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Nonsuicidal self-injury as a gateway to suicide in young adults.
J Adolesc Health 2013; 52(4):486-92JA

Abstract

PURPOSE

To investigate the extent to which nonsuicidal self-injury (NSSI) contributes to later suicide thoughts and behaviors (STB) independent of shared risk factors.

METHODS

One thousand four hundred and sixty-six students at five U.S. colleges participated in a longitudinal study of the relationship between NSSI and suicide. NSSI, suicide history, and common risk/protective factors were assessed annually for three years. Analyses tested the hypotheses that the practice of NSSI prior to STB and suicide behavior (excluding ideation) reduced inhibition to later STB independent of shared risk factors. Analyses also examined factors that predicted subsequent STB among individuals with NSSI history.

RESULTS

History of NSSI did significantly predict concurrent or later STB (AOR 2.8, 95%, CI 1.9-4.1) independent of covariates common to both. Among those with prior or concurrent NSSI, risk of STB is predicted by > 20 lifetime NSSI incidents (AOR 3.8, 95% CI, 1.4-10.3) and history of mental health treatment (AOR 2.2, 95% CI, 1.9-4.6). Risk of moving from NSSI to STB is decreased by presence of meaning in life (AOR .6, 95% CI, .5-.7) and reporting parents as confidants (AOR, .3, 95% CI, .1-.9).

CONCLUSIONS

NSSI prior to suicide behavior serves as a "gateway" behavior for suicide and may reduce inhibition through habituation to self-injury. Treatments focusing on enhancing perceived meaning in life and building positive relationships with others, particularly parents, may be particularly effective in reducing suicide risk among youth with a history of NSSI.

Authors+Show Affiliations

Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY 14853, USA. jlw43@cornell.eduNo 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, Non-U.S. Gov't

Language

eng

PubMed ID

23298982

Citation

Whitlock, Janis, et al. "Nonsuicidal Self-injury as a Gateway to Suicide in Young Adults." The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, vol. 52, no. 4, 2013, pp. 486-92.
Whitlock J, Muehlenkamp J, Eckenrode J, et al. Nonsuicidal self-injury as a gateway to suicide in young adults. J Adolesc Health. 2013;52(4):486-92.
Whitlock, J., Muehlenkamp, J., Eckenrode, J., Purington, A., Baral Abrams, G., Barreira, P., & Kress, V. (2013). Nonsuicidal self-injury as a gateway to suicide in young adults. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 52(4), pp. 486-92. doi:10.1016/j.jadohealth.2012.09.010.
Whitlock J, et al. Nonsuicidal Self-injury as a Gateway to Suicide in Young Adults. J Adolesc Health. 2013;52(4):486-92. PubMed PMID: 23298982.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsuicidal self-injury as a gateway to suicide in young adults. AU - Whitlock,Janis, AU - Muehlenkamp,Jennifer, AU - Eckenrode,John, AU - Purington,Amanda, AU - Baral Abrams,Gina, AU - Barreira,Paul, AU - Kress,Victoria, Y1 - 2012/12/03/ PY - 2012/05/08/received PY - 2012/09/17/revised PY - 2012/09/18/accepted PY - 2013/1/10/entrez PY - 2013/1/10/pubmed PY - 2013/9/14/medline SP - 486 EP - 92 JF - The Journal of adolescent health : official publication of the Society for Adolescent Medicine JO - J Adolesc Health VL - 52 IS - 4 N2 - PURPOSE: To investigate the extent to which nonsuicidal self-injury (NSSI) contributes to later suicide thoughts and behaviors (STB) independent of shared risk factors. METHODS: One thousand four hundred and sixty-six students at five U.S. colleges participated in a longitudinal study of the relationship between NSSI and suicide. NSSI, suicide history, and common risk/protective factors were assessed annually for three years. Analyses tested the hypotheses that the practice of NSSI prior to STB and suicide behavior (excluding ideation) reduced inhibition to later STB independent of shared risk factors. Analyses also examined factors that predicted subsequent STB among individuals with NSSI history. RESULTS: History of NSSI did significantly predict concurrent or later STB (AOR 2.8, 95%, CI 1.9-4.1) independent of covariates common to both. Among those with prior or concurrent NSSI, risk of STB is predicted by > 20 lifetime NSSI incidents (AOR 3.8, 95% CI, 1.4-10.3) and history of mental health treatment (AOR 2.2, 95% CI, 1.9-4.6). Risk of moving from NSSI to STB is decreased by presence of meaning in life (AOR .6, 95% CI, .5-.7) and reporting parents as confidants (AOR, .3, 95% CI, .1-.9). CONCLUSIONS: NSSI prior to suicide behavior serves as a "gateway" behavior for suicide and may reduce inhibition through habituation to self-injury. Treatments focusing on enhancing perceived meaning in life and building positive relationships with others, particularly parents, may be particularly effective in reducing suicide risk among youth with a history of NSSI. SN - 1879-1972 UR - https://www.unboundmedicine.com/medline/citation/23298982/Nonsuicidal_self_injury_as_a_gateway_to_suicide_in_young_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1054-139X(12)00405-3 DB - PRIME DP - Unbound Medicine ER -