Abstract
Although self-injurious thoughts and behaviors are a global health concern, little is known about suicidal threat/gesture(s) where a person leads others to believe they want to end their lives when they have no intention to do so. This study assessed the lifetime prevalence of self-injurious thoughts and behaviors among both community adolescents (n = 1117) and in clinical youth (n = 191). Suicide threats/gestures were common among youth; 12.2% of community adolescents and 18.0% of clinical youth reporting having made a suicide threat/gesture, most commonly in the context of other self-injurious thoughts and behaviors. Across both samples, suicide threats/gestures were not uniquely associated with suicide attempts, and youth who reported suicide threats/gestures in the context of a history of self-harm or suicide plan(s) were no more likely to report a history of suicide attempt(s). Suicide threats/gestures were distinguished from suicide attempts in that they primarily fulfilled positive social functions, rather than autonomic functions. Findings suggest that suicidal threats/gestures are common in both community and clinical youth, and are not uniquely associated with suicide attempts, but rather function to communicate distress to others.
Highlights
Self-injurious thoughts and behaviors (SITBs) are a global public health concern
Suicidal phenomena are further distinguished into suicidal ideation, suicide plans, and suicide attempts, with a suicide attempt being defined as engaging in self-injurious behavior
When it comes to the functions of SITBs, the previous research has found suicidal ideation, suicide plans, suicide attempts, and non-suicidal self-injury (NSSI) serve largely automatic negative and automatic positive functions [3, 4, 9, 22]
Summary
Self-injurious thoughts and behaviors (SITBs) are a global public health concern. Globally, nearly 800,000 people die by suicide each year [33], with recent evidence to suggest rates of self-injury among adolescents have increased in recent years [10]. 22.3% of a US youth sample recruited from community and outpatient settings reported a lifetime history of suicide threats/gestures, 12.8% a past year history, and 2.1% a past month history [22]. The four-function model proposes that self-injurious behavior can be maintained by four distinct reinforcement processes: automatic negative reinforcement (i.e., to reduce aversive internal states), automatic positive reinforcement (i.e., to generate positive emotions or stimulation), social negative reinforcement (i.e., to escape from uncomfortable social situations), and social positive reinforcement (i.e., to gain support from others) [24] When it comes to the functions of SITBs, the previous research has found suicidal ideation, suicide plans, suicide attempts, and NSSI serve largely automatic negative and automatic positive functions [3, 4, 9, 22]. Preliminary evidence suggests that suicide threats/gestures are largely characterized by social positive functions [9]
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