TPC-Journal-V6-Issue1

61 Kelly Emelianchik-Key, NCC, is an Assistant Professor at Florida Atlantic University. Rebekah J. Byrd, NCC, is an Assistant Professor at East Tennessee State University. Amanda C. La Guardia, NCC, is an Assistant Professor at Sam Houston State University. Correspondence can be addressed to Kelly Emelianchik-Key, Department of Counselor Education, 777 Glades Road, Building 47, Room 458, Boca Raton, FL 33431, kemelian@fau.edu. Kelly Emelianchik-Key, Rebekah J. Byrd, Amanda C. La Guardia Adolescent Non-Suicidal Self-Injury: Analysis of the Youth Risk Behavior Survey Trends Issues regarding the diagnosis and treatment of non-suicidal self-injury (NSSI) continue to be of increasing concern to practitioners in educational and mental health settings. Given this rising concern, it is important to note that the majority of research regarding self-injury has focused on the symptomology and treatment of Caucasian females; little work has been done regarding the prevalence, presentation and treatment of self-injury with other populations (Marchetto, 2006). This article provides a rationale for addressing gender, culture and other issues of diversity in relation to self-injurious behaviors, including analysis of the Youth Risk Behavior Survey to provide empirical evidence for why additional issues of diversity need to be addressed. Implications for clinical counseling practice are discussed. Keywords : self-injury, NSSI, adolescent, youth risk, trends Self-injury is a significant issue with a variety of psychological, social, legal and ethical consequences and implications (Froeschle & Moyer, 2004; McAllister, 2003; Nock & Mendes, 2008; White Kress, Drouhard, & Costin, 2006). Self-injurious behavior is commonly associated with the cutting, bruising or burning of the skin. It also can include trichotillomania, interfering with wound healing and extreme nail biting (Klonsky & Olino, 2008; Zila & Kiselica, 2001). In assessing severity, it is important to note that self-inflicted wounds typically do not require any medical attention, as those who engage in self-injury will usually care for any open wounds in order to prevent infection (Walsh, 2006). The typical duration of a self-injurious act is usually less than 30 minutes, resulting in immediate relief from the emotional turmoil precipitating the behavior (Alderman, 1997; Gratz, 2007). It is difficult to estimate the prevalence of self-injury for many reasons. Nock (2009) noted that reports indicating increased estimates in this behavior derive from “anecdotal reports and estimates from small cross-sectional studies” (p. 81). Given the many ethical and legal ramifications involved in working with clients that self-injure, it is important to understand how self-injury typically manifests itself, how it affects differing populations based on gender and cultural differences, and the level of danger it truly represents to the person choosing to utilize it. Self-Injury and Suicidal Intent The current average age of those beginning to engage in self-injury is as early as 12 years old, but onset typically begins in adolescence (Lundh, Karim, & Quilisch, 2007; Trepal & Wester, 2007). Self- injury is found as a frequently occurring issue in the adolescent population (Jacobson, Muehlenkamp, Miller, & Turner, 2008; Nock, Joiner, Gordon, Lloyd-Richardson, & Prinstein, 2006). The majority of reported self-injury and research regarding it has been focused on Caucasian females. Within this particular population, self-injury is typically not associated with increased danger beyond the injury itself unless onset co-occurs with a psychotic episode or is co-morbid with suicidal ideation (Conaghan & Davidson, 2002; Walsh, 2006). Self-injury is the intentional harm to one’s self (usually in the form of cutting, burning, or hitting) to alleviate distress and regulate emotions (Nock & Favazza, 2009) with no intent to die. Usually, reporting of self-injury is necessitated by the concern that the act The Professional Counselor Volume 6, Issue 1, Pages 61–75 http://tpcjournal.nbcc.org © 2016 NBCC, Inc. and Affiliates doi:10.15241/kk.6.1.61