Social context during non-suicidal self-injury indicates suicide risk

The link between non-suicidal self-injury (NSSI) and suicide is complex. Previous research indicates that self-injurers endorsing automatic/intrapersonal functions (as opposed to social/interpersonal functions) for NSSI are more likely to have considered and attempted suicide. Subsequent research suggests that those endorsing automatic/intrapersonal functions are more likely to self-injure exclusively while alone. Based on these findings, we hypothesized that the social context during NSSI (i.e., the extent to which one self-injures alone versus around others) represents an easily measurable and theoretically meaningful marker for suicide risk among those who self-injure. Participants were 205 young adults who had performed one or more NSSI behaviors and completed several clinical measures. In general, self-injurers scored higher on measures of suicidality and suicide risk factors (i.e., depression, anxiety, borderline personality disorder symptomatology) than a non-injuring control sample (n = 596). In addition, self-injurers who engage in NSSI alone were more likely to report a history of suicide ideation, plans, and attempts compared to other self-injurers. Endorsement of automatic/intrapersonal functions only partially explained the relationship between the social context during NSSI and suicidality. Consistent with the study hypothesis, social context during NSSI appears to be a marker for suicide risk in individuals who engage in NSSI.