Psychiatric and Self‐Injury Profiles of Adolescent Suicide Attempters versus Adolescents Engaged in Nonsuicidal Self‐Injury

Abstract

To better delineate the unique correlates of self-injurious behaviors (SIB), psychiatric profiles of mutually exclusive groups of adolescents who made a suicide attempt (SA) versus those engaged in nonsuicidal self-injury (NSSI) were examined. Contrary to hypotheses, the NSSI group endorsed earlier onsets of SIB and suicidal ideation (SI), as well as higher rates of depression and anxiety compared with their SA counterparts. Future work is warranted to understand the role of SI, including duration of SI and anxiety in the development of NSSI, and to identify risk and resiliency factors useful in predicting an adolescent's SIB status.

Self‐injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self‐injury

“…The KSADS‐PL was administered only to NSSI and SA participants and not their parents due to logistical constraints of assessing an inpatient population (e.g., short lengths of stay, somewhat limited access to family members). Our previously published examination of psychopathology in this sample confirms a high correlation between NSSI and SA participant KSADS‐PL diagnoses and parent completed reports about psychopathology (Kim et al., ).…”

“…Another interpretation is that NSSI provides a coping strategy to avert an SA (Nock & Prinstein, ). In our prior study of psychopathology among this group of adolescents engaged in either NSSI‐only or SA‐only, we found that NSSI participants were significantly more likely to report engaging in self‐harm to cope with their current emotional state than SA participants, whereas SA participants were more likely to endorse escaping from someone or something (Kim et al., ). This aligns with Nock and Prinstein's four‐function model of NSSI, suggesting that NSSI is an automatically/self‐reinforcing process (rather than being reinforced by others) helping the individual cope with negative emotions (Klonsky & Olino, ; Nock & Prinstein, ).…”

“…With regard to DSM‐oriented psychiatric diagnoses, both the NSSI and SA groups were most characterized by depression and anxiety (SA: 69% Major Depressive Disorder [MDD], 20% Generalized Anxiety Disorder [GAD]; NSSI: 88% MDD, 41% GAD). However, the proportion of NSSI participants diagnosed with MDD [ χ 2 = 8.47, p < .05] was significantly greater than the proportion of SA participants diagnosed with the disorder per the KSADS‐PL (Kim et al., ).…”

“…The NSSI‐only participants did demonstrate acquired capability, having engaged in NSSI at an earlier age of onset than SA participants made their first SA. They also showed greater social isolation than SA participants via greater levels of withdrawn/depressed and internalizing problems on the CBCL (Kim et al., ). Thus, it is possible that perceived burdensomeness is the missing ingredient preventing our NSSI‐only participants from having yet made an SA, but unfortunately, we did not specifically assess perceived burdensomeness.…”

Prevalence and Risk-Markers of Self-Harm in Autistic Children and Adults

“…Despite the clear rationale for research on self-harm in autism, studies of self-harm often explicitly exclude autistic participants (see Kim et al 2015 ; Dickstein et al 2015 ). One possible reason for this exclusion is an a priori definition of self-harm that categorises the typically repetitive self-injurious behaviours exhibited by autistic people as qualitatively different to self-harm shown by neurotypical individuals.…”