Latent Class Analysis of Nonsuicidal Self-Injury Among Justice-Involved Juveniles: Association With Motivational and Emotional Aspects of Self-Harm Behavior

• Author: Zsolt Horváth,Boglárka Drubina,Kenneth G. Rice,Gyöngyi Kökönyei,Melinda Reinhardt
• Published date: 01 July 2021
• Date: 01 July 2021
• DOI: http://doi.org/10.1177/0093854821998411
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2021, Vol. 48, No. 7, July 2021, 902 –922.

DOI: https://doi.org/10.1177/0093854821998411

Article reuse guidelines: sagepub.com/journals-permissions

© 2021 International Association for Correctional and Forensic Psychology

902

LATENT CLASS ANALYSIS OF NONSUICIDAL

SELF-INJURY AMONG JUSTICE-INVOLVED

JUVENILES

Association With Motivational and Emotional Aspects

of Self-Harm Behavior

MELINDA REINHARDT

Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

14th District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary

ZSOLT HORVÁTH

Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

BOGLÁRKA DRUBINA

Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

GYÖNGYI KÖKÖNYEI

Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary

SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University,

Budapest, Hungary

KENNETH G. RICE

Department of Counseling and Psychological Services, Center for the Study of Stress, Trauma, and Resilience, Georgia

State University, Atlanta, USA

AUTHORS’ NOTE: Melinda Reinhardt was supported by the National Research, Development, and

Innovation Office—NKFIH, Budapest, Hungary, under grant number PD 128332. Gyöngyi Kökönyei was sup-

ported by the National Research, Development, and Innovation Office—NKFIH, Budapest, Hungary, under

grant number FK 128614; furthermore, she was supported by the MTA-SE-NAPB Genetic Brain Imaging

Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University (Grant No. KTIA_

NAP_13-2-2015-0001) and Hungarian Brain Research Programe (Grant No. 2017-1.2.1-NKP-2017-00002).

Zsolt Horváth was supported by the ÚNKP-20-3 New National Excellence Program of the Ministry for

Innovation and Technology from the source of the National Research, Development, and Innovation Fund and

by the ELTE Thematic Excellence Programme 2020, supported by the National Research, Development, and

Innovation Office (TKP2020-IKA-05). Correspondence concerning this article should be addressed to Melinda

Reinhardt, Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and

Psychology, Eötvös Loránd University, Izabella Street 46, H-1064 Budapest, Hungary; e-mail: reinhardt.

melinda@ppk.elte.hu.

998411CJBXXX10.1177/0093854821998411Criminal Justice and BehaviorReinhardt et al. / Latent Class Analysis of Nonsuicidal Self-Injury

research-article2021

Reinhardt et al. / LATENT CLASS ANALYSIS OF NONSUICIDAL SELF-INJURY 903

Significantly higher rates of nonsuicidal self-injury (NSSI) have been discovered among justice-involved juveniles. Our

study aimed to discriminate homogeneous subgroups of justice-involved youth with different self-harm behavior character-

istics based on latent class analysis. A total of 244 adolescents (92.6% boys; Mage = 16.99, SD = 1.28) in Hungarian juvenile

detention centers completed measures of NSSI and dissociation. High-NSSI (Class 1; 9%), moderate-NSSI (Class 2; 42.6%),

and low-NSSI (Class 3; 48.4%) profiles were detected relating to different forms of NSSI. Multiple comparisons showed that

girls were members of Class 1 and 2 at higher rates and these subgroups showed significantly higher dissociation proportions

than Class 3. Our findings pointed out diversity in self-harm profiles with different characteristics in terms of methods and

severity of self-harm, experienced emotions, and other emotion regulation tendencies among justice-involved adolescents.

These results suggest sophisticated treatment approaches to match variations in severity and presentation.

Keywords: nonsuicidal self-injury; justice-involved juveniles; dissociation; latent class analysis

Nonsuicidal self-injury (NSSI) comprises different forms of deliberate harm to one’s

body tissue, such as self-cutting, self-burning, self-bruising, self-biting, or self-

scratching without suicidal intent (International Society for the Study of Self-Injury, 2018).

Numerous authors emphasize that these maladaptive behaviors are increasingly present in

adolescence (In-Albon et al., 2013) and young adulthood (Saraff & Pepper, 2014). NSSI

behaviors are associated with additional physical problems (Victor & Klonsky, 2014), as

well as with different psychological difficulties and dysfunctions (e.g., maladaptive emo-

tion regulation; Zelkowitz et al., 2017). NSSI could also be a risk factor for suicide intent

or behavior (Andover & Gibb, 2010). However, it is essential to distinguish NSSI from

other self-injurious behaviors (i.e., suicidal ideation and suicide attempts) in which self-

destructive thoughts and actions are associated with suicidal intent (Klonsky et al., 2014).

Only a limited number of studies discuss NSSI and its correlates with psychological and

behavioral issues among incarcerated people. Although there is variability in NSSI mea-

surement quality, a worrying level of NSSI has been observed in prisons (Fotiadou et al.,

2006) and even more in juvenile detention centers (Kenny et al., 2008; Kirchner et al.,

2008). According to the systematic review of Dixon-Gordon et al. (2012), the prevalence of

NSSI in custody contexts ranges between 0.1% and 15% among adults and between 4.5%

and 24% among young incarcerated people. The lifetime prevalence of NSSI covers an

even wider range among justice-involved adults (8.6%–48%). Lifetime prevalence rates for

NSSI range between 7% and 11% in young justice-involved populations (Dixon-Gordon

et al., 2012). Note that NSSI studies carried out with justice-involved samples are highly

heterogeneous in terms of gender distribution, age range, sample size, and nationality.

Studies also differ in whether lifetime prevalence or prevalence of self-harm in custody was

measured. Nevertheless, across studies, cutting is the most common form of NSSI, both

among younger and older incarcerated people (Dixon-Gordon et al., 2012). Scratching, skin

piercing and picking, and burning are also frequently observed forms of NSSI among jus-

tice-involved adults (Sakelliadis et al., 2010). In contrast, headbanging and kicking things

are more specific to justice-involved young people (Kenny et al., 2008).

Research is limited and inconsistent regarding gender differences in NSSI among justice-

involved adolescents. Some surveys showed that, compared with boys, girls have a higher

proportion of previous self-harm (Shepherd et al., 2013). Other studies detected a nonsig-

nificant relationship between gender and previous (Kenny et al., 2008) or current self-harm

acts (Webb, 2017).