Patterns of Non-Suicidal Self Injury Methods among Korean Youths: Associations with Sociodemographic, Psychosocial, and Clinical Characteristics

To identify heterogeneous patterns of non-suicidal self-injury among Korean youths and examine the associations with sociodemographic, psychosocial, and clinical characteristics. We studied 701 Korean youths aged 9 to 24 with a history of NSSI. Using latent class analysis (LCA), we identified NSSI patterns within the sample, employing R3STEP and DU3STEP features to explore predictors and distal outcomes across identified classes. Eight NSSI methods were included as indicators of LCA (e.g., cutting skin, hitting oneself, pulling out hair, and burning skin). Predictors encompassed sociodemographic factors, receipt of mental health services, and traumatic experiences. Distal outcomes evaluated NSSI-related psychosocial and clinical characteristics (e.g., NSSI severity, suicide behavior, self-esteem, automatic thoughts). As a result of LCA, we identified a 4-class model: Skin-damaging (15.84%), Hitting/Cutting (32.10%), Cutting (25.68%), and Multiple methods (26.39%). Significant predictors included past or present psychiatric treatments and the number of traumatic experiences. Distal outcomes differed across the classes overall, with Multiple Methods demonstrating the most severe psychosocial and clinical symptoms and Skin-damaging milder than other classes. Specifically, youths in Multiple Methods class showed the most severe NSSI, the highest social exposure to NSSI, most frequent automatic negative thoughts, highest suicidal behaviors, lowest self-esteem, least positive body image, and minimal time spent on body care and protection. This study reveals heterogeneous NSSI patterns among Korean youths, with associations with sociodemographic, psychosocial, and clinical characteristics. The findings emphasize the importance of pattern-based screening and tailored interventions for youths based on their NSSI patterns.