Help-seeking patterns for non-suicidal self-injury across borderline symptom profiles in a large sample of university students.

BACKGROUND: Non-suicidal self-injury (NSSI) is common in young adults and may represent a marker of current or emerging borderline pathology. However, rates of help-seeking for NSSI are low, potentially delaying recognition of clinically relevant borderline symptoms. To our knowledge, research on NSSI help-seeking has not examined whether help-seeking differs according to underlying borderline symptom profiles. This study therefore examined whether patterns of NSSI help-seeking differ across borderline symptom profiles in a community sample of university students. METHODS: In this cross-sectional study, latent class analysis was used to identify borderline symptom profiles in a community sample of 1,476 (68.5% female) Swedish university students based on the McLean Screening Instrument for BPD. Differences in help-seeking behavior, encouragement to seek help, help sources, and help-seeking attitudes were examined using three-step auxiliary analyses. Mixture logistic regression models assessed within-profile predictors. RESULTS: Four borderline symptom profiles were identified in the full sample: Full Spectrum, Internalizing, Externalizing, and Asymptomatic. Among participants with lifetime NSSI (n = 581), help-seeking did not differ significantly across profiles, whereas encouragement to seek help and help-seeking attitudes did. Encouragement was the most consistent correlate of help-seeking across profiles, while attitudes were not reliably associated with help-seeking behavior. Among participants who had sought help and provided help-source data (n = 297), sources of help did not differ across profiles. There was no evidence that predictors of help-seeking differed across profiles. CONCLUSIONS: NSSI help-seeking did not differ significantly across borderline symptom profiles. Instead, encouragement from others to seek help was more consistently associated with help-seeking across profiles. This may be particularly important for individuals with more internalizing presentations, whose distress may be less visible and therefore less likely to elicit encouragement to seek support.