Abstract
Non-suicidal self-injuries (NSSIs) have been identified as one of the most predictive factors of suicidal behaviours in adolescents. However, it remains unknown whether certain functions of NSSIs are associated with suicide risk, and what are the underlying mechanisms. Therefore, we aimed to investigate the association between functions of NSSIs and suicide risk in adolescents with conduct disorder (CD), which shares some common characteristics with NSSIs. Participants were 215 adolescents (155 females, 72.1%) with CD. Functions of NSSIs, depressive symptoms, the levels of impulsivity, anxiety, self-esteem and aggression were examined. There were 77 adolescents with lifetime history of NSSIs (35.8%). Among them, adolescents with lifetime history of suicide attempt were significantly more likely to report anti-dissociation and anti-suicide function of NSSIs. They had significantly higher levels of anxiety as well as significantly lower self-esteem. Higher lifetime number of NSSIs was associated with higher odds of reporting anti-dissociation and anti-suicide functions. Moreover, these two functions fully mediated the association between lifetime number of NSSIs and suicide risk after co-varying for depressive and anxiety symptoms as well as self-esteem. The present findings indicate that anti-suicide and anti-dissociation functions of NSSIs might be crucial predictors of suicide risk in adolescents with CD.
Highlights
Published: 7 October 2021Suicidality among adolescents remains one of crucial concerns in both medical and social fields of modern societies
The results of our research indicate the role of Non-suicidal self-injuries (NSSIs)’s functions, our findings should be interpreted with caution due to potential recall bias with respect to reporting the number of NSSIs by participants
Our study sample was not large and the sample size and cross-sectional design should be highlighted as main limitations of our study but the specificity of mental disorders seems to be important and might be responsible for a lack of consistency in the results within different clinical samples, and further might lead to the conclusion that symptomatic differences between mental disorders may affect the effect of various mediators including the impact of specific functions of
Summary
Published: 7 October 2021Suicidality among adolescents remains one of crucial concerns in both medical and social fields of modern societies. Non-suicidal self-injuries (NSSIs) have been identified as one of the strongest risk factors of suicidal behaviours in adolescents according to previous studies [1,2]. Younger age at onset of NSSIs, in comparison with suicide attempts, has been replicated by studies conducted in the general population and in patients diagnosed with mental disorders, indicating that NSSIs precede suicidal behaviours [3,4,5]. Taking into account significantly higher prevalence of NSSIs in comparison with suicidal attempts estimated in the general population of adolescents Functions of NSSIs seem to play an important role in shaping suicidal behaviours.
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