Characteristics of nonsuicidal self-injury among veterans.

OBJECTIVE: The current study aimed to (a) assess basic nonsuicidal self-injury (NSSI) characteristics using a validated clinical interview among a sample of veterans not recruited for specific diagnostic or environmental criteria and (b) examine the relation between NSSI and medical severity of prior suicide attempts (SAs) among veterans. DESIGN: We conducted secondary data analyses among a combined sample of veterans (N = 165) from two parent studies conducted at a large VA Medical Center that implemented identical recruitment protocols. No psychiatric criteria were utilized for inclusion or exclusion purposes. RESULTS: Approximately 16% of participants reported NSSI history and almost 21% reported SA history. NSSI history was associated with probability of prior SA but not the medical severity of prior SA. CONCLUSIONS: NSSI is a prevalent concern among veterans and is associated with probability of SA. It remains unclear whether prior NSSI is associated with more medically serious SA in this population.

Differential suicide risk factors in rural middle and high school students.

Few studies have examined risk factors associated with suicidal ideation and attempts among younger adolescents compared to their high-school aged counterparts. To gain a better understanding of unique risk factors associated with suicidal ideation and attempts among middle-school aged students, the current study employed secondary data analyses on a statewide sample of middle school (6th and 8th grade; n = 7,453) and high school students (10th and 12th grade; n = 5,996) in the United States. Logistic regression analyses were used to determine the effects of fourteen empirically derived risk factors on odds of reporting suicidal ideation (SI) and suicide attempts (SA) in the past year. Results indicated unique factors associated with risk for SI and SA among middle and high school students. For middle-school aged students, female sex, lower perceptions of school safety, sensation seeking, psychological distress, bullying victimization, early initiation of drug use, and community disorganization predicted past year SI. Female sex, white race, perceptions of school safety, bullying victimization, aggregate drugs used, psychological distress, and community disorganization predicted SA. Conversely, sex, age, perceptions of school safety, and community disorganization were not associated with suicidal behavior in high school students. Developmental explanations and avenues for future research are discussed.

A Daily Diary Investigation of the Defective Self Model Among College Students With Recent Self-Injury.

The Defective Self Model of self-injury (Hooley, Ho, Slater, & Lockshin, 2010) asserts that individuals choose to self-injure to gratify the desire for self-punishment associated with a self-critical cognitive style. Specifically, self-injury is used to regulate negative self-directed thoughts and emotions and is made accessible via the belief that the individual deserves punishment. This study sought to test primary assumptions of the Defective Self Model using a 2-week daily diary protocol. It was hypothesized that trait self-criticism would predict daily self-injury urge intensity and behaviors directly, as well as indirectly, through daily thoughts about deserving punishment. We also posited that guilt would predict self-injury urge intensity and behaviors beyond sadness, hostility, and fear. Support for primary hypotheses was mixed. Self-criticism did not directly predict self-injury outcomes, but did indirectly predict urge intensity through daily thoughts about punishment. Daily guilt predicted self-injury urge intensity beyond daily sadness, hostility and fear and was the only type of negative affect associated with self-injury behavior. Results are primarily contextualized through a social cognitive lens in which self-injury urge is precipitated by the activation of a self-critical schema in daily life. Alternatively, self-criticism may serve as a gateway to initial self-injury but lack the sensitivity to predict individual self-injury episodes. Treatments designed to reduce self-critical thoughts and bolster self-compassion may decrease self-injury urge intensity, thereby affecting the frequency of self-injury episodes.

Interpersonal needs and suicide risk: The moderating roles of sex and brooding.

OBJECTIVES: This paper tested two moderators, brooding and participant sex, on the respective relations between thwarted belongingness (TB), perceived burdensomeness (PB), and suicide risk. METHOD: Using a cross-sectional design in a sample of undergraduates (N = 278), two hierarchical regression models examining the three-way interaction between brooding, sex, and either TB or PB on suicide risk were conducted. RESULTS: A significant two-way interaction of brooding and TB was detected, but no moderating effect of sex was observed. There was a significant three-way interaction of brooding, sex, and PB on suicide risk. CONCLUSIONS: High levels of TB and brooding produce increased suicide risk across sexes. The relation between PB and suicide risk is dependent on brooding for females but not males.

