Abstract
BackgroundNonsuicidal self-injury (NSSI) and suicidal ideation (SI) are both distressing and quite common, particularly in youth. Given the relationship between these two phenomena, it is crucial to learn how we can use information about NSSI to understand who is at greatest risk of suicidal thoughts. In this study, we investigated how characteristics of nonsuicidal self-injury related to SI among treatment-seeking adolescents and young adults.MethodsData were collected during routine program evaluation for a self-injury treatment program. Correlations between recent SI and NSSI characteristics were calculated for adolescent and young adult patients (N = 1502).ResultsLow severity methods of NSSI (e.g. banging) were more strongly associated with SI than high severity methods (e.g. breaking bones). SI was associated with intrapersonal (automatic) NSSI functions. SI was associated with some indices of NSSI severity, such as number of methods and urge for NSSI, but not with others, such as age of onset.ConclusionsThis study provides a valuable opportunity to expand our knowledge of suicide risk factors beyond those that may apply broadly to self-injurers and to non-injurers (e.g., depression, substance use) to NSSI-related factors that might be specifically predictive of suicidal thoughts among self-injurers. Findings inform clinical risk assessment of self-injurious youth, a population at high risk of suicidal thoughts and behaviors, and provide further insight into the complex NSSI/suicide relationship.
Highlights
Nonsuicidal self-injury (NSSI) and suicidal ideation (SI) are both distressing and quite common, in youth
SI and Demographic Characteristics A plurality of patients reported no SI over the week prior to intake (34.28 %), while a further 31.18 % reported thinking about suicide a little of the time, 16.25 % reported thinking about suicide half the time, 12.57 % reported thinking about suicide most of the time, and 5.72 % reported thinking about suicide all of the time
There were no statistically significant differences in mean SI level by ethnic group (Cohen’s d = .12, p = .13, higher SI in non-Hispanic Caucasians compared to other ethnic groups), gender (Cohen’s d = .20, p = .008, higher SI in females compared to males), age (Cohen’s d = .04, p = .51, higher SI in adolescents compared to young adults), or number of psychiatric diagnoses (Cohen’s d = −.06, p = .26, lower SI associated with more psychiatric diagnoses)
Summary
Nonsuicidal self-injury (NSSI) and suicidal ideation (SI) are both distressing and quite common, in youth. Nonsuicidal self-injury (NSSI) is the intentional, selfdirected destruction of bodily tissue engaged in for purposes neither suicidal nor socially sanctioned, and includes behaviors such as cutting, burning, or hitting [1]. Several studies have demonstrated rates of suicidal ideation (SI) at least double that of non-injurers. These findings have been replicated cross-nationally in the US [9], China [10], and Sweden [11]; in all cases, the relationship remained even after removing individuals who had attempted suicide in addition to engaging in NSSI.
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