Non-Suicidal Self-Injury Elevates Suicide Risk among United States Military Personnel with Lifetime Attempted Suicide

Abstract

Military psychiatric inpatients with and without a lifetime history of non-suicidal self-injury (NSSI), combined with a history of at least one suicide attempt, were compared on suicide ideation severity, number of suicide attempts, and Interpersonal-Psychological Theory of Suicide variables. Data were derived from baseline assessments performed in a psychotherapy randomized controlled trial. Lifetime history of NSSI and lifetime number of suicide attempts were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS; Posner et al., 2011). Individuals with versus without a combined lifetime history of attempted suicide and NSSI showed significant elevations on thwarted belongingness and acquired capability for suicide. No significant between-group differences were found on perceived burdensomeness, frequency, duration, and controllability of suicide ideation, or number of lifetime suicide attempts. A history of NSSI, above and beyond attempted suicide, appears to increase service members’ social alienation and acquired capability for suicide.

Keywords:

• acquired capability for suicide
• interpersonal theory of suicide
• military
• non-suicidal self-injury
• self-harm
• suicide attempt

Additional information

Funding

Funding support for the preparation of this manuscript has been provided to Dr. Ghahramanlou-Holloway by the Department of Defense, Congressionally Directed Medical Research Program (W81XWH-08-2-0172), Military Operational Medicine Research Program (W81XWH-11-2-0106), and the National Alliance for Research on Schizophrenia and Depression (15219).

Notes on contributors

Margaret M. Baer

Margaret M. Baer, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Jessica M. LaCroix

Jessica M. LaCroix, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Joy C. Browne

Joy C. Browne, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Helena O. Hassen

Helena O. Hassen, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Kanchana U. Perera

Kanchana U. Perera, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Jennifer Weaver

Jennifer Weaver, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.

Alyssa Soumoff

Alyssa Soumoff, Walter Reed National Military Medical Center, Bethesda, MD, USA.

Marjan Ghahramanlou-Holloway

Marjan Ghahramanlou-Holloway, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.