Prevalence, characteristics and functions of non-suicidal self-injury among young adults in higher leaming institutions in Kedah, Malaysia

Non-suicidal self-injury (NSSI) is defined as the deliberate infliction of damage, pain or both to one’s own body tissue without the intention of suicide. NSSI is a serious and prevalent problem within adolescents throughout the world with the prevalence range of 17-34%. A broad variety of different functions can underlie acts of NSSI.The objective of the study was to determine the prevalence of NSSI behaviour among students in higher learning institutions, to describe the sociodemographic characteristics (age, sex, socioeconomical status, ethnicity and parent’s education level), to determine the functions of NSSI and to determine the association between the functions of NSSI (based on the Four Functional Model (FFM) and the NSSI behaviour among young adults of higher learning institutions. This study employed cluster sampling to select 552 respondents, aged 18-23, from a polytechnic from Kedah. and other higher learning institutes.NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM). The descriptive statistics were first conducted to examine the frequency and basic characteristics of NSSI in the sample selected. The demographic factors are described. Group comparisons was conducted using chi square test, for the proportion of categorical measures and simple logistic regression and multiple logistic regression test to find an equation that best predicts the probability of NSSI behaviour. A total of 27.5% young adolescents had reported self-injuring behaviour with most of them frequently hitting oneself, picking on a wound, cutting/carving skin, hitting self on purpose, and biting. The most common reasons for NSSI were ‘to punish oneself, ‘to feel relaxed’, ‘to make others angry’ and ‘to stop bad feelings. Automatic Negative Reinforcement (ANR) and Automatic Positive Reinforcement (APR) are both was found associated to the NSSI behaviour. APR had significant positive relationship (OR=3.51, 95 % CI: 1.72-7.13), suggesting that those who reported positive reinforcement as a motivation were 3.51 times more likely in engage in NSSI. ANR significant positive relationship (OR=2.04, 95% CI:1.02-4.08), suggesting that those who reported positive reinforcement as a motivation were 2.04 times more likely in engage in NSSI. The study reported 27.5% prevalence rate reported. Key findings show that NSSI is more common among females, 19-year-olds, first-year students, and those from lower socioeconomic backgrounds, particularly those with parents holding secondary education. NSSI behaviors are mainly driven by internal emotional factors, such as relaxation, self-punishment, and emotional relief, and are significantly influenced by positive and negative reinforcement mechanisms. Logistic regression analysis confirms that reinforcement mechanisms, along with demographic factors like gender and maternal education, are major predictors of NSSI. The study emphasizes the importance of early intervention targeting emotional regulation and coping strategies to prevent more severe mental health issues. It recommends tailored prevention and treatment programs, incorporating mindfulness, grounding techniques, and therapies like DBT and CBT, to support young adults and reduce NSSI behaviors.

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