completion of the survey, all participants were debriefed and
provided with a list of resources including Web sites, local help
lines, and mental health service contacts.

Results

The overwhelming majority of students (82.5%) reported first

starting NSSI at age 19 or younger, with 60.8% reporting begin-
ning at 16 years or younger. While 8.7% were currently engaging
in self-injury, 38.9% reported having self-injured within the past
year, and 52.1% stated that they had not engaged in NSSI for a
year or more (21.7% more than 1 year, 8.7% 2 years, 13.0%
3 years, and 8.7% 5 years).

Social Influence of NSSI

First, to provide an indication of social learning, we asked the

participants how they first thought of the idea of engaging in NSSI.
Twenty-two percent knew someone else who had engaged in the
behaviour, and 21.6% read about it or heard about it through the
media (e.g., television, movies, or Internet). Thus, 43.6% reported
that their self-injury was learnt socially, whereas 39% did not
know how they first thought of self-injury, and 17.4% gave a
response that indicated that the behaviour was not learnt socially
(e.g., “I just felt like doing it”).

The participants were asked whether anyone else knew that they

had engaged in NSSI, with 86% indicating that someone knew.
Sixty-five percent reported talking to their friends about self-
injury. A follow-up question asked how frequently the participants
talked about the behaviour. Of the total sample, 33.3% reported
talking about it once or twice, 23.8% reported 3 to 10 times, and
9.5% reported talking about self-injury with friends more than 10
times.

Thirty percent of participants indicated that someone had told

them that they were planning to self-injure. Of these 7 participants,
28.6% tried to talk them out of it, 28.6% did not talk about it,
14.2% sympathized with them, and 28.6% both tried to talk them

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HEATH, ROSS, TOSTE, CHARLEBOIS, AND NEDECHEVA

out of it and sympathized with them. Although only 7 participants
had indicated that someone had spoken to them prior to engaging
in self-injury, 74% reported that they had at least one friend who
had engaged in self-injurious behaviour. The participants were
asked what methods of self-injury their friends had engaged in.
Thirty-five percent did not engage in the same method as their
friends, whereas 52% used some of the same methods, and 13%
engaged in the exact same method of self-injury as their friends. Of
the 17 participants in the self-injury group who reported that a
friend had self-injured, the majority (58.8%) reported that their
friend had been the one to first engage in self-injury. To ascertain
how public these behaviours may be, we asked the participants
whether they had engaged in the behaviour in front of friends or
with friends; 17.4% had engaged in self-injury in front of friends,
and 4.3% had engaged in self-injury as a group with their friends.

Motivations for NSSI

The participants responded to several questions designed to tap

their beliefs about underlying motivations for NSSI. The reasons
most often endorsed when describing their own motivations to
engage in self-injury included “to relieve/escape unwanted
thoughts and feelings” (69.6%), “to feel a sense of control”
(56.5%), “to communicate hurting” (47.8%), and “to punish my-
self” (43.5%). Two categories of motivations were examined:
emotional/internal and social/external. Ninety-one percent of par-
ticipants endorsed emotional/internal motivations, such as escape
unwanted thoughts and feelings, gain a sense of control, or feel
alive. Social/external motivations (e.g., feel close to someone, get
attention, to not feel like an outsider) were endorsed by 65.2%.
Fifty-seven percent of participants endorsed reasons that crossed
emotional and social domains, whereas 43% endorsed reasons
within only one domain.

When participants were asked to indicate what they felt were the

main reasons for other people to engage in self-injury, the re-
sponses differed slightly. The most commonly endorsed item was
“to get attention” (66.7%), followed by “to relieve/escape un-
wanted thoughts and feelings” (61.9%), “to communicate hurting”
(52.4%), and “to punish themselves” (47.6%). Ninety-five percent
of participants felt that others’ self-injury had emotional/internal
motivations, and 78.9% endorsed social/external motivations.
Seventy-nine percent of participants endorsed reasons for others
that crossed both emotional and social domains.

Social Support

To examine the differences in social support between those who

self-injure and the comparison group, we performed an analysis of
variance using both subscale scores on the CASSS as dependent
variables. In examining scores on these subscales of the CASSS,
we found a significant difference between the NSSI group (M

⫽

45.70, SD

⫽ 10.11) and the comparison group (M ⫽ 53.35, SD ⫽

10.19) on the Close Friend subscale, F(1, 44)

⫽ 6.538, p ⫽ .014,

d

⫽ ⫺0.75 (moderate effect size). No significant difference was

found on the Parent subscale, F(1, 44)

⫽ .566, p ⫽ .456, d ⫽

⫺0.22 (small effect size).

Bivariate Pearson correlations were calculated to explore the

relationship between social support and lifetime frequency of
NSSI. Both the Parent and Close Friend subscales of the CASSS

were included, and frequency was tapped by the question, “How
many times have you self-injured over your lifetime?” No signif-
icant correlations were found.

