An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA

TLDR

The study examined the prevalence of non‑suicidal self‑injury and related suicidal behaviors in German adolescents and compared rates with a U.S. sample using cross‑nationally validated tools. Data were collected from 665 adolescents (mean age 14.8 yr) in schools, who completed the Self‑Harm Behavior Questionnaire, the Ottawa Self‑Injury Inventory, and a German version of the CES‑D. About a quarter of participants reported NSSI, 9.5 % engaged in repetitive self‑harm, 6.5 % had attempted suicide, and no significant cross‑national differences were found, indicating that NSSI is a worldwide phenomenon in Western cultures.

Abstract

Background This study examined the prevalence of non-suicidal self-injury (NSSI), suicide attempts, suicide threats and suicidal ideation in a German school sample and compared the rates with a similar sample of adolescents from the midwestern USA by using cross-nationally validated assessment tools. Method Data were provided from 665 adolescents (mean age 14.8 years, s.d .=0.66, range 14–17 years) in a school setting. Students completed the Self-Harm Behavior Questionnaire (SHBQ), the Ottawa Self-Injury Inventory (OSI) and a German version of the Center for Epidemiological Studies–Depression Scale (CES-D). Results A quarter of the participants (25.6%) endorsed at least one act of NSSI in their life, and 9.5% of those students answered that they had hurt themselves repetitively (more than four times). Forty-three (6.5%) of the students reported a history of a suicide attempt. No statistically significant differences were observed between the German and US samples in terms of self-injury or suicidal behaviors. Conclusions By using the same validated assessment tools, no differences were found in the prevalence and characteristics of self-injury and suicidal behaviors between adolescents from Germany and the USA. Thus, it seems that NSSI has to be understood as worldwide phenomenon, at least in Western cultures.