Familial and Individual Correlates of Nonsuicidal Self-Injury in the Offspring of Mood-Disordered Parents

Cox, Lara Jo; Stanley, Bárbara; Melhem, Nadine M.; Oquendo, María A.; Birmaher, Boris; Burke, Ainsley K.; Kolko, David J.; Zelazny, Jamie; Mann, J. John; Porta, Giovanna; Brent, David A.

doi:10.4088/jcp.11m07196

Cited by 19 publications

(22 citation statements)

References 52 publications

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“…Nonetheless, NSSI is a risk factor for suicide attempts 23,24 and suicidal ideation. 25 More than 90% of adolescent suicide victims met criteria for a psychiatric disorder before their death. Immediate risk factors include agitation, intoxication, and a recent stressful life event.…”

Section: Adolescents At Increased Riskmentioning

confidence: 99%

Suicide and Suicide Attempts in Adolescents

Shain¹,

Braverman²,

Adelman³

et al. 2016

Pediatrics

318

153

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Suicide is the second leading cause of death for adolescents 15 to 19 years old. This report updates the previous statement of the American Academy of Pediatrics and is intended to assist pediatricians, in collaboration with other child and adolescent health care professionals, in the identification and management of the adolescent at risk for suicide. Suicide risk can only be reduced, not eliminated, and risk factors provide no more than guidance. Nonetheless, care for suicidal adolescents may be improved with the pediatrician’s knowledge, skill, and comfort with the topic, as well as ready access to appropriate community resources and mental health professionals.

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Section: Adolescents At Increased Riskmentioning

confidence: 99%

Suicide and Suicide Attempts in Adolescents

Shain¹,

Braverman²,

Adelman³

et al. 2016

Pediatrics

318

153

View full text Add to dashboard Cite

show abstract

“…19 Those who engaged in nonsuicidal self-injury were also younger than those who had made suicide attempts prior to entry into the study. In contrast to previous reports on the predictors of suicide attempt in this and other samples, nonsuicidal self-injury was not related to a history of parental suicidal behavior or abuse.…”

mentioning

confidence: 96%

“…On the other hand, some reports indicate that nonsuicidal self-injury is actually a stronger predictor of eventual suicidal behavior than a previous history of suicide attempt. 12,13 In fact, Joiner and colleagues have hypothesized that repeated engagement in nonsuicidal self-injury may reduce the threshold for suicidal behavior by increasing pain tolerance and decreasing the fear of self-injury, 17–19 suggesting that the prevention of suicidal behavior may be predicated on helping the patient to stop engaging in nonsuicidal self-injury.…”

mentioning

confidence: 99%

A Longitudinal Study of Nonsuicidal Self-Injury in Offspring at High Risk for Mood Disorder

Cox

Stanley²,

Melhem³

et al. 2012

J. Clin. Psychiatry

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Objective To determine the demographic and clinical predictors of nonsuicidal self-injury and to examine the longitudinal relationship between nonsuicidal self-injury and suicide attempt. Method This was a longitudinal cohort study of the familial transmission of suicidal behavior. The sample consisted of probands with DSM-IV mood disorder (n = 212), 54.2% of whom were suicide attempters, and their offspring aged at least 10 years (n = 352), followed for a mean of 3.8 years. Personal, parental, and familial characteristics were assessed annually to identify the most parsimonious subset of these variables associated with nonsuicidal self-injury, the primary outcome. Data were collected between August 1998 and August 2007. Results Of 352 offspring, 7.4% (n = 26) engaged in nonsuicidal self-injury during follow-up. In the final model examining predictors at baseline, the most severe time point, and the time point prior to nonsuicidal self-injury, only predictors from the most proximal time point were significant, namely younger age (odds ratio [OR] = 0.75, P = .002), diagnosis of current major depression (OR = 5.09, P < .001), and suicidal ideation (OR = 1.46, P = .02). In 2 of the 3 single time point models, baseline nonsuicidal self-injury was the most significant predictor of nonsuicidal self-injury during follow-up. Suicide attempt was predicted by both baseline nonsuicidal self-injury and suicide attempt, but when both were included in the model, nonsuicidal self-injury was a significant predictor (OR = 7.50, P = .009), but suicide attempter was not (OR = 3.78, P = .08); offspring aggression (OR = 1.11, P = .01) predicted suicide attempt but not nonsuicidal self-injury. Parental histories of nonsuicidal self-injury, suicide attempt, and abuse were not predictive of nonsuicidal self-injury. Conclusions Nonsuicidal self-injury may be an earlier manifestation of a shared diathesis with suicide attempt, consisting of depression and suicidal ideation, and that diathesis may lead to suicidal behavior in the face of greater offspring aggression and family pathology. The apparent bidirectional temporal relationship between nonsuicidal self-injury and suicide attempt may be explained by this shared diathesis.

