An Exploration of Differences Between Deliberate Self-Harm with and without Suicidal Intent Amongst a Clinical Sample of Young People in Singapore: A Cross-Sectional Study

Abstract

This study examined differences between young people with mental illness who engage in deliberate self-harm with and without suicidal intent, as well as socio-demographic and clinical factors that are related to the increased likelihood of suicide attempt amongst self-harming young people. A total of 235 outpatients with mental illness who had engaged in deliberate self-harm were recruited from a tertiary psychiatric hospital in Singapore. Participants completed a self-report questionnaire which collected information on their socio-demographic background, self-harm history, diagnosis, depressive symptoms and childhood trauma. A total of 31.1% had reported a history of attempted suicide. Multiple logistic regression conducted found that engaging in self-harm ideation between 1 and 7 days (OR = 4.3, p = 0.30), and more than 1 week (OR = 10.5, p < 0.001) (versus no engagement in any self-harm ideation at all), were significantly associated with greater likelihood of attempted suicide. This study reports a relatively high prevalence rate of reported suicide attempts amongst young people with mental illness who engaged in self-harm. Identifying self-harm behaviors and treating it early could be the first step in managing potential suicidal behaviors among those who engage in self-harm.

Exploring the suicidal continuum: Deliberate self-harm diversity and severity as predictors of suicidal ideation and suicide attempts

“…According to our initial hypothesis, the diversity of DSH behaviors was a predictor of SI and SAs, which remained significant when controlling for the effect of DSH severity. These results are similar to those found in previous studies (Hamza and Willoughby, 2013;Samari et al, 2020;Wester et al, 2016). However, in our study, diversity was a stronger predictor of SAs than in the study of Duarte and colleagues (2020), which highlights the importance of DSH diversity both for clinical and research settings.…”

“…Thus, in the current study, we have two main goals: a) to characterize DSH diversity and severity, SI and SAs, and how these variables relate in a clinical and community sample of Portuguese adolescents with a history of DSH; and b) to analyze how impactful is the diversity and severity of DSH on SI and SAs. Since previous research has concluded that DSH diversity is associated with SI and SAs, we hypothesize that DSH diversity will predict SI and SAs (Duarte et al, 2020;Hamza and Willoughby, 2013;Samari et al, 2020;Wester et al, 2016). There is also evidence that individuals who have SAs engage in more severe DSH (Stewart et al, 2017).…”

“…Researchers have found that participants with more DSH behaviors have increased levels of psychopathological symptoms (Klonsky and Olino, 2008;Ammerman et al, 2019), which may be a sign that these individuals' mental state is worsening, therefore contributing to an increase in SI and leading them to consider suicide (Wester et al, 2016). Also, the engagement in DSH might desensitize adolescents and young adults regarding the pain and fear linked to suicide (Franklin et al, 2011;Muehlenkamp and Gutierrez, 2007), consequently contributing to a greater capability or receptiveness to engage in STBs (Klonsky and May 2015;Samari et al, 2020). Focusing on the severity of DSH behaviors, our results were not totally in line with our theoretical predictions.…”

Does cannabis use in adolescence predict self‐harm or suicide? Results from a Finnish Birth Cohort Study

“…In contrast, only a handful of longitudinal studies have assessed the association between cannabis use and suicide death with mixed findings 1,3–6 . In addition to suicidal behavior‐related outcomes, “self‐harm” and “deliberate self‐harm” defined as intentional self‐injurious behavior regardless of preceding objective have been examined in previous research 3,7,8 . A recent meta‐analysis of nine cohort studies by Escelsior et al reported an association between cannabis use and self‐injurious behavior 9 .…”

“… 1 , 3 , 4 , 5 , 6 In addition to suicidal behavior‐related outcomes, “self‐harm” and “deliberate self‐harm” defined as intentional self‐injurious behavior regardless of preceding objective have been examined in previous research. 3 , 7 , 8 A recent meta‐analysis of nine cohort studies by Escelsior et al reported an association between cannabis use and self‐injurious behavior. 9 Yet, significant knowledge gaps remain in our understanding of the association between specifically adolescent cannabis use and subsequent intentional self‐injury‐related outcomes.…”