Abstract
Prior research has established a connection between non-suicidal self-injury (NSSI) and suicidal behavior. The interpersonal-psychological theory of suicidal behavior (IPTS) posits that an individual must possess both a desire and capability for suicide in order to engage in a lethal suicide attempt. The IPTS conceptualizes the role of NSSI in suicidal behavior as contributing to an individual’s acquired capability. The primary aim of this study was to investigate the relationship between frequency of engagement in NSSI and suicidal desire (thwarted belongingness and perceived burdensomeness). In this study, undergraduate students (n = 999) completed various questionnaires online. Results revealed a significant, positive association between NSSI frequency and thwarted belongingness and a non-significant association between NSSI frequency and perceived burdensomeness. Additionally, results indicated a significant indirect effect of NSSI frequency on burdensomeness and belongingness through depression and borderline personality disorder symptoms. The direct effect of NSSI frequency on belongingness remained significant; however, the direct effect of NSSI frequency on burdensomeness did not. These findings suggest that the relationship between NSSI and suicide is not strictly limited to acquired capability, but rather includes a component of suicidal desire.
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Notes
We also re-ran our analyses utilizing versatility in NSSI methods in place of NSSI frequency. All results remained the same across indirect and direct effects.
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed., ). Arlington:American Psychiatric Publishing.
Andover, M. S., & Gibb, B. E. (2010). Non-suicidal self-injury, attempted suicide, and suicidal intent among psychiatric inpatients. Psychiatry Research, 178(1), 101–105.
Anestis, M. D., Bagge, C. L., Tull, M. T., & Joiner, T. E. (2010). Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior. Journal of Psychiatric Research, 45(5), 603–611.
Anestis, M. D., Pennings, S. M., & Williams, T. J. (2014). Preliminary results from an examination of episodic planning in suicidal behavior. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 35, 186–192.
Anestis, M. D., Khazem, L. R., & Law, K. C. (2015). How many times and how many ways: the impact of non-suicidal self-injury methods on the relationship between non-suicidal self-injury frequency and suicidal behavior. Suicide and Life-Threatening Behavior.
Asarnow, J. R., Porta, G., Spirito, A., Emslie, G., Clarke, G., Wagner, K. D., & Brent, D. A. (2011). Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 772–781.
Barrios, L. C., Everett, S. A., Simon, T. R., & Brener, N. D. (2000). Suicide ideation among US college students: associations with other injury risk behaviors. Journal of American College Health, 48(5), 229–233.
Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R.-D., Domsalla, M., Chapman, A. L., Steil, R., Philipsen, A., & Wolf, M. (2009). (2009). the short version of the borderline symptom list (BSL-23): development and initial data on psychometric properties. Psychopathology, 42, 32–39.
Franklin, J. C., Hessel, E. T., & Prinstein, M. J. (2011). Clarifying the role of pain tolerance in suicidal capability. Psychiatry Research, 189, 362–367.
Gratz, K. L. (2001). Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. Journal of Psychopathology and Behavioral Assessment, 23(4), 253–263.
Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm : an empirical and conceptual review, 192–205.
Harwood, D., Hawton, K., Hope, T., & Jacoby, R. (2001). Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case–control study. International Journal of Geriatric Psychiatry, 16(2), 155–165.
Hayes, A. F. (2013). An introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York:Guilford Press.
Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008). An examination of nonsuicidal self-injury among college students. Journal of Mental Health Counseling, 30(2), 137–156.
Heath, N. L., Ross, S., Toste, J. R., Charlebois, A., & Nedecheva, T. (2009). Retrospective analysis of social factors and nonsuicidal self-injury among young adults. Canadian Journal of Behavioural Science, 41, 180–186.
Hooley, J. M., Ho, D. T., Slater, J., & Lockshin, A. (2010). Pain perception and non-suicidal self-injury: a laboratory investigation. Personality Disorders: Theory Research, and Treatment, 1, 170–179.
Joiner, T. E. (2005). Why people die by suicide. Cambridge:Harvard University Press..
Kline, R. B. (2005). Principles and practices of structural equation modeling (2nd ed., ). New York:Guilford Press.
Klonsky, E. D. (2009). The functions of self-injury in young adults who cut themselves: clarifying the evidence for affect-regulation. Psychiatry Research, 166, 260–268.
