Double trouble

Nonsuicidal self-injury and its relationship to suicidal ideation and number of past suicide attempts in clinical adolescents

Hayden Mbroh, Lucas Zullo, Nicholas Westers, Laura Stone, Jessica King, Betsy Kennard, Graham Emslie, Sunita Stewart

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Death by suicide is one of the leading causes of mortality among adolescents, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide attempts (SAs). The underlying bases for this relationship are unknown. We derived two hypotheses from the Interpersonal Psychological Theory of Suicide (IPTS): unmet interpersonal needs would explain NSSI's association with suicidal ideation (SI) and increased capability for suicide would explain NSSI's relationship with SA. Methods: Adolescents hospitalized on a psychiatric inpatient unit (N = 289) provided measures of current SI, number of past SAs, unmet interpersonal needs (perceived burdensomeness and thwarted belongingness), capability for suicide (fearlessness about death [FAD] and pain tolerance), depressive symptoms, and number of NSSI methods utilized. Results: Depressive symptoms, but not unmet interpersonal needs, explained NSSI's association with SI. FAD and SI, but not depressive symptoms or pain tolerance, accounted for NSSI's relationship with SA. FAD was associated with SA, but it did not fully account for NSSI's relationship with SA. Limitations: This study utilized a cross-sectional design and retrospective, self-report measures. Conclusions: Our study provides partial support for the role of the IPTS variables in NSSI's relationship with SA in adolescents. The finding that depressive symptoms and not unmet interpersonal needs explained NSSI's relationship with SI contradicts the IPTS. However, in those with SI, FAD was linearly associated with SA, which is consistent with the IPTS. Future studies are needed to clarify the persistent basis for NSSI's relationship with SA beyond FAD and SI.

Original languageEnglish (US)
Pages (from-to)579-585
Number of pages7
JournalJournal of Affective Disorders
Volume238
DOIs
StatePublished - Oct 1 2018

Fingerprint

Suicidal Ideation
Suicide
Wounds and Injuries
Psychological Theory
Depression
Hospitalized Adolescent
Pain

Keywords

  • Clinical adolescents
  • Ideation-to-action framework
  • Interpersonal Psychological Theory of Suicide
  • Nonsuicidal self-injury
  • Suicidal ideation
  • Suicide attempt

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

@article{1bc1f3bc33804665a85cb28d12da56dd,
title = "Double trouble: Nonsuicidal self-injury and its relationship to suicidal ideation and number of past suicide attempts in clinical adolescents",
abstract = "Background: Death by suicide is one of the leading causes of mortality among adolescents, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide attempts (SAs). The underlying bases for this relationship are unknown. We derived two hypotheses from the Interpersonal Psychological Theory of Suicide (IPTS): unmet interpersonal needs would explain NSSI's association with suicidal ideation (SI) and increased capability for suicide would explain NSSI's relationship with SA. Methods: Adolescents hospitalized on a psychiatric inpatient unit (N = 289) provided measures of current SI, number of past SAs, unmet interpersonal needs (perceived burdensomeness and thwarted belongingness), capability for suicide (fearlessness about death [FAD] and pain tolerance), depressive symptoms, and number of NSSI methods utilized. Results: Depressive symptoms, but not unmet interpersonal needs, explained NSSI's association with SI. FAD and SI, but not depressive symptoms or pain tolerance, accounted for NSSI's relationship with SA. FAD was associated with SA, but it did not fully account for NSSI's relationship with SA. Limitations: This study utilized a cross-sectional design and retrospective, self-report measures. Conclusions: Our study provides partial support for the role of the IPTS variables in NSSI's relationship with SA in adolescents. The finding that depressive symptoms and not unmet interpersonal needs explained NSSI's relationship with SI contradicts the IPTS. However, in those with SI, FAD was linearly associated with SA, which is consistent with the IPTS. Future studies are needed to clarify the persistent basis for NSSI's relationship with SA beyond FAD and SI.",
keywords = "Clinical adolescents, Ideation-to-action framework, Interpersonal Psychological Theory of Suicide, Nonsuicidal self-injury, Suicidal ideation, Suicide attempt",
author = "Hayden Mbroh and Lucas Zullo and Nicholas Westers and Laura Stone and Jessica King and Betsy Kennard and Graham Emslie and Sunita Stewart",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.jad.2018.05.056",
language = "English (US)",
volume = "238",
pages = "579--585",
journal = "Journal of Affective Disorders",
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publisher = "Elsevier",

