by Sachet R. Valjee and Steven J. Collings
A co-occurrence of non-suicidal self-injury (NSSI) and suicide attempts (SA)
has been documented in the literature, with such co-occurrence tending to be associated
with higher psychological and behavioural problems. However, to date no such study has
been conducted in Africa. This study sought to determine the prevalence of, and risk factors
for, the co-occurrence of NSSI and SA in a non-clinical sample of South African adolescents.
A cross-sectional study was conducted among 636 high school
students (age: 12-18 years; Mage =15.3) attending a school in the city of Durban, KwaZuluNatal, South Africa. Data were collected using a structured questionnaire, with NSSI and SA
being assessed using items adapted from the Self-Harm subscale of the Risk-Taking and
Self-Harm Inventory for Adolescents, with various validated measures being used to assess
participants’ psychological well-being, and a revised version of the Adverse Child Experience
Questionnaire being used to assess childhood adverse experiences. Data analyses were
conducted using descriptive statistics, with risk factors for the co-occurrence of NSSI and
SA being assessed using a multinomial logistic regression analysis.
Reported prevalence rates for: past 12-month NSSI were 26.7%, past 12-month
SA were 16.4%, with the co-occurrence of these conditions during the past 12-months being
9.0%; with risk factors for co-occurrence being an older age, female sex, self-identifying as
Black African, emotion dysregulation, suicidal ideation, depression, and peer exclusion.
Comparatively high rates for the co-occurrence of non-suicidal behaviour and
suicide attempts reported in this study suggests the need for targeted intervention
strategies designed to address identified risk factors. There is also a clear need for further
research among adolescents living in other low- to middle-income African countries in order
to assess the generalizability of study findings.