Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents

JOURNAL OF AFFECTIVE DISORDERS

卷:292

Article

Czyz, E. K.¹  Glenn, Catherine R.^2,3  Arango, Alejandra¹  Koo, Hyun Jung¹  King, C. A.^1,4 

[1] Univ Michigan, Dept Psychiat, 4250 Plymouth Rd, Ann Arbor, MI 48109 USA

[2] Old Dominion Univ, Dept Psychol, Norfolk, VA USA

[3] Virginia Consortium Program Clin Psychol, Norfolk, VA USA

[4] Univ Michigan, Dept Psychol, Ann Arbor, MI USA

关键词: Dolescents;    Nonsuicidal self-injury;    Suicidal ideation;    Nonsuicidal self-injury functions;    Daily diary;    Adolescents;    ecological momentary assessment;   

DOI  :  10.1016/j.jad.2021.05.104

来源: Elsevier

【 摘 要 】

Background: In this daily dairy study of adolescents at elevated suicide risk, we examined proximal associations between nonsuicidal self-injury (NSSI) and suicidal thoughts as well as behaviors. We also investigated the prominence of the anti-suicide function underlying NSSI engagement, relative to intrapersonal and interpersonal motives. Methods: Seventy-eight adolescents (67.9% female; ages 13-17) hospitalized due to suicide risk completed daily surveys assessing NSSI and suicidal thoughts for four weeks after discharge (n=1621 observations). Suicidal behavior (actual, aborted, interrupted suicide attempts) was assessed at 1-month follow-up. Results: Over and above lifetime NSSI, adolescents who generally experienced more enduring (OR=2.54, p=<.001) and intense (OR=1.87, p=.002) suicidal ideation were more likely to engage in NSSI on a given day. Moreover, NSSI likelihood increased when adolescents experienced more enduring (OR=1.99, p<.001) and intense (OR=1.66, p<.001) ideation relative to their typical levels. This pattern was consistent for those with recent NSSI. The anti-suicide function of NSSI was frequently endorsed at hospitalization and when NSSI occurred daily (65.6% of the time), alongside the intrapersonal-negative motive (to avoid aversive states). Exploratory analyses suggest adolescents with suicidal behavior within the month after discharge experienced higher NSSI levels reported daily over the same period (Hedge's g=1.26, p=<.001). Limitations: Daily-level associations were examined concurrently and generalizability of results is limited by sample characteristics. Conclusions: The notable proximal associations between NSSI and suicidal thoughts and behaviors, as well as the prominence of the anti-suicide function, point to the importance of intervention efforts targeting these intersecting phenomena among adolescents at elevated suicide risk.

【 授权许可】

Free