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A longitudinal study of nonsuicidal self-injury in offspring at high risk for mood disorder.
J Clin Psychiatry. 2012 Jun; 73(6):821-8.JC

Abstract

OBJECTIVE

To determine the demographic and clinical predictors of nonsuicidal self-injury and to examine the longitudinal relationship between nonsuicidal self-injury and suicide attempt.

METHOD

This was a longitudinal cohort study of the familial transmission of suicidal behavior. The sample consisted of probands with DSM-IV mood disorder (n = 212), 54.2% of whom were suicide attempters, and their offspring aged at least 10 years (n = 352), followed for a mean of 3.8 years. Personal, parental, and familial characteristics were assessed annually to identify the most parsimonious subset of these variables associated with nonsuicidal self-injury, the primary outcome. Data were collected between August 1998 and August 2007.

RESULTS

Of 352 offspring, 7.4% (n = 26) engaged in nonsuicidal self-injury during follow-up. In the final model examining predictors at baseline, the most severe time point, and the time point prior to nonsuicidal self-injury, only predictors from the most proximal time point were significant, namely younger age (odds ratio [OR] = 0.75, P = .002), diagnosis of current major depression (OR = 5.09, P < .001), and suicidal ideation (OR = 1.46, P = .02). In 2 of the 3 single time point models, baseline nonsuicidal self-injury was the most significant predictor of nonsuicidal self-injury during follow-up. Suicide attempt was predicted by both baseline nonsuicidal self-injury and suicide attempt, but when both were included in the model, nonsuicidal self-injury was a significant predictor (OR = 7.50, P = .009), but suicide attempter was not (OR = 3.78, P = .08); offspring aggression (OR = 1.11, P = .01) predicted suicide attempt but not nonsuicidal self-injury. Parental histories of nonsuicidal self-injury, suicide attempt, and abuse were not predictive of nonsuicidal self-injury.

CONCLUSIONS

Nonsuicidal self-injury may be an earlier manifestation of a shared diathesis with suicide attempt, consisting of depression and suicidal ideation, and that diathesis may lead to suicidal behavior in the face of greater offspring aggression and family pathology. The apparent bidirectional temporal relationship between nonsuicidal self-injury and suicide attempt may be explained by this shared diathesis.

Authors+Show Affiliations

Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22687609

Citation

Cox, Lara J., et al. "A Longitudinal Study of Nonsuicidal Self-injury in Offspring at High Risk for Mood Disorder." The Journal of Clinical Psychiatry, vol. 73, no. 6, 2012, pp. 821-8.
Cox LJ, Stanley BH, Melhem NM, et al. A longitudinal study of nonsuicidal self-injury in offspring at high risk for mood disorder. J Clin Psychiatry. 2012;73(6):821-8.
Cox, L. J., Stanley, B. H., Melhem, N. M., Oquendo, M. A., Birmaher, B., Burke, A., Kolko, D. J., Zelazny, J. M., Mann, J. J., Porta, G., & Brent, D. A. (2012). A longitudinal study of nonsuicidal self-injury in offspring at high risk for mood disorder. The Journal of Clinical Psychiatry, 73(6), 821-8. https://doi.org/10.4088/JCP.11m07250
Cox LJ, et al. A Longitudinal Study of Nonsuicidal Self-injury in Offspring at High Risk for Mood Disorder. J Clin Psychiatry. 2012;73(6):821-8. PubMed PMID: 22687609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A longitudinal study of nonsuicidal self-injury in offspring at high risk for mood disorder. AU - Cox,Lara J, AU - Stanley,Barbara H, AU - Melhem,Nadine M, AU - Oquendo,Maria A, AU - Birmaher,Boris, AU - Burke,Ainsley, AU - Kolko,David J, AU - Zelazny,Jamie M, AU - Mann,J John, AU - Porta,Giovanna, AU - Brent,David A, Y1 - 2012/05/15/ PY - 2011/07/06/received PY - 2011/09/21/accepted PY - 2012/6/13/entrez PY - 2012/6/13/pubmed PY - 2012/9/27/medline SP - 821 EP - 8 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 73 IS - 6 N2 - OBJECTIVE: To determine the demographic and clinical predictors of nonsuicidal self-injury and to examine the longitudinal relationship between nonsuicidal self-injury and suicide attempt. METHOD: This was a longitudinal cohort study of the familial transmission of suicidal behavior. The sample consisted of probands with DSM-IV mood disorder (n = 212), 54.2% of whom were suicide attempters, and their offspring aged at least 10 years (n = 352), followed for a mean of 3.8 years. Personal, parental, and familial characteristics were assessed annually to identify the most parsimonious subset of these variables associated with nonsuicidal self-injury, the primary outcome. Data were collected between August 1998 and August 2007. RESULTS: Of 352 offspring, 7.4% (n = 26) engaged in nonsuicidal self-injury during follow-up. In the final model examining predictors at baseline, the most severe time point, and the time point prior to nonsuicidal self-injury, only predictors from the most proximal time point were significant, namely younger age (odds ratio [OR] = 0.75, P = .002), diagnosis of current major depression (OR = 5.09, P < .001), and suicidal ideation (OR = 1.46, P = .02). In 2 of the 3 single time point models, baseline nonsuicidal self-injury was the most significant predictor of nonsuicidal self-injury during follow-up. Suicide attempt was predicted by both baseline nonsuicidal self-injury and suicide attempt, but when both were included in the model, nonsuicidal self-injury was a significant predictor (OR = 7.50, P = .009), but suicide attempter was not (OR = 3.78, P = .08); offspring aggression (OR = 1.11, P = .01) predicted suicide attempt but not nonsuicidal self-injury. Parental histories of nonsuicidal self-injury, suicide attempt, and abuse were not predictive of nonsuicidal self-injury. CONCLUSIONS: Nonsuicidal self-injury may be an earlier manifestation of a shared diathesis with suicide attempt, consisting of depression and suicidal ideation, and that diathesis may lead to suicidal behavior in the face of greater offspring aggression and family pathology. The apparent bidirectional temporal relationship between nonsuicidal self-injury and suicide attempt may be explained by this shared diathesis. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/22687609/A_longitudinal_study_of_nonsuicidal_self_injury_in_offspring_at_high_risk_for_mood_disorder_ L2 - http://www.psychiatrist.com/jcp/article/pages/2012/v73n06/v73n0615.aspx DB - PRIME DP - Unbound Medicine ER -