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Adolescent self-injurers: comparing non-ideators, suicide ideators, and suicide attempters.
Open accessAbstract
Adolescent non-suicidal self-injury (NSSI) and suicidality are serious health concerns; however, factors that contribute to the transition from NSSI to suicide ideation and suicide attempts are unclear. To address this gap, we investigated whether demographic characteristics, child maltreatment, and psychiatric factors are associated with the level suicidality among adolescents with a history of self-injury. Participants were three groups of adolescent inpatient self-injurers (n = 397, 317 female), aged 13-18 years (M = 15.44, SD = 1.36): (a) non-ideators (n = 96; no current suicide ideation and no lifetime suicide attempts), (b) suicide ideators (n = 149; current ideation and no lifetime attempts), and (c) suicide attempters (n = 152; current ideation and at least one lifetime attempt). Participants completed interviews assessing psychiatric diagnoses, suicidality, and NSSI characteristics, as well as questionnaires on childhood trauma, psychiatric symptoms, and risky behavior engagement. Depression severity was associated with greater odds being a suicide ideator (p < 0.001, OR = 1.04) and an attempter (p < 0.001, OR = 1.05) compared to a non-ideator. Suicide attempters used more NSSI methods and reported greater risky behavior engagement than non-ideators (p = 0.03, OR = 1.29 and p = 0.03, OR = 1.06, respectively) and ideators (p = 0.015, OR = 1.25 and p = 0.04, OR = 1.05, respectively); attempters used more severe NSSI methods (e.g., burning). Our results identify a wide range of risk markers for increasing lethality in a sample at high risk for suicide mortality; future research is needed to refine risk assessments for adolescent self-injurers and determine the clinical utility of using risk markers for screening and intervention.
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“Persistent death wishes in adolescents are typically interpreted as persistent or chronic suicidality, which is associated with increased hopelessness,8 emotion regulation problems,9 early-onset self-harm,10 and co-occurring psychiatric diagnoses.11”
From Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders (2025) · cites this paper as [10]
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Citations
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · cited 1×
“Radloff, 1977) The CES-D is a 20-item self-report inventory assessing depression symptom severity in the past week.”
BackgroundAssessment of suicidal intention: The Scale for Suicide Ideation.
Beck, A. T., Kovacs, M., & Weissman, A. (1979) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.47.2.343 · Cited by 3,419 · cited 6×
“BSS items had excellent reliability in our adolescent sample (a ¼ 0.92).”
BackgroundMethodInfluential(2006) · PubMed · Cited by 3,378
Casey, B. J., Jones, R. M., & Hare, T. A. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1440.010 · Cited by 3,345 · cited 2×
“…increases in risk-taking and impulsivity during adolescence are thought to arise from increased maturation of limbic circuitry, responsible for heightened emotional reactivity, relative to under-developed prefrontal regions, responsible for inhibition and impulse control (Casey et al., 2008).”
BackgroundJoiner, T. E. (2007) · Harvard University Press eBooks · doi:10.2307/j.ctvjghv2f · Cited by 2,891
Youth risk behavior surveillance-United States, 2017
Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Queen, B., Lowry, R., Chyen, D., Whittle, L., Thornton, J., et al. (2018) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss6708a1 · Cited by 2,502
The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity
MARCH, J. S., PARKER, J. D. A., SULLIVAN, K., STALLINGS, P., & CONNERS, C. K. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199704000-00019 · Cited by 2,236 · cited 1×
“Multidimensional anxiety scale for children (MASC; March et al., 1997) The MASC is a 39-item self-report questionnaire assessing current anxiety symptoms.”
BackgroundToward a clinical model of suicidal behavior in psychiatric patients
Mann, J. J., Waternaux, C., Haas, G. L., & Malone, K. M. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.2.181 · Cited by 1,791 · cited 2×
“For example, aggression may play a critical role in adult suicide attempts (Mann et al., 1999).”
