Clarifying the Role of Multiple Self-Damaging Behaviors in the Association Between Emotion Dysregulation and Suicide Risk Among College Students.

Suicidal behaviors are increasingly prevalent among college students. Although emotion dysregulation is theorized to increase suicide risk, research supporting this relationship is mixed. Engagement in self-damaging behaviors may play a role in the relationship between emotion dysregulation and suicide risk, theoretically by increasing one's capability of engaging in suicidal behaviors. Such behaviors may interact with emotion dysregulation to predict suicide risk. Alternatively, engaging in self-damaging behaviors may mediate the emotion dysregulation-suicide risk relationship. We examined the potential moderating and mediating roles of engagement in multiple self-damaging behaviors in the relationship between emotion dysregulation and suicide risk among college students. Participants were 181 undergraduate students who reported a history of self-damaging behaviors (i.e., non-suicidal self-injury, alcohol misuse, drug misuse, disordered eating), overall emotion dysregulation, and suicide risk. Findings revealed an interactive effect of emotion dysregulation and self-damaging behaviors on suicide risk, with engagement in more forms of self-damaging behaviors conferring higher risk for suicide, particularly in the context of greater emotion dysregulation. The model testing self-damaging behaviors as a mediator was also significant, such that greater emotion dysregulation had an indirect effect on elevated suicide risk via number of self-damaging behaviors. These findings help clarify associations among emotion dysregulation, self-damaging behaviors, and suicide risk, and have implications for specific targets of intervention and for the prevention of suicide by college students.