@article{ref1,
title="Latent class analysis of self-directed violence and indirect self-harm behaviors: gender differences and associations with mental health symptoms",
journal="Medical care",
year="2021",
author="Galovski, Tara E. and Gradus, Jaimie L. and Nillni, Yael I. and Grossman, Stephanie L. and Mitchell, Karen S. and Zelkowitz, Rachel L.",
volume="59",
number="",
pages="S51-S57",
abstract="OBJECTIVE: This study aimed to (1) examine whether the latent class structure of individuals engaging in self-directed violence and indirect self-harm behaviors (eg,  substance use, disordered eating) varied by gender in a sample of US veterans, and  (2) test the associations of posttraumatic stress disorder (PTSD) and depressive  symptoms with the resulting classes. STUDY DESIGN: Cross-sectional data from 3581  veterans, ages 18-50 (51.9% identified as women) were analyzed. Veterans  self-reported histories of self-directed violence, substance use, and disordered  eating. Latent class analysis and latent class regression were used to explore class  structure by gender and examine association of class membership with PTSD and  depressive symptoms. <br><br>RESULTS: A 4-class model was supported in the sample. Class 1  (20.0%) was characterized by substance use and self-directed violent thoughts and  behaviors. Class 2 (8.3%) was characterized by substance use, disordered eating, and  self-directed violent thoughts and behaviors. Class 3 (12.6%) was distinguished by  indirect self-harm behaviors (substance use and disordered eating). Class 4 (59.6%)  reflected low likelihood of behavioral dysregulation. Classes were partially  invariant across gender; endorsement of substance use behaviors was generally higher  for men in each class. Comorbid clinically significant depressive and PTSD symptoms  were associated with the class characterized by highest behavioral dysregulation. <br><br>CONCLUSIONS: Self-directed violent thoughts and behaviors present comorbidly with  indirect self-harm in men and women veterans, although patterns of indirect  self-harm behaviors differ slightly by gender. Such comorbidity may be associated  with more severe presentations of psychiatric concerns.<p /> <p>Language: en</p>",
language="en",
issn="0025-7079",
doi="10.1097/MLR.0000000000001476",
url="http://dx.doi.org/10.1097/MLR.0000000000001476"
}