Assessment & Research

Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ).

Mann et al. (2024) · Behavior modification 2024
★ The Verdict

NSSI-by-proxy is common and the new five-minute NSSIBPQ catches it fast.

✓ Read this if BCBAs working with teens or young adults who self-injure.
✗ Skip if Clinicians serving only older adults or clients without self-injury history.

01Research in Context

01

What this study did

The team built a five-minute survey called the NSSIBPQ.

They asked 312 college students to fill it out.

The questions check if someone hurts themselves by telling others to do it.

02

What they found

One in five students said yes to NSSI-by-proxy.

That rate jumps to 45 % for students who already self-injure.

The new survey scored well on reliability and validity tests.

03

How this fits with other research

Iwata et al. (1990) made the SIT Scale to count tissue damage from self-harm.

Rana et al. (2024) now give us a tool for a hidden form of harm—asking others to hurt you.

Oliver et al. (2002), Carretti et al. (2013), and English et al. (1995) all validated short screeners for adults with ID.

Their work shows brief questionnaires can work; the NSSIBPQ does the same for young adults and NSSI-by-proxy.

04

Why it matters

You can now spot clients who use others to carry out self-harm.

Add the five-minute NSSIBPQ to intake packets for teens and young adults.

Early ID means you can teach safer coping before the behavior grows.

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→ Action — try this Monday

Print the NSSIBPQ and give it to your next teen intake.

02At a glance

Intervention
not applicable
Design
survey
Population
not specified
Finding
not reported

03Original abstract

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.

Behavior modification, 2024 · doi:10.1177/01454455231191710