self-injury, suicide, personality

what is non-suicidal self-injury (NSSI)?

deliberate & immediate damage of body tissue without suicidal intent

• cutting

• scratching carving scraping

• burning

• self-hitting/self-battery

what are the reports of NSSI?

people of all ages and backgrounds

• pre-adolescents: 6-9%

• adolescents: ~17+%

• university students: ~20-25%

• adults: 5-6%

what are peak ages of onset?

• early-mid adolescence & then early adulthood (university)

  • but, people of all ages self-injure

• people who idenitify as nonbinary & LGBTQ2S+ are at greater risk for NSSI *content matters

• some evidence indicates people marginalized & discriminated due to race are at higher risk*

what contributes to NSSI?

• many factors involved

• each person’s experience is unique

  • mental health difficulties

  • mental illness (e.g. major depression, EDs, BPD)

  • stress, adversity (e.g. bullying, trauma, marginalization, racism, transphobia)

  • stigmatization

  • social isolation & percieved lack of support

  • impact & role of scarring

  • adverse impact on academics

  • possible suicide risk

how is NSSI related to emotion?

many people who self-injure report difficulty with coping/emotion regulation

• current lived experience → past lived experience → no lived experiene

people who self-injure often report more difficulty tolerating difficult emotions & want to escape these experiences quickly

what is the intrapersonal reason for NSSI?

emotion regulation/coping - most common

• to get relief from unwanted, painful, aversive emotion

self-punishment - 2nd most common

• express hatred toward oneself, punish oneself, damage oneself

to feel something (aka anti-dissociation)

• to feel calm, alive, to feel a physical sensation

anti-suicide

• to reduce suicidal thinking/urges

• avoid acting on an urge

what is the interpersonal reason for NSSI?

interpersonal reasons tend to be less common

interpersonal communication/messaging

• to communicate or get a response (help, support)

• stop a consequence (stop a relationship ending/avoid being alone)

NSSI is NOT attention-seeking or manipulation

what personality traits increase with NSSI?

• perfectionsim

• self-criticism/self-hatred

• neuroticism

• negative body image

like many traits, these are NON-SPECIFIC PREDICTORS

what are the 5 subtypes of impulsivity related to NSSI?

• negative urgency: acting impulsively in context of negative emotion

  • may have particular relevance

• positive urgency: acting impulsively in context of positive emotion

  • affective (emotional -+) subtypes may be most relevant

• perseverance: ability to stay on a task until it’s completed

• predetermination: stopping one’s actions so a plan can be made

• sensation seeking: tendency to seek adventure/excitement

ALL have been linked to suicidal behaviour

how is the big 5 related to NSSI?

high:

• neuroticism

• openness to experience

  • may be due to feelings (subfacet)

  • feelings = experience of negative emotion

low:

• extraversion

• conscientiousness

how is suicide related to NSSI?

• most reliable predictor of suicidal behaviour

• emerging adults with NSSI history are 5.5x more likelyto attempt suicide

• but, most people who self-injure do not attempt suicide

what are some examples of personality & suicide risk?

how is impulsivity linked to suicide?

McGirr et al., 2008:

examined impulsivity among 645 people ages 18-87 who died by suicide

METHOD: psychological autopsy

after death:

• interviewing family/friends; collecting medical + psychiatric records

• offers data/insight about what led to suicide

MAIN FINDING:

higher impulsivity played a larger role in the suicide of younger individuals — this was less the case the older the individual

how can we explain all of this together?

• NSSI & suicide are significant mental health concerns globally

• both are complex due to myriad (often intersecting) factors

• recovery can be fostered & person-centred approaches hold promise