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Self-reported nonsuicidal self-injury (NSSI) and sex as self-injury (SASI): Relationship to abuse, risk behaviors, trauma symptoms, self-esteem and attachment.

Authors
  • Zetterqvist, Maria1
  • Svedin, Carl Göran2
  • Fredlund, Cecilia3
  • Priebe, Gisela4
  • Wadsby, Marie3
  • Jonsson, Linda S5
  • 1 Department of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: [email protected] , (Sweden)
  • 2 Barnafrid, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. , (Sweden)
  • 3 Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. , (Sweden)
  • 4 Barnafrid, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Psychology, Lund University, Lund, Sweden. , (Sweden)
  • 5 Barnafrid, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: [email protected] , (Sweden)
Type
Published Article
Journal
Psychiatry research
Publication Date
Jul 01, 2018
Volume
265
Pages
309–316
Identifiers
DOI: 10.1016/j.psychres.2018.05.013
PMID: 29778052
Source
Medline
Keywords
License
Unknown

Abstract

This study focuses on a conceptually unexplored behavior among adolescents who report deliberately using sex as a means of self-injury. In a large high school-based sample (n = 5743), adolescents who engaged in sex as self-injury (SASI, n = 43) were compared to adolescents who reported direct nonsuicidal self-injury (NSSI, n = 933) and those who reported both NSSI and SASI (n = 82). Results showed that significantly more adolescents with SASI had experience of penetrating sexual abuse, as well as more sexual partners compared to those with NSSI. The SASI group also had higher levels of self-reported trauma symptoms, such as dissociation, posttraumatic stress and sexual concerns compared to those with NSSI, suggesting a distinct relationship between sexual abuse, trauma symptoms and engaging in sex as self-injury. There was no difference between the SASI and NSSI groups regarding experiences of emotional and physical abuse, self-esteem, parental care or overprotection or symptoms of depression, anxiety and anger. Adolescents who engaged in both NSSI + SASI stood out as a more severe and burdened group, with more experience of abuse, risk behaviors and impaired psychosocial health. Adolescents with traumatic experiences such as sexual abuse need to be assessed for SASI and vice versa.

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