NSSI and Suicide

The relationship between NSSI and suicidal thoughts and behaviours is complex. Although NSSI is not engaged with conscious suicidal intent, it is the most reliable predictor of later suicidal behaviour. People who have a history of NSSI are between 3-5 times more likely to report later ideation or attempt.

Take home points:

·   A history of NSSI is associated with increased risk of later suicidal thoughts and behaviours.

·   However predictive accuracy is relatively weak.

·   More frequent NSSI, and use of a variety of methods, are associated with increased risk of attempt, among people with a history of NSSI.

·   Suicidal intent can fluctuate over time; risk assessment and ongoing monitoring of intent among people who self-injure may be warranted.

Recommended reading:

1. Hamza, Stewart, & Willoughby. (2012). Examining the link between nonsuicidal self-injury and suicidal behavior: A review of the literature and an integrated model. Clinical Psychology Review, 32, 482-495.

2. Victor and Klonsky (2014). Correlates of suicide attempts among self-injurers: A meta-analysis. Clinical Psychology Review, 34, 282-297.

3. Kiekens et al., (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviours. J Affective Disorders, 239, 171-179.

4. Whitlock et al. (2013). Nonsuicidal self-injury as a gateway to suicide in young adults. J Adolescent Health, 52, 486-492.

5. Ribeiro et al., (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine, 46, 225-236.

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