Discussion

Social Influences in NSSI

The results of this study, although primarily descriptive in

nature, offer support for the social modelling effects of NSSI.
These findings support the view that, despite psychological vul-
nerabilities that may predispose individuals to self-injure, episodes
of NSSI may also be socially influenced. The present results are
consistent with Hodgson’s (2004) study, which found that a large
number of individuals who self-injured learnt about the behaviour
from outside sources, including the media. Understanding the role
of social factors is critical given the increased rates of NSSI noted
in recent publications, as well as reports by mental health profes-
sionals that they are regularly dealing with this behaviour (Heath,
Toste, & Beettam, 2006; Whitlock, Muehlenkamp, & Eckenrode,
2008).

A more complicated situation arises when looking at peer social

networks as a source of information about the spread of NSSI.
Findings highlight the possible influence of peers with respect to
the initiation of NSSI in adolescence, in that 74% of participants
reported at least one friend who also self-injured. In 1989, lower
rates were noted by Favazza and Conterio (1989), with only 24%
of their sample reporting that a friend also engaged in the behav-
iour. These differences may stem, in part, from changing percep-
tions and views of NSSI as a more normative, less “disturbed”
behaviour (Adler & Adler, 2007). Further evidence for the social
component of NSSI stems from the finding that participants were
highly likely to use the same methods of self-injury as their peers.
In addition, almost half of the NSSI group reported that their
friend(s) had been the first to self-injure. As with other risky
behaviours, including suicidal ideation (Prinstein et al., 2001),
NSSI appears to become entrenched in an individual’s network of
peers. Nock and Prinstein (2005) maintain that friends may in-
crease an individual’s access to NSSI through priming. They
suggest that for some youth, the observation that the NSSI of their
peers elicits desirable responses from others leads them to be more
likely to engage in NSSI themselves.

In his elaborated social theory of NSSI, Nock (2008) hypoth-

esised that self-injury is an attempt to achieve attention, support, or
a sense of belonging for a substantial minority of youth engaging
in this behaviour. The present findings support Nock’s theory by
further demonstrating the degree to which individuals interact
around their NSSI, making it a shared experience. If the peer group
serves to normalise the behaviour, then it would follow that there
would be high levels of openness and low levels of secretiveness
in terms of disclosure and discussion about NSSI among friends. In
fact, results reveal that more than 65% of participants who engaged
in NSSI reported talking about this behaviour with their friends. In
addition, one third of participants indicated that someone had told
them they were planning to self-injure or that they had engaged in
self-injury in front of friends. Most surprising was the finding that
86% of respondents reported that someone, usually a friend or
family member, knew about their NSSI. Prior to these results, the
prevailing view had been that NSSI is a secretive act (Adler &

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SOCIAL FACTORS AND NONSUICIDAL SELF-INJURY

Adler, 2005, 2007; Purington & Whitlock, 2004). However, it may
be that this assumption has endured because past studies have
typically reported disclosure of NSSI to professionals as opposed
to peers or family (Whitlock, Eckenrode, et al., 2006). Present
results highlight the need to assess disclosure to mental health and
medical professionals, family members, and peers.

Motivations for NSSI

In examining the reported motivations for engaging in NSSI, we

found that participants endorsed both emotional/internal motiva-
tions and social/external motivations for their own NSSI. It is
interesting that, when participants were asked what they felt were
reasons why others engage in NSSI, they endorsed a similar rate of
emotional/internal motivations but a much higher rate of social/
external motivations.

These results are similar to those reported by Nock and Prinstein

(2004), who provided evidence for a functional model of NSSI in
which the behaviour provides automatic reinforcement (e.g., re-
lease of negative affect or creation of a physiological state) or
social reinforcement (e.g., escape from aversive situations or at-
tention gains). Nock and Prinstein found that participants endorsed
automatic and social functions, but that the automatic reinforce-
ment played a more significant role in terms of NSSI behaviours.

The consistent finding that individuals who engage in NSSI

endorse both emotional and social reasons for the behaviour sug-
gests that, although friends and the media may help establish an
environment where NSSI is more probable, the actual act of
self-injury seems to be performed primarily out of emotional need.
Taken together, the present results suggest that affiliation with
peers who self-injure may be related to increases in NSSI among
individuals with poor coping skills and emotional regulation
difficulties.

