Category: Suicide and Self-Injury

PS4- #B41 - Frequency and Methods of Nonsuicidal Self-Injury and Their Association With Interpersonal Cognitions Among Adolescents

Friday, Nov 17
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Self-Injury | Suicide | Adolescents

Objective
Nonsuicidal self-injury (NSSI) has been called “double trouble” because it has been associated with both suicide ideation (SI) and suicide attempt (SA) (Guan, Fox, Prinstein, 2012; Klonsky, May, & Glenn, 2013; Klonsky, Oltmanns, & Turkheimer, 2003; Turner et al., 2013). NSSI has frequently been examined in relation to SA but less so in relation to SI. Traditionally, cognitions have been examined in CBT paradigms of cognitive distortions and negative attributions, and there is emerging evidence highlighting the importance of these variables in suicide prevention research. Joiner’s (2005) Interpersonal Psychological Theory of Suicide (IPTS) offers a framework that proposes that two interpersonal cognitive variables, perceived burdensomeness (PB) and thwarted belongingness (TB) are mediators for all risk factors for SI. In an adult, non-clinical sample PB and TB mediated the associations between NSSI and SI (Chu, Rogers, & Joiner, 2016). This present study examines the association between NSSI and SI within an adolescent clinical sample. Aims of this study were to examine (1) the association of lifetime presence or absence of NSSI (NSSI-L), frequency of NSSI (NSSI-F), and number of NSSI methods used (NSSI-M) with SI and (2) whether these associations are mediated by PB, TB, and their interactions as predicted by the IPTS.

Methods
Participants were 310 youth, (M age = 14.88, SD = 1.42) recruited during acute hospitalization. The majority were Caucasian (81%) and girls (79%).  


Measures included the Interpersonal Needs Questionnaire (INQ-15), Columbia Suicide Severity Rating Scale (C-SSRS; recent most severe ideation and NSSI), and the Quick Inventory of Depressive Symptoms – Adolescent Self-Report (QIDS; suicide item excluded).


Results
NSSI-L (r =.18), NSSI-M (r = .21), and NSSI-F (r = .16) were correlated with SI. NSSI-M was also correlated with PB (r = .17) and TB (r = .19) as was NSSI-F with TB (r = .13). All correlations were significant (p < .005).  


Age, sex, and depression were controlled in all analyses. In all three multiple regression analyses examining the independent predictions of NSSI, PB, TB, and PB*TB to most recent severe ideation (SI), the NSSI predictor, TB, and depression contributed unique variance to SI. PROCESS analyses indicated mediation through depression but not TB for NSSI-L. There were indirect effects from NSSI-F to SI through TB but not for depression. No indirect effects were found when analyzing NSSI-M’s effect on SI.


Conclusions
We found that all measures of NSSI were positively and directly associated with suicide ideation after controlling for all other variables. Our findings provide further support for NSSI’s contribution to “double trouble,” the idea that NSSI is a doubly important risk factor in that it contributes to both SI and SA. However, the IPTS variables did not fully mediate NSSI’s relation to SI, which contradicts the final common pathway clause of the IPTS. Future studies should examine potential mediators of the association between NSSI and SI. 

Hayden Mbroh

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Lucas Zullo

Doctoral Student in Clinical Psychology
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas

Nicholas Westers

Children's Medical Center Dallas

Michael Eaddy

Graduate Research Assistant
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center
Dallas, Texas

Sunita Stewart

Licensed Psychologist, Professor of Psychiatry
Children's Health – Children's Medical Center/University of Texas Southwestern Medical Center