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“…Other research has shown that methods and motivations for self-harm change over time, and that many different motivations may occur in the same episode. [30][31][32][33] In addition, Cox et al 5 in a longitudinal study, found that a history of NSSI predicted future SA, and that SA after baseline predicted future NSSI. Similarly, other studies have found that people who frequently engage in NSSI are more likely to attempt suicide.…”

Section: Discussionmentioning

confidence: 99%

Correlates of Nonsuicidal Self-Injury and Suicide Attempts among Tertiary Care, Emergency Department Patients

et al. 2015

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Objective:In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the distinction between nonsuicidal self-injury (NSSI) and suicidal behaviour disorder is highlighted in the section Conditions for Further Study. Diagnostic criteria classify NSSI and suicidal behaviour disorder as distinct disorders, with the latter including suicide attempt (SA). This study examined the prevalence and correlates of NSSI in emergency department (ED) settings and compared them to SA.Methods: Data came from adult referrals to psychiatric services in 2 EDs between January 2009 and June 2011 (n = 5336). NSSI was compared with SA, as well as no suicidal behaviour, across a broad range of demographic and diagnostic correlates.Results: NSSI was more highly associated with female sex, childhood abuse, anxiety disorders, major depressive disorder (MDD), aggression and impulsivity, age under 45, and substance use disorders (SUDs), compared with presentations without suicidal behaviour. Comparing NSSI and SA, no differences were observed on sex, age, history of child abuse, or presence of anxiety or SUDs. Recent life stressors (OR 1.44; 95% CI 1.05 to 1.99), active suicidal ideation (OR 8.84; 95% CI 5.26 to 14.85), MDD (OR 3.05; 95% CI 2.23 to 4.17), previous psychiatric care or SA (OR 1.89; 95% CI 1.36 to 2.64), and single marital status (OR 1.63; 95% CI 1.20 to 2.22) contributed to a higher SA rate. Among people with NSSI, 83.7% presented only once to an ED. Among people who presented multiple times, only 18.2% re-presented with NSSI.Conclusions: NSSI is associated with early life adversity and psychiatric comorbidity. Most people present only once to ED services, and self-harm presentations seemed to change over time. Future studies should continue to clarify whether NSSI and SA have distinct risk profiles. Résultats : L'AMNS était associée de façon plus marquée avec le sexe féminin, les mauvais traitements dans l'enfance, les troubles anxieux, le trouble dépressif majeur W W W Corrélats de l'automutilation non suicidaire et des tentatives de suicide chez les patients des soins tertiaires et des services d'urgence

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Familial and Individual Correlates of Nonsuicidal Self-Injury in the Offspring of Mood-Disordered Parents

Cited by 19 publications

References 52 publications

Suicide and Suicide Attempts in Adolescents

Suicide and Suicide Attempts in Adolescents

A Longitudinal Study of Nonsuicidal Self-Injury in Offspring at High Risk for Mood Disorder

Correlates of Nonsuicidal Self-Injury and Suicide Attempts among Tertiary Care, Emergency Department Patients

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