Evaluation of the impact of psychopathology, identity status and mentalization on nonsuicidal self-injury among adolescents

Nonsuicidal self-injury (NSSI) is defined as deliberate damage to body tissue without suicidal intent. Although mentalization-based therapy has been found to be effective in adolescents with NSSI, there are very few empirical studies investigating mentalization problems in adolescents with NSSI. This study is designed as a cross-sectional case-control study to assess impact of identity diffusion, psychopathology, and mentalization on NSSI in adolescence. The sample of the study consisted of 153 adolescents aged 12-18 years, 56 with NSSI, 45 psychiatric patients without NSSI, and 52 healthy controls. All participants filled in the Self-Injurious Behaviour Screening Questionnaire, Assessment of Identity Development in Adolescence (AIDA), and Youth Self Report (YSR), and those who had NSSI additionally completed the Inventory of Statements About Self-injury (ISAS). The mentalization of all adolescents was assessed by using "The Movie for the Assessment of Social Cognition" (MASC). Results showed that the adolescents with NSSI had more identity diffusion, higher levels of psychopathology, and lower levels of mentalization. The findings of this study suggest that adolescents with NSSI should be evaluated using a multidimensional assessment that takes into account identity, psychological problems, and mentalization. As our study is the first to evaluate the relationship between NSSI, identity diffusion, psychopathology, and mentalization, it would be beneficial to replicate with a similar design in future longitudinal and community-based studies.