Kraus Laura, Schmid Marc, In-Albon Tina
Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Germany.
Department of Child and Adolescent Psychiatry, University of Basel, Basel, Switzerland.
Front Psychiatry. 2020 Jun 3;11:490. doi: 10.3389/fpsyt.2020.00490. eCollection 2020.
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 anti-suicide strategy.
Subjects were 56 female adolescents, aged 12-18 years ( = 15.95 years, = 1.27), recruited from different inpatient child and adolescent psychiatric units. All participants fulfilled the 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.
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 ( = -.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 (β = .557).
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.
已有大量研究探讨非自杀性自伤（NSSI）与自杀倾向之间的关系。一方面，NSSI是自杀倾向的一个重要风险因素，包括自杀念头和行为。另一方面，有人认为NSSI的一个功能可能是作为一种应对机制，可帮助个体在短期内避免自杀。本研究调查了女性住院青少年中自杀倾向与NSSI之间的关系，重点关注NSSI作为一种抗自杀策略。
研究对象为56名年龄在12至18岁之间（平均年龄=15.95岁，标准差=1.27）的女性青少年，她们来自不同的儿童和青少年住院精神科病房。所有参与者均符合非自杀性自伤障碍（NSSI-D）的研究标准。为评估自杀倾向、NSSI-D以及当前和既往诊断情况，进行了一次结构化临床访谈。
三分之一（32.1%）的参与者表示NSSI是一种避免自杀的短期应对策略。在参与者进行NSSI之前，报告其抗自杀功能的频率高于减少人际问题（t=-0.59）。在进行NSSI之前，从负面情绪中获得缓解和产生积极情绪的报告频率与避免自杀的频率相同。为避免自杀而进行NSSI的参与者与报告其他功能的参与者在其他NSSI特征、自杀倾向或精神病理学方面没有显著差异。结果表明，抗自杀功能显著预测当前自杀意念的持续时间（β=0.557）。
本研究为以下观点提供了初步支持，即患有NSSI-D的女性青少年经常使用NSSI来避免自杀。鉴于NSSI与自杀倾向的高度共现性，我们的结果强调了对患有NSSI的青少年进行自杀倾向临床评估以及评估包括抗自杀功能在内的多种NSSI功能的重要性。
