(PS9-A19) Characteristics of Self-harm on Adolescent Psychiatric Inpatient Units Based on Neurodevelopmental Diagnoses

Engagement in self-harm is common among youth admitted to psychiatric inpatient units. Previous research has sought to characterize self-harm among youth admitted to psychiatric inpatient units. Importantly, autistic individuals also represent a population with high engagement in self-harm, yet little is understood regarding the characteristics and functions of self-harm among this population. Moreover, limited research has sought to understand self-injury among individuals with other neurodevelopmental diagnoses (NDDs). Existing research suggest that different diagnostic populations may engage in different self-harm methods. Accordingly, this study aims to compare aspects of daily reports of self-harm experienced during inpatient stays among adolescent psychiatric inpatients based on having a diagnosis of autism, other NDDs (e.g., ADHD, tic disorder), or no NDDs.    

Data were derived from a larger study of risk factors among a sample of 118 suicidal adolescent inpatients ages 12-19, recruited from a large, urban adolescent inpatient psychiatric unit. Patients who were admitted for serious risk of suicide were eligible to participate. After completing a baseline assessment that queried for mental health diagnoses, including NDDs, participants met each weekday with a study staff member for the duration of their stay on the inpatient unit to answer a series of self-report questions, including items about self-harm engagement, frequency, and methods used since the last survey. Based on diagnostic data, participants were classified into three diagnostic groups: 1) autistic individuals, 2) non-autistic individuals with a different NDD diagnosis, and 3) individuals with no NDD diagnoses.

There was no significant difference in the number of participants who reported any engagement in self-harm (χ²=.08, p=.96) or in frequency of self-harm (F=2.40, p=.12) during the duration of the study based on diagnostic group. For each self-injury method, there were no significant differences in the use of any method across diagnostic groups (ps >.05).

Findings revealed that in an inpatient unit where patients are presenting for serious self-harm risk, there are no significant differences with regards to engagement, frequency, or methods used for self-harm on the inpatient unit based on autism and NDD status. This may be due to inherent limitations to patients’ typical self-harm practices on an inpatient unit, resulting in individuals going beyond their typical behavioral repertoire in this setting. These analyses provide valuable clinical information regarding a lack of differences in self-harm by these diagnostic subgroups. Future research should seek to further explore functional purposes of self-harm on inpatient units and how this differs by diagnoses.