E K Czyz1, Catherine R Glenn2, Alejandra Arango3, Hyun Jung Koo3, C A King4. 1. Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States. Electronic address: ewac@umich.edu. 2. Department of Psychology, Old Dominion University, Norfolk, VA, United States; Virginia Consortium Program in Clinical Psychology, Norfolk, VA, United States. 3. Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States. 4. Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
Abstract
BACKGROUND: In this daily dairy study of adolescents at elevated suicide risk, we examined proximal associations between nonsuicidal self-injury (NSSI) and suicidal thoughts as well as behaviors. We also investigated the prominence of the anti-suicide function underlying NSSI engagement, relative to intrapersonal and interpersonal motives. METHODS: Seventy-eight adolescents (67.9% female; ages 13-17) hospitalized due to suicide risk completed daily surveys assessing NSSI and suicidal thoughts for four weeks after discharge (n=1621 observations). Suicidal behavior (actual, aborted, interrupted suicide attempts) was assessed at 1-month follow-up. RESULTS: Over and above lifetime NSSI, adolescents who generally experienced more enduring (OR=2.54, p=<.001) and intense (OR=1.87, p=.002) suicidal ideation were more likely to engage in NSSI on a given day. Moreover, NSSI likelihood increased when adolescents experienced more enduring (OR=1.99, p<.001) and intense (OR=1.66, p<.001) ideation relative to their typical levels. This pattern was consistent for those with recent NSSI. The anti-suicide function of NSSI was frequently endorsed at hospitalization and when NSSI occurred daily (65.6% of the time), alongside the intrapersonal-negative motive (to avoid aversive states). Exploratory analyses suggest adolescents with suicidal behavior within the month after discharge experienced higher NSSI levels reported daily over the same period (Hedge's g=1.26, p=<.001). LIMITATIONS: Daily-level associations were examined concurrently and generalizability of results is limited by sample characteristics. CONCLUSIONS: The notable proximal associations between NSSI and suicidal thoughts and behaviors, as well as the prominence of the anti-suicide function, point to the importance of intervention efforts targeting these intersecting phenomena among adolescents at elevated suicide risk.
BACKGROUND: In this daily dairy study of adolescents at elevated suicide risk, we examined proximal associations between nonsuicidal self-injury (NSSI) and suicidal thoughts as well as behaviors. We also investigated the prominence of the anti-suicide function underlying NSSI engagement, relative to intrapersonal and interpersonal motives. METHODS: Seventy-eight adolescents (67.9% female; ages 13-17) hospitalized due to suicide risk completed daily surveys assessing NSSI and suicidal thoughts for four weeks after discharge (n=1621 observations). Suicidal behavior (actual, aborted, interrupted suicide attempts) was assessed at 1-month follow-up. RESULTS: Over and above lifetime NSSI, adolescents who generally experienced more enduring (OR=2.54, p=<.001) and intense (OR=1.87, p=.002) suicidal ideation were more likely to engage in NSSI on a given day. Moreover, NSSI likelihood increased when adolescents experienced more enduring (OR=1.99, p<.001) and intense (OR=1.66, p<.001) ideation relative to their typical levels. This pattern was consistent for those with recent NSSI. The anti-suicide function of NSSI was frequently endorsed at hospitalization and when NSSI occurred daily (65.6% of the time), alongside the intrapersonal-negative motive (to avoid aversive states). Exploratory analyses suggest adolescents with suicidal behavior within the month after discharge experienced higher NSSI levels reported daily over the same period (Hedge's g=1.26, p=<.001). LIMITATIONS: Daily-level associations were examined concurrently and generalizability of results is limited by sample characteristics. CONCLUSIONS: The notable proximal associations between NSSI and suicidal thoughts and behaviors, as well as the prominence of the anti-suicide function, point to the importance of intervention efforts targeting these intersecting phenomena among adolescents at elevated suicide risk.
Authors: Kimberly A Van Orden; Tracy K Witte; Kelly C Cukrowicz; Scott R Braithwaite; Edward A Selby; Thomas E Joiner Journal: Psychol Rev Date: 2010-04 Impact factor: 8.934
Authors: Kelly Posner; Gregory K Brown; Barbara Stanley; David A Brent; Kseniya V Yershova; Maria A Oquendo; Glenn W Currier; Glenn A Melvin; Laurence Greenhill; Sa Shen; J John Mann Journal: Am J Psychiatry Date: 2011-12 Impact factor: 18.112
Authors: Catherine R Glenn; Elizabeth C Lanzillo; Erika C Esposito; Angela C Santee; Matthew K Nock; Randy P Auerbach Journal: J Abnorm Child Psychol Date: 2017-07
Authors: Erika C Esposito; Annie M Duan; Jaclyn C Kearns; Evan M Kleiman; Yeates Conwell; Catherine R Glenn Journal: Res Child Adolesc Psychopathol Date: 2022-03-07