Relationships between the frequency and severity of non‐suicidal self‐injury and suicide attempts in youth with borderline personality disorder

Andrewes, Holly; Hulbert, Carol; Cotton, Sue; Betts, Jennifer; Chanen, Andrew M

doi:10.1111/eip.12461

Cited by 60 publications

(42 citation statements)

References 47 publications

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“…Our results indicate that a higher number of NSSI methods (OR = 1.81) significantly predicts lifetime suicide attempts, which is in line with previous research (e.g., (7,19). Consistent with findings from Andrewes et al (51) and Burke et al (27), higher levels of depressive symptoms significantly predict current suicidal ideation (OR = 1.09). Previous studies (27,28) found that the anti-suicide function was an important predictor of occurrence of suicidal ideation.…”

Section: Discussionsupporting

confidence: 92%

Anti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents

2020

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Background: There have been numerous studies investigating the relationship between nonsuicidal self-injury (NSSI) and suicidality. On the one side, NSSI is an important risk factor for suicidality, including suicidal thoughts and behaviors. On the other side, it has been suggested that one function of NSSI might be as a coping mechanism that can help individuals in the short term avoid suicide. The present study investigated the relationship between suicidality and NSSI in female inpatient adolescents, focusing on NSSI as an antisuicide strategy. Methods: Subjects were 56 female adolescents, aged 12-18 years (M = 15.95 years, SD = 1.27), recruited from different inpatient child and adolescent psychiatric units. All participants fulfilled the DSM-5 research criteria for nonsuicidal self-injury disorder (NSSI-D). To assess suicidality, NSSI-D, and current and past diagnoses, a structured clinical interview was conducted. Results: NSSI as a short-term coping strategy for avoiding suicide was indicated by one third (32.1%) of the participants. Before participants engaged in NSSI, the anti-suicide function was reported more frequently than reducing interpersonal problems (d =-.59). Getting relief from negative emotions and inducing positive feelings were reported at the same frequency as avoiding suicide before NSSI. Participants engaging in NSSI to avoid suicide and those reporting other functions did not significantly differ regarding other NSSI characteristics, suicidality, or psychopathology. Results indicate that the anti-suicide function significantly predicts the duration of current suicidal ideation (b = .557). Conclusion: This study provides preliminary support for the idea that NSSI is frequently used by female adolescents with NSSI-D to avoid suicide. Given the high co-occurrence of NSSI and suicidality, our results underline the importance of clinical assessment of suicidality and several NSSI functions, including the anti-suicide function, in adolescents with NSSI.

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Section: Discussionsupporting

confidence: 92%

Anti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents

2020

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“…In part, this might reflect the natural history of self‐harm in young people or secular trends that reflect the different eras in which these cohorts were collected. However, it does accord with recent data in 107 outpatient youth (15–25 years old) with BPD reporting a 76% 12‐month prevalence for self‐mutilation and a 66% 12‐month prevalence for suicide attempts . This does give one pause for thought regarding where such young patients with extreme levels of self‐mutilation might end up later in life?…”

supporting

confidence: 75%

Borderline personality disorder is not a variant of normal adolescent development

Chanen

2017

Personality & Mental Health

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It now seems extraordinary to recall the time when clinicians believed that young people could not become depressed. Yet, it was only in the 1980s that the contemporary concept of depression entered mainstream child and adolescent psychiatry. Three decades later and this special issue of the Journal asks a variant of this question about BPD. It does say something about the crisis of legitimacy for BPD in mainstream psychiatry that we are still asking if BPD is non-normative in young people, when a wealth of evidence now suggests that BPD can take its rightful place as a severe mental disorder across the life course. 1 This series of papers systematically asks whether young people with BPD differ from their healthy peers on a range of parameters. It should not be surprising to learn that the answer is an emphatic yes. These data add to what is now a coherent literature demonstrating that young people with BPD differ from their healthy peers, not only on the parameters presented in this special issue but also on many others, such as substance use. 2 Zanarini and colleagues 3 note that psychiatrically healthy adolescents are not devoid of BPD features. They conceive of these features as 'manifestations of adolescent angst'. However, the normative adolescent development literature has tended to move away from such ideas. It might be that these are 'subthreshold' features, which point to the dimensional nature of the BPD construct. This does raise the issue of whether the arbitrary categorical threshold set by DSM-5 (five of nine criteria) is the appropriate cut point for treatment initiation, which brings us to the paper by Stepp and colleagues. 4 This begins to address this question in new analyses from the informative high-risk community sample in the Pittsburgh Girls Study. This study identifies dimensions of childhood temperament and psychopathology symptom severity that predict 'conversion' to a positive screen for BPD over a 14-year follow-up. This study highlights the need for a broad-based, integrated model of disorder 'onset', rather than one for each diagnostic 'silo'.A key premise of Stepp and Lazarus' study seems to be that childhood temperament and psychopathology are qualitatively different to BPD. Yet, existing research highlights substantial overlap in the content covered across the domains of temperament, normal-range child personality and child personality pathology. 5 This suggests that the same phenomena (in this case, emotion dysregulation and impulsivity) might be being measured but given different labels during different developmental periods. Nonetheless, this

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“…NSSI is a public health problem that cannot be ignored by college students, which seriously damages their physical and mental health. Studies have shown that early NSSI can lead to suicidal behavior and other mental illnesses later in life [33,34,35].…”

Section: Discussionmentioning

confidence: 99%

Mediating Effect of Social Support in the Relationship Between Childhood Abuse and Non-Suicidal Self-Injury Among Chinese Undergraduates: The Role of Only-Child Status

Song

Wang

et al. 2019

IJERPH

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Previous research has found a relationship between child abuse and non-suicidal self-injury (NSSI). However, few studies have examined the role of social support underlying this association. Moreover, the influence of the only child status on the mediating effect of social support has not been studied yet. The aim of this study was to investigate the mediating role of social support on the association between specific forms of child abuse and NSSI as well as the role of the only child status on the mediated pathways, among undergraduates. A total of 4799 participants were selected from two medical colleges in the Anhui province using stratified cluster sampling. Pearson's correlation analysis was used in analyzing the relationship. Bootstrapping procedures were applied to examine the mediating effects. After adjusting for confounders, the results showed that the mediating effect of social support on the association between childhood abuse and NSSI was not significant in the total sample. However, among only children, the mediating effects of social support between overall childhood abuse, physical abuse, emotional abuse, and NSSI were 9.65%, 14.82%, and 8.12%, respectively. Moreover, the mediating effect of social support from family and relatives was relatively higher than that from other sources. Social support had a mediating effect on the relationship between childhood abuse and NSSI among only-children. The enhancing of social support may contribute to the prevention and control of NSSI for those who were only-children in undergraduates, especially those who have experienced childhood abuse.

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Relationships between the frequency and severity of non‐suicidal self‐injury and suicide attempts in youth with borderline personality disorder

Cited by 60 publications

References 47 publications

Anti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents

Anti-Suicide Function of Nonsuicidal Self-Injury in Female Inpatient Adolescents

Borderline personality disorder is not a variant of normal adolescent development

Mediating Effect of Social Support in the Relationship Between Childhood Abuse and Non-Suicidal Self-Injury Among Chinese Undergraduates: The Role of Only-Child Status

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