Social Support

Although results reveal no differences in parent social support

between the groups, individuals who did not engage in NSSI
reported significantly higher levels of friend support than individ-
uals who did engage in NSSI. These results are consistent with
reports that adolescents who self-injure describe themselves as
being loners or feeling more lonely (Adler & Adler, 2005), as well
as with Nock’s (2008) theory that individuals who engage in NSSI
may feel that they need to communicate in this extreme manner
because they do not have available support. Finally, the absence of
a relationship between the degree of social support and lifetime
frequency suggests that NSSI behaviours are not likely to occur
more or less often as a function of the support the individual is
receiving from parents or peers. This is an important finding that
provides preliminary evidence that individuals who engage in
NSSI as a repetitive versus transient behaviour are not distin-
guished by social factors. However, this finding needs to be
replicated and is only tentative because of the small numbers in the
present study.

Limitations

Despite the interesting findings of the present study, several

limitations should be noted. First, the small sample of individuals

with NSSI and the definition of NSSI (“to deal with stress”)
employed for initial screening recruitment limit the generalizabil-
ity of the results. Of the 85 participants who endorsed NSSI in the
screening, only 23 agreed to complete the follow-up survey. Thus,
it is possible that the 23 who agreed to follow-up were individuals
for whom NSSI is a socially oriented behaviour and, as such, were
more willing to discuss issues of coping and stress. Future research
is needed to establish whether the social element documented
herein is characteristic of a subset of individuals who self-injure or
more pervasive among all of those who engage in this behaviour.
Similarly, in the screening, we solicited those who used the target
behaviour to “deal with stress.” It would be important to consider
whether reports of NSSI not limited to dealing with stress would
result in a different group. In addition, the present study relied on
nonstandardized self-report measures of social interactions around
NSSI. There is pressing need to establish the psychometric prop-
erties of the newly emerging measures in this field. Nevertheless,
the current findings provide important information for understand-
ing the role of social factors on the NSSI behaviours of youth and
young adults.

Conclusion

In sum, the results of the study point to a high degree of social

influence in the manifestation of NSSI among youth. Based on the
results, the picture that emerges is that NSSI behaviours are often
enhanced by sources external to the individual, such as peers and
the media. Findings further indicate that many young adults re-
called hearing about NSSI for the first time from outside sources,
including the media, Internet, and their peers. In addition, they
reported that NSSI often occurred within their peer group. The
high level of openness that was revealed by the participants is
counter to current views that NSSI is a stigmatized behaviour.
Furthermore, although emotional regulation difficulties may be the
underlying function of NSSI, many individuals engage in the
behaviour for social reasons. Thus, by examining social factors,
the current study provides valuable information to the field of
NSSI. Although many theoretical formulations have focused on
emotional factors in the etiology of NSSI, the current study shifts
the focus to examine the social influence among university stu-
dents who report a history of NSSI. The presented findings under-
score the importance of the interaction between emotional and
social factors in the occurrence of NSSI. Future research is needed
to examine the development trajectory of adolescence and the
effect that peers may have in the initiation or maintenance of
self-injurious behaviours.

Re´sume´

Des rapports re´trospectifs des influences sociales dans
l’automutilation non suicidaire (AMNS), prenant en compte
l’initiation, la divulgation, la me´thode ainsi que les motifs ayant mene´
au comportement, ont e´te´ examine´s pour 23 e´tudiants a` l’universite´
(21 femmes, 2 hommes). Le niveau de soutien des parents et des pairs
accorde´ aux sujets pratiquant l’AMNS a e´te´ compare´ a` celui offert a`
des membres d’un groupe te´moin ne pratiquant pas l’AMNS. La
fre´quence de l’AMNS au cours de la vie et le soutien social ont e´te´
e´value´s. Inopine´ment, il a e´te´ constate´ que les comportements
d’AMNS e´taient fortement influence´s par des facteurs sociaux : 65 %

184

HEATH, ROSS, TOSTE, CHARLEBOIS, AND NEDECHEVA

des sujets ont dit avoir parle´ d’automutilation a` leurs amis; 58,8 % ont
indique´ qu’un ami s’e´tait d’abord adonne´ a` l’automutilation; 17,4 %
ont affirme´ s’eˆtre automutile´s en pre´sence d’amis. Presque tous les
participants (91 %) ont dit que leur automutilation reposait sur des
motivations e´motionnelles; toutefois, les motivations sociales e´taient
aussi courantes (65,2 %). Le soutien social de pairs s’est re´ve´le´
moindre chez le groupe pratiquant l’AMNS que chez le groupe
te´moin. Toutefois, il n’a pas e´te´ e´tabli que le soutien social constituait
un facteur relie´ a` la fre´quence a` vie. Les auteurs discutent des
re´percussions d’une explication de l’AMNS comme comportement
pouvant eˆtre influence´ par des facteurs sociaux.

Mots-cle´s : jeunes adultes, colle`ge, automutilation non suicidaire,
automutilation de´libe´re´e, influence sociale, soutien social

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Received May 15, 2008

Revision received February 18, 2009

Accepted February 18, 2009

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