BackgroundA scale for the assessment of hedonic tone the Snaith-Hamilton pleasure scale
Snaith, R. P., Hamilton, M., Morley, S., Humayan, A., Hargreaves, D., & Trigwell, P. (1995) · British Journal of Psychiatry · doi:10.1192/bjp.167.1.99 · Cited by 1,778 · cited 1×
“Snaithehamilton pleasure scale (SHAPS; Snaith et al., 1995) The SHAPS is a 14-item self-report inventory assessing respondents’ ability to experience pleasure.”
BackgroundSheehan, D. V., Sheehan, K. H., Shytle, R. D., Janavs, J., Bannon, Y., Rogers, J. E., Milo, K. M., Stock, S. L., & Wilkinson, B. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05305whi · Cited by 1,730 · cited 1×
“It has strong psychometric properties and is concordant with goldstandard interviews (Sheehan et al., 2010).”
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Duarte, E., Silva, S., & Gouveia‐Pereira, M. (2023) · European Journal of Mental Health · doi:10.5708/ejmh.18.2023.0004 · Cited by 4
Wiginton, J. M., Baral, S., Sanchez, T., Wilcox, H. C., & Murray, S. M. (2024) · Archives of Suicide Research · doi:10.1080/13811118.2024.2436143 · Cited by 2
“High-risk sex (Mustanski et al., 2014; Stewart et al., 2017) and economic insecurities have been linked to suicide attempts, including among SMM (Clark et al., 2022; Ferlatte et al., 2017, 2019; Kaniuka et al., 2024; Mereish et al., 2019; Salway & Gesink, 2018).”
Gómez-Tabares, A. S., & Restrepo, J. E. (2025) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2025.843 · Cited by 2
“A strong correlation exists between NSSI and both suicidal ideation and suicide attempts in adolescents (Stewart et al. , 2017).”
Ni, J., Liao, X., Liu, J., & Jiang, Q. (2025) · BMC Public Health · doi:10.1186/s12889-025-25799-y · Cited by 3
“Non-suicidal self-injury (NSSI) specifically involves self-inflicted damage to body tissue without any suicidal intent, encompasses behaviors such as cutting, burning, and scratching [2–4].”
Montanari, S., Callovini, T., Bartolucci, G., Marcelli, I., Autullo, G., Koukopoulos, A. E., Moccia, L., Pepe, M., Kotzalidis, G. D., Nicola, M. D., et al. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.107979 · Cited by 2
Emergency Department Adolescent Suicidality
Sheridan, D. C., & Lin, A. (2022) · Pediatric Emergency Care · doi:10.1097/pec.0000000000002629 · Cited by 2
Exploration and Analysis of Predictors of Suicidal Ideation in Vocational High School Students
俞, 华. (2022) · Advances in Psychology · doi:10.12677/ap.2022.125232 · Cited by 1
Liu, J., Zhai, X., Gao, C., Zhang, S., Fei, D., Zhang, X., Jin, M., & Wang, Y. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1781733 · Cited by 1
“Among adolescents with MDD, the reported prevalence of NSSI is notably higher, ranging from 51.0% to 81.9% (13 – 15), and the co-occurrence of NSSI with MDD substantially ampli fi es suicide risk (16).”
InfluentialRaiaan, M. A. K., Mukta, S. H., Fahad, N. M., Ali, M. E., & Islam, N. (2026) · Discover Computing · doi:10.1007/s10791-026-10209-7 · Cited by 1
“These findings are consistent with previous findings [78, 79].”
Reichl, C., Fink, E., von den Driesch, L., Lerch, S., Koenig, J., Berger, T., & Kaess, M. (2026) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-026-01122-4 · Cited by 2
“Over time, experiences such as NSSI may habitu-ate individuals to pain, thereby lowering pain sensitivity and diminishing the natural aversion to self-injury [40].”
Case Report: Treatment policy for female adolescents in the grip of chronic suicidality
de Koppel, M. V., Mérelle, S. Y. M., Stikkelbroek, Y. A. J., van der Heijden, P. T., Spijker, J., