Anti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents.

Laura Kraus,Tina In-Albon,Marc Schmid

doi:10.3389/fpsyt.2020.00490

Laura Kraus, Tina In-Albon + Show 1 more

Open Access

https://doi.org/10.3389/fpsyt.2020.00490

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Abstract

BackgroundThere have been numerous studies investigating the relationship between nonsuicidal self-injury (NSSI) and suicidality. On the one side, NSSI is an important risk factor for suicidality, including suicidal thoughts and behaviors. On the other side, it has been suggested that one function of NSSI might be as a coping mechanism that can help individuals in the short term avoid suicide. The present study investigated the relationship between suicidality and NSSI in female inpatient adolescents, focusing on NSSI as an anti-suicide strategy.MethodsSubjects were 56 female adolescents, aged 12–18 years (M = 15.95 years, SD = 1.27), recruited from different inpatient child and adolescent psychiatric units. All participants fulfilled the DSM-5 research criteria for nonsuicidal self-injury disorder (NSSI-D). To assess suicidality, NSSI-D, and current and past diagnoses, a structured clinical interview was conducted.ResultsNSSI as a short-term coping strategy for avoiding suicide was indicated by one third (32.1%) of the participants. Before participants engaged in NSSI, the anti-suicide function was reported more frequently than reducing interpersonal problems (d = -.59). Getting relief from negative emotions and inducing positive feelings were reported at the same frequency as avoiding suicide before NSSI. Participants engaging in NSSI to avoid suicide and those reporting other functions did not significantly differ regarding other NSSI characteristics, suicidality, or psychopathology. Results indicate that the anti-suicide function significantly predicts the duration of current suicidal ideation (β = .557).ConclusionThis study provides preliminary support for the idea that NSSI is frequently used by female adolescents with NSSI-D to avoid suicide. Given the high co-occurrence of NSSI and suicidality, our results underline the importance of clinical assessment of suicidality and several NSSI functions, including the anti-suicide function, in adolescents with NSSI.

Highlights

According to the Diagnostic and Statistical Manual of Mental Disorders [5th ed.; [1]], nonsuicidal self-injury (NSSI) is defined as repetitive, socially unaccepted acts of intentional self-inflicted damage to one’s own body tissue without suicidal intent
To address the first research question on how many adolescents with NSSI disorder (NSSI-D) have engaged in NSSI to avoid suicide in contrast to other functions, and how frequently, several analyses were performed
Assessing functions of NSSI according to diagnostic criterion B of NSSI-D, the most common functions were to get relief from a negative emotion (n = 49, 87.5%), to induce a positive emotional state (n = 40, 71.4%), to avoid a suicide attempt (n = 18, 32.1%), and to reduce interpersonal problems (n = 11, 19.6%)

Summary

Introduction

According to the Diagnostic and Statistical Manual of Mental Disorders [5th ed.; [1]], nonsuicidal self-injury (NSSI) is defined as repetitive (at least 5 days in 1 year), socially unaccepted acts of intentional self-inflicted damage to one’s own body tissue without suicidal intent. In addition to the high prevalence rates, of special concern is that NSSI is a major risk factor for suicidal thoughts and behaviors [(4); see [5], for a systematic review and metaanalysis]. They often co-occur, as adolescents with NSSI report frequent suicidal thoughts [6, 7], NSSI and suicidal behavior are discrete entities. There have been numerous studies investigating the relationship between nonsuicidal self-injury (NSSI) and suicidality. The present study investigated the relationship between suicidality and NSSI in female inpatient adolescents, focusing on NSSI as an antisuicide strategy

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