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The present research examined the latent structure of self-injurious behavior (SIB) to determine whether suicidal self-injury (SSI) and nonsuicidal self-injury (NSSI) reflect categorically distinct types of SIB or dimensional variations of the same construct. Participants consisted of 1,525 female undergraduates across several universities in the United States who completed the Survey of College Mental Health and Well Being and endorsed a history of SIB. Empirically derived indicators representing intent to die, suicidal history, frequency of SIB, severity of SIB, and number of methods of SIB were submitted to three mathematically independent taxometric procedures. Results of multiple consistency tests converged to indicate that the latent structure of SIB is continuous, with individuals who engage in SSI and NSSI differing in degree rather than kind. The implications of these dimensional findings for the theoretical conceptualization, assessment, and treatment of SIB are discussed.

The disparity between urban and rural suicide rates is increasing. In response to thismajor public health problem, clinicians and schoolmental health researchers designed a systematic crisis intervention protocol to be used with adolescents presenting with suicidal or homicidal ideation. The prevention of escalating adolescent crisis events (PEACE) protocol is a comprehensive risk assessment designed for use by licensed clinicians working collaboratively with school personnel. A revised and extended version of the PEACE protocol was employed during 68 crisis events involving 42 high school students in 2013-14. These results and clinical implications of utilizing a systematic protocol to address potential suicidal or violence threats are discussed.

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