Does Nonsuicidal Self-Injury Predict Later Suicidal Attempts? A Review of Studies

Abstract

Co-occurrence of nonsuicidal self-injury (NSSI) and suicide attempts (SA) might occur because they share common risk factors, or alternatively because one leads to the other. Using search terms salient to NSSI and SA, we screened 555 studies to identify 17 that presented temporal data about NSSI and SA. Much of the evidence indicates that NSSI predates SA, especially among females and individuals with depressive symptoms, or diagnosed with borderline personality disorder or mood disorders. However, in some studies, associated risk factors likely accounted for the effect. Greater NSSI frequency to a threshold increases risk for later SA. Findings suggest that the behaviors have common predisposing factors, but that there is also a potent gateway effect whereby NSSI precedes SA.

Keywords:

• Longitudinal studies
• review
• risk
• self-injurious behavior
• suicide
• attempted

ACKNOWLEDGEMENTS

Dr. MacKinnon would like to acknowledge the support of the Hardy Lok Fund for his contributions to this work.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Stephanie K. Griep

Stephanie K. Griep, MHS, Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA. Dean F.

Dean F. MacKinnon

MacKinnon, MD, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.