Does Nonsuicidal Self-Injury Predict Future Suicide Attempts in Adolescents?

According to a recent study conducted by Karen Guan of the Department of Psychology at the University of North Carolina at Chapel Hill, nonsuicidal self-injurious (NSSI) behaviors may predict future suicide attempts, but no suicide gestures or threats of suicide. There is a large amount of research examining the levels of NSSI and other maladaptive behaviors among teens. During adolescence, teens are faced with numerous stressors such as bullying, academic concerns, and peer pressure. They are often first introduced to sex, drugs, and alcohol during their teen years. One way in which adolescents cope with the stress is to engage in cutting, burning, or self-mutilation. Although this is not seen as life-threatening, the risk of more harmful injury and further destructive behavior is very high. Some research has suggested that teens who engage in NSSI are at increased risk for suicide later, even though the NSSI is not intended to cause death. But very little research has looked at how NSSI behaviors influence future threats of suicide.

To address this void, Guan followed 399 teens for two and half years, starting when they entered their freshman year in high school, and assessed their levels of depression, NSSI behaviors, suicide attempts, and suicide gestures or threats. Guan discovered that the teens with high levels of NSSI at the beginning of the study were more likely to attempt or think about suicide than those with low levels of NSSI. However, they did not engage in higher levels of suicidal gestures or threats. Additionally, the results revealed that those with the most severe depressive symptoms also had the highest levels of NSSI. Guan believes that even though teens may begin using NSSI with no intention of taking their own lives, they may eventually become immune to the feelings they get and need more extreme measures to cope with their stress. They may also begin to fear death less as they injure themselves more. Guan added, “Overall, results offer empirical evidence for the importance of NSSI as a construct that has predictive value in assessing risk for adolescent suicide ideation and attempts.”

Guan, K., Fox, K. R., Prinstein, M. J. (2012). Nonsuicidal self-injury as a time-invariant predictor of adolescent suicide ideation and attempts in a diverse community sample. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029429

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  • Duncan


    August 9th, 2012 at 12:12 PM

    Quite clearly, I think that we can see that the more immune that kids become to harm and pain the greater the likelihood that they could attempt suicide in their futures and not think much about that pain or the lingering consequences. When kids become so separated from what they might have to do to end their lives, plus they see this as an only solution to problems that they could be having in their lives at that time, then that becomes a pretty serious and dangerous situation. If your child is wngaging in this kind of behavior I would urge you to see this as more than irresponsible, but instead view it as a wake up call that you need to take some action now to prevent something really serious from occurring later on.

  • JackiE


    August 9th, 2012 at 1:16 PM

    Self harm shud never b ignored..if a teen is capable of harmin himself then he may just go another step and try to end his life.n this study just proves that!whats more concerning is d fact that there is no signs of suicide later on-which can make it so difficult to predict!i just hope these young ppl realize the value of their lives.

  • darla


    August 9th, 2012 at 2:11 PM

    If I saw that my daughter was inflicting intentional harm to herself via cutting, burning, etc., don’t for a skinny minute think that I would ignore that!

  • Greg


    August 9th, 2012 at 7:20 PM

    Suicide risk in the future or not,injuring oneself is not a healthy habit at all and it definitely needs attention.If you’re not looking for things such as these as a parent,then really,you have got to pull your socks up as a parent and monitor your child better.

  • pressley


    August 10th, 2012 at 4:28 AM

    could lead to some dangerous assumptions to say that one always leads to another
    the behavior should certainly be addressed and rectified but it does not always lead to the other

  • JustJulia


    August 10th, 2012 at 11:16 AM

    I have no real idea about whether or not self injury really does lead to higher suicide rates or rates of attempted suicide in adolescents. What I do know is that if you allow this type of behavior to continue without seeking advice and help from someone who is trained in this area, I think that you and your family could really face some real threats of this happening later on. I have always thought that all of this self injury stuff like cutting for example, is a serious cry for help when the child does not know how to ask for that help. There is obviously something going on with that person that indicated pretty clearly to me that they need help and that this is the only way they know how to get someone in a position to get that help for them to sit up and take notice. Hopefully it will not tunr into something very serious, but as I always tend to err on the side of caution I definitely think that as a parent this would be something that I would have to pursue just to make sure that we got help before things went beyond that point where there is no room for help anymore.

  • Mike


    August 11th, 2012 at 4:33 AM

    This kind of behavior is crazy, man! Me and my friends, we were all just normal and we ight cut school but I think that I can safely say tnat cutting ourselves on purpose was never on any of our minds! Kids today just baffle me with the things they come up with for attention!

  • adolph


    August 12th, 2012 at 9:11 AM

    When these kids they see those celebs doing the same things then they want to know what this is all about and they start trying stuff, not because they feel like they should take own life but because they want to know why all the fuss, what’s this about. Curiosity

  • zeke green

    zeke green

    August 13th, 2012 at 4:33 AM

    So really, what we need to pay more attention to are the kids with higher levels of depression because these are probably the kids who will be most likely to harm themselves later on.

  • Martina


    August 14th, 2012 at 11:12 AM

    Depressed, anxious, whatever!
    Injuring your own self for no reason is not normal
    You don’t think this will lead to tragedy sooner or later, you are dreaming
    These are kids crying out for help and so many times no one is listening

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