Stability of reported trauma over extended intervals: Initial evaluation of an exposure screening protocol.

The reliability and validity of reported exposure to significant trauma is critical to research evaluating outcomes following serious and distressing life events. The current study examined the reliability of reported exposure to disaster, fire, transportation accidents, physical assault, and sexual assault across 5- (N = 251), 12- (N = 223), and 24-month (N = 109) intervals in undergraduates completing a screening measure of probable trauma (N = 3,045). Concordance with later responses to an alternate checklist and events assessed via clinical interview was examined in a subset of participants (N = 274). Five-month reliabilities ranged from good to fair (κ = .40-.71) and were similar to 1-2 week retest estimates in the extant literature. Reliabilities for fire, accidents, and sexual assault remained stable over 12- and 24-month intervals. Coefficients for disaster and physical assault decreased over time. Agreement with the alternate checklist was fair to excellent in those completing the follow-up assessment (κ = .51-.87). Concordance with interview-based trauma was acceptable for accidents (κ = .52) and sexual violence (κ = .82) but poor for disaster, fire, and physical assault (κ = .34-.38). Specificity, negative predictive power, and negative likelihood ratios suggest checklists may hold utility in ruling out previous trauma. Sensitivities indicate that screening instruments may broadly capture individuals experiencing traumatic life events although positive predictive power was limited except in the prediction of traffic accidents and sexual assault. Variability across domains suggests that the properties of checklist measures could be better conceptualized at the level of individual exposure events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Before, During, and After Self Injury: The Practice Patterns of Nonsuicidal Self Injury.

Little is currently known about the repetitive behaviors that take place before, during, and after nonsuicidal self-injury (NSSI). These practice patterns surrounding repetitive self-injury may be part of a habituation process in NSSI. Congruent with the opponent process theory (OPT), the mechanisms through which NSSI is reinforced may include preparation, engagement, and follow-up practice patterns to achieve the desired effect. This may result in increased habituation leading to a change in method and resulting NSSI severity. College students with a history of NSSI (N = 80) completed questionnaires, including an instrument to assess practice patterns around NSSI. High levels of NSSI practice patterns were positively related to various NSSI characteristics and clinical correlates, suggesting higher levels of NSSI severity. Further, NSSI versatility partially explained the relationship between NSSI practice patterns and habituation. Consistent with OPT, practice patterns associated with repetitive NSSI may lead an individual to change methods, fostering habituation to self-injury.

Interpersonal needs and psychological pain: The role of brooding and rejection sensitivity.

The interpersonal theory of suicide proposes that thwarted belongingness (TB) and perceived burdensomeness (PB) predict psychological pain and desire for suicide. Brooding may be a mechanism in explaining how TB and PB predict pain. The conceptual similarity between rejection sensitivity (RS) and TB suggests that individuals with high RS may be likely to experience psychological pain in the context of TB. To test this model, 155 college students completed measures of psychological pain, TB, PB, brooding, and RS. As predicted, brooding mediated the relations between both TB and PB and psychological pain. RS interacted with TB in predicting psychological pain.

Self-Concept Clarity and Emotion Dysregulation in Nonsuicidal Self-Injury.

Recent research has linked identity instability with engagement in nonsuicidal self-injury (NSSI; Claes, Luyckx, & Bijttebier, 2014; Claes et al., 2015). This study examined the relationship between self-concept clarity (SCC), an index of identity stability, and NSSI in a sample of 147 college students, using a cross-sectional survey design. The relationship between SCC and emotion dysregulation in NSSI severity was also examined. SCC was significantly negatively associated with NSSI engagement, as well as NSSI frequency and versatility, above negative affect or age. SCC fully accounted for the variance originally explained by emotion dysregulation in NSSI versatility. NSSI frequency was not significantly predicted by emotion regulation, but self-concept clarity reached marginal significance. These findings provide preliminary support for identity instability as a contributing factor to a relationship between emotion dysregulation and NSSI severity. Possible explanations and future research directions are discussed.