Klonsky, E. D., Oltmanns, T. F., & Turkheimer, E. (2003). Deliberate self-harm in a nonclinical population: prevalence and psychological correlates. The American Journal of Psychiatry, 160(8), 1501–1508.
Klonsky, E. D., May, A. M., & Glenn, C. R. (2013). The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. Journal of Abnormal Psychology, 122, 231–237.
Linehan, M. M., & Heard, H. L. (1992). Dialectical behavior therapy for borderline personality disorder. In J. F. Clarkin, E. Marziali, & H. Munroe-Blum (Eds.), Borderline personality disorder: Clinical and empirical perspectives (pp. 248–267). New York: Guilford Press.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutck, D. A., Reynolds, S. K., & Linedenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney:Psychology Foundation Monograph.
Muehlenkamp, J. J., & Gutierrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behaviro, 34, 12–23.
Nixon, M. K., Cloutier, P. F., & Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1333–1341.
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885–890.
Nock, M. K., Joiner, T. E., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72.
Paris, J. (2002). Chronic suicidality among patients with borderline personality disorder. Psychiatric Services, 53(6), 738–742.
Pompili, M., Girardi, P., Ruberto, A., & Tatarelli, R. (2005). Suicide in borderline personality disorder: a meta-analysis. Nordic Journal of Psychiatry, 59(5), 319–324.
Russ, M. J., Roth, S. D., Lerman, A., Kakuma, T., Harrison, K., Shindledecker, R. D., & Mattis, S. (1992). Pain perception in self-injurious patients with borderline personality disorder. Biological Psychiatry, 32(6), 501–511.
Russ, M. J., Campbell, S. S., Kakuma, T., Harrison, K., & Zanine, E. (1999). EEG theta activity and pain insensitivity in self-injurious borderline patients. Psychiatry Research, 89(3), 201–214.
Schmahl, C., Greffrath, W., Baumgartner, U., Schlereth, T., Magerl, W., Philipsen, A., & Treede, R.-D. (2004). Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli and pain ratings. Pain, 11, 470–479.
Schmahl, C., Bohus, M., Esposito, F., Treede, R-D., Di Salle, F., Greffath, W, Seifritz, E. (2006). Neural correlates of antinociception in borderline personality disorder. Archives of General Psychiatry, 63, 659–667.
Smith, A., Ribeiro, J., Mikolajewski, A., Taylor, J., Joiner, T., & Iacono, W. (2012). An examination of environmental and genetic contributions to the determinants of suicidal behavior among male twins. Psychiatry Research, 197, 60–65.
Tang, J., Yu, Y., Wu, Y., Du, Y., Ma, Y., Zhu, H., Liu, Z. (2011). Association between non-suicidal self-injuries and suicide attempts in Chinese adolescents and college students: a cross-section study. PloS One 6(4): e17977.
Turner, B. J., Layden, B. K., Butler, S. M., & Chapman, A. L. (2013). How often, or how many ways: clarifying the relationship between non-suicidal self-injury and suicidality. Archives of Suicide Research, 17, 397–415.
Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008). Suicidal desire and the capability for suicide: tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 76, 72–83.
Van Orden, K. A., Cukrowicz, K. C., Witte, T. K., & Joiner, T. E. (2012). Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the interpersonal needs questionnaire. Psychological Assessment, 24(1), 197–215.
Whitlock, J., & Knox, K. L. (2007). The relationship between self-injurious behavior and suicide in a young adult population. Archives of Pediatrics & Adolescent Medicine, 7, 634–640.
Wilkinson, P., Kelvin, R., Roberts, C., Dubicka, B., & Goodyer, I. (2011). Clinical and psychosocial predictors of suicide attempts and non-suicidal self-injury in adolescent depression antidepressants and psychotherapy trial (ADAPT). The American Journal of Psychiatry, 168(5), 495–501.
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Assavedo, B.L., Anestis, M.D. The Relationship Between Non-Suicidal Self-Injury and Both Perceived Burdensomeness and Thwarted Belongingness. J Psychopathol Behav Assess 38, 251–257 (2016). https://doi.org/10.1007/s10862-015-9508-8
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DOI: https://doi.org/10.1007/s10862-015-9508-8