Background/Hypotheses As risk factors for nonsuicidal self-injury (NSSI), most studies
highlight the importance of internalising disorders, while only a few researches show
the connection between externalising disorders and NSSI. Although some papers have
introduced the idea that increasing prevalence rates of NSSI are connected to the
broader use of the internet, associations between NSSI and pathological internet use
(PIU) are understudied. According to our hypothesis, there is a connection between
PIU and NSSI, but this is mediated by psychopathological factors from both internalising
and externalising dimensions. Methods In line with the dimensional approach of psychiatric
disorders, participants (N = 363) were recruited from both clinical (N = 202 psychiatric
inpatient) and nonclinical (N = 161 adolescents from secondary schools) settings.
Measurements: Demographic Questionnaire; Strengths and Difficulties Questionnaire
(SDQ); Deliberate Self-Harm Inventory (DSHI); Young Diagnostic Questionnaire for Internet
Addiction (YDQ), Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).
Results There was high NSSI frequency (39.9%-71% of them were girls) in our sample.
NSSI was significantly more frequent among those who showed threshold symptoms on
SDQ than in the subthreshold group [H(3) = 53.293, p <.001]. In the NSSI frequency,
there was also a significant difference between 'normal' internet users and both 'maladaptive'
and 'pathological' internet users [H(2) = 10.039, p <.05 p = .007]. According to the
mediator models, the relationship between PIU and NSSI is not a direct association;
it is mediated by all examined psychopathological factors (M.I.N.I. kid diagnoses)
except for obsessive-compulsive disorder (OCD), alcohol abuse and dependence, and
adjustment disorder. Conclusions We found a high frequency of NSSI. According to our
results, PIU in itself is not a risk factor for NSSI but might become a risk factor
in the presence of comorbid psychiatric disorders. All of these findings draw the
attention of clinicians to the importance of careful screening of comorbid disorders
with PIU.