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TY - JOUR

T1 - Double trouble

T2 - Nonsuicidal self-injury and its relationship to suicidal ideation and number of past suicide attempts in clinical adolescents

AU - Mbroh, Hayden

AU - Zullo, Lucas

AU - Westers, Nicholas

AU - Stone, Laura

AU - King, Jessica

AU - Kennard, Betsy

AU - Emslie, Graham

AU - Stewart, Sunita

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Death by suicide is one of the leading causes of mortality among adolescents, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide attempts (SAs). The underlying bases for this relationship are unknown. We derived two hypotheses from the Interpersonal Psychological Theory of Suicide (IPTS): unmet interpersonal needs would explain NSSI's association with suicidal ideation (SI) and increased capability for suicide would explain NSSI's relationship with SA. Methods: Adolescents hospitalized on a psychiatric inpatient unit (N = 289) provided measures of current SI, number of past SAs, unmet interpersonal needs (perceived burdensomeness and thwarted belongingness), capability for suicide (fearlessness about death [FAD] and pain tolerance), depressive symptoms, and number of NSSI methods utilized. Results: Depressive symptoms, but not unmet interpersonal needs, explained NSSI's association with SI. FAD and SI, but not depressive symptoms or pain tolerance, accounted for NSSI's relationship with SA. FAD was associated with SA, but it did not fully account for NSSI's relationship with SA. Limitations: This study utilized a cross-sectional design and retrospective, self-report measures. Conclusions: Our study provides partial support for the role of the IPTS variables in NSSI's relationship with SA in adolescents. The finding that depressive symptoms and not unmet interpersonal needs explained NSSI's relationship with SI contradicts the IPTS. However, in those with SI, FAD was linearly associated with SA, which is consistent with the IPTS. Future studies are needed to clarify the persistent basis for NSSI's relationship with SA beyond FAD and SI.

AB - Background: Death by suicide is one of the leading causes of mortality among adolescents, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide attempts (SAs). The underlying bases for this relationship are unknown. We derived two hypotheses from the Interpersonal Psychological Theory of Suicide (IPTS): unmet interpersonal needs would explain NSSI's association with suicidal ideation (SI) and increased capability for suicide would explain NSSI's relationship with SA. Methods: Adolescents hospitalized on a psychiatric inpatient unit (N = 289) provided measures of current SI, number of past SAs, unmet interpersonal needs (perceived burdensomeness and thwarted belongingness), capability for suicide (fearlessness about death [FAD] and pain tolerance), depressive symptoms, and number of NSSI methods utilized. Results: Depressive symptoms, but not unmet interpersonal needs, explained NSSI's association with SI. FAD and SI, but not depressive symptoms or pain tolerance, accounted for NSSI's relationship with SA. FAD was associated with SA, but it did not fully account for NSSI's relationship with SA. Limitations: This study utilized a cross-sectional design and retrospective, self-report measures. Conclusions: Our study provides partial support for the role of the IPTS variables in NSSI's relationship with SA in adolescents. The finding that depressive symptoms and not unmet interpersonal needs explained NSSI's relationship with SI contradicts the IPTS. However, in those with SI, FAD was linearly associated with SA, which is consistent with the IPTS. Future studies are needed to clarify the persistent basis for NSSI's relationship with SA beyond FAD and SI.

KW - Clinical adolescents

KW - Ideation-to-action framework

KW - Interpersonal Psychological Theory of Suicide

KW - Nonsuicidal self-injury

KW - Suicidal ideation

KW - Suicide attempt

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U2 - 10.1016/j.jad.2018.05.056

DO - 10.1016/j.jad.2018.05.056

M3 - Article

VL - 238

SP - 579

EP - 585

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

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