Background
Non-suicidal self-injury (NSSI) displays an alarmingly high
prevalence rate among university students, placing them at high
risk for adverse long-term outcomes, including suicide.
Aims
This study aimed to achieve a better understanding of factors
contributing to NSSI in university student populations by
examining reasons for NSSI and histories of stressful events and
coping strategies.
Method
A total of 185 university students with a lifetime history of NSSI
were assessed for depressive symptoms and NSSI characteristics.
They completed three questionnaires on NSSI reasons,
stressful events and coping strategies during childhood and
adolescence. Each questionnaire included an ‘others’ option
combined with an open-ended response box. After descriptive
analysis of the closed questions, these open-ended responses
were qualitatively categorised and analysed as predictors of
depression severity and NSSI continuation from adolescence
into adulthood.
Results
Qualitative analysis identified eight, five and ten categories from
the open-ended responses for NSSI reasons, stressful events
and coping strategies, respectively, with substantial to almost
perfect interrater reliability. Two qualitative reason categories,
one stressful event category and two coping strategy categories
significantly predicted depression severity (β = 0.21–0.23).
Participants reporting events in the stressful events category
‘Traumatisation and experiences of violence’ were three times
more likely to continue NSSI into adulthood (f 2 = 0.07).
Conclusions
This study demonstrates the value of mixed-methods
approaches. Stable qualitative categories highlight the need to
capture individual variations in NSSI-related factors. It emphasises
trauma-related stressors due to their influence on
depression severity and persistence of NSSI into adulthood.