Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well-understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. We used ecological momentary assessment methods to measure suicidal and non-suicidal SITBs as they naturally occur in real-time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signal-and event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1-30 minutes), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors.Self-injurious behaviors are among the leading causes of death and injury worldwide (Nock, Borges et al., 2008;WHO, 2008), and represent one of the most perplexing problems facing psychological scientists. Philosophers have speculated about the nature of suicidal selfinjury for centuries (e.g., Kant, Camus, Rousseau, Satre, Hobbes, Locke, Hume)(see Minois, 1999), and over the past 50 years scientists have used systematic research methods to study self-injurious thoughts and behaviors (SITBs). SITBs include both suicidal behaviors (e.g., Correspondence to: Matthew K. Nock, Ph.D., 33 Kirkland Street, 1280, Cambridge, MA 02138, nock@wjh.harvard.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/ pubs/journals/abn.
HHS Public AccessAuthor manuscript J Abnorm Psychol. Author manuscript; available in PMC 2017 January 23.
Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript suicidal thoughts, suicide attempts) as well as non-suicidal self-injury (NSSI), which refers to the direct, deliberate destruction of body tissue in the absence of lethal intent (Nock & Favazza, 2009;Nock, Wedig, Janis, & Deliberto, 2008). This research has provided valuable info...