Pattern of self-injurious behavior and suicide attempts in Italian custodial inmates: A cluster analysis approach

Self-injurious behaviors and suicide attempts are more frequent in prison settings than in the general population and represent a crucial problem. The aims of this work are to assess the prevalence of self-injurious behaviors and suicide attempts in an Italian prison setting, to determine whether inmates could be differentiated based on profiles of psychological distress and impulsiveness, and to assess the predictive power of the proposed profiles. A sample of 1422 male inmates of a north Italian penitentiary was assessed upon admission with a clinical interview and completed a set of self-report questionnaires to assess psychological distress and impulsiveness; the number of self-injurious behaviors and suicide attempts occurring in the first year of detention was recorded. A cluster analysis approach was used. Prevalence of self-Injurious behaviors and suicide attempts is similar to what has been observed in previous work. Cluster analysis revealed four clusters: dysregulated (high impulsivity and distress), impulsive (high impulsivity and mean distress), mildly distressed (mean impulsivity and moderate distress) and well-balanced (low impulsivity and distress). The four clusters help to discriminate subjects more at risk of self-injurious behaviors and suicide attempts and are confirmed by the inclusion of risk factors such as marital status and relatives'/social support. Clinical implications are discussed.