OBJECTIVE. The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample.

METHODS. A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded.

RESULTS. The lifetime prevalence rate of having ≥1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and >24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and ≥1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors.

CONCLUSIONS. A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their self-injurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors.

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