Interconnectivity among different nonsuicidal self-injurious methods – a network analysis

Abstract Background An important indicator of self-harm severity is the co-occurrence of different nonsuicidal self-injurious (NSSI) behaviors. However, there is little research on how different self-injurious behaviors (e.g., cutting, biting, burning, carving) are related. In contrast to person-cen...

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Main Authors: Melinda Reinhardt, Kenneth G. Rice, Hunggu Cho, Zsolt Horváth
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-07045-2
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author Melinda Reinhardt
Kenneth G. Rice
Hunggu Cho
Zsolt Horváth
author_facet Melinda Reinhardt
Kenneth G. Rice
Hunggu Cho
Zsolt Horváth
author_sort Melinda Reinhardt
collection DOAJ
description Abstract Background An important indicator of self-harm severity is the co-occurrence of different nonsuicidal self-injurious (NSSI) behaviors. However, there is little research on how different self-injurious behaviors (e.g., cutting, biting, burning, carving) are related. In contrast to person-centred approaches, variable-centred network analysis helps to identify the most meaningful associations between different forms of NSSI behavior, thus allowing the identification of structural patterns in different NSSI methods. Based on network analysis, it will be possible to examine which NSSI methods are the most central and which are most closely linked to other methods. Methods We used network analysis to investigate interconnections between 12 different self-harm methods. The Inventory of Statements About Self-Injury [24] was utilized to assess the types and frequency of NSSI in a community adult sample. Results More than one-third (39.7%; n = 744) of 1873 adults reported at least one episode of NSSI in their lifetime. Most (77%) of those engaged in NSSI used more than one NSSI method. The most frequently used NSSI methods were hitting self, interfering with wound healing, pinching, biting, and severe scratching. In the NSSI methods network analysis, severe scratching, cutting, and pinching had the highest rates of interrelationship with other NSSI behaviors. Moreover, the interconnectedness of certain specific NSSI-methods (i.e., cutting with burning and carving; severe scratching with pinching, biting and hitting self) have a greater risk of co-occurrence (versatility). Conclusions Although different NSSI methods occurred as distinct entities, some play a more central role in the network. Our results suggest that the NSSI methods identified as central should be given more attention in clinical settings as these behaviors may indicate the severity of the condition. Specifically, when assessing and treating those who engage in self-harm, clinicians may find it useful to create a detailed map of the person-specific NSSI-methods to inform risk assessment and treatment.
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spelling doaj-art-22618d9755d94ecbbdad48be21af73a62025-08-20T03:03:38ZengBMCBMC Psychiatry1471-244X2025-07-0125111410.1186/s12888-025-07045-2Interconnectivity among different nonsuicidal self-injurious methods – a network analysisMelinda Reinhardt0Kenneth G. Rice1Hunggu Cho2Zsolt Horváth3Institute of Psychology, ELTE Eötvös Loránd UniversityMatheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State UniversityMatheny Center for the Study of Stress, Trauma, and Resilience, Department of Counseling and Psychological Services, Georgia State UniversityInstitute of Psychology, ELTE Eötvös Loránd UniversityAbstract Background An important indicator of self-harm severity is the co-occurrence of different nonsuicidal self-injurious (NSSI) behaviors. However, there is little research on how different self-injurious behaviors (e.g., cutting, biting, burning, carving) are related. In contrast to person-centred approaches, variable-centred network analysis helps to identify the most meaningful associations between different forms of NSSI behavior, thus allowing the identification of structural patterns in different NSSI methods. Based on network analysis, it will be possible to examine which NSSI methods are the most central and which are most closely linked to other methods. Methods We used network analysis to investigate interconnections between 12 different self-harm methods. The Inventory of Statements About Self-Injury [24] was utilized to assess the types and frequency of NSSI in a community adult sample. Results More than one-third (39.7%; n = 744) of 1873 adults reported at least one episode of NSSI in their lifetime. Most (77%) of those engaged in NSSI used more than one NSSI method. The most frequently used NSSI methods were hitting self, interfering with wound healing, pinching, biting, and severe scratching. In the NSSI methods network analysis, severe scratching, cutting, and pinching had the highest rates of interrelationship with other NSSI behaviors. Moreover, the interconnectedness of certain specific NSSI-methods (i.e., cutting with burning and carving; severe scratching with pinching, biting and hitting self) have a greater risk of co-occurrence (versatility). Conclusions Although different NSSI methods occurred as distinct entities, some play a more central role in the network. Our results suggest that the NSSI methods identified as central should be given more attention in clinical settings as these behaviors may indicate the severity of the condition. Specifically, when assessing and treating those who engage in self-harm, clinicians may find it useful to create a detailed map of the person-specific NSSI-methods to inform risk assessment and treatment.https://doi.org/10.1186/s12888-025-07045-2Nonsuicidal self-injury methodsNetwork analysisCommunity adults
spellingShingle Melinda Reinhardt
Kenneth G. Rice
Hunggu Cho
Zsolt Horváth
Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
BMC Psychiatry
Nonsuicidal self-injury methods
Network analysis
Community adults
title Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
title_full Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
title_fullStr Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
title_full_unstemmed Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
title_short Interconnectivity among different nonsuicidal self-injurious methods – a network analysis
title_sort interconnectivity among different nonsuicidal self injurious methods a network analysis
topic Nonsuicidal self-injury methods
Network analysis
Community adults
url https://doi.org/10.1186/s12888-025-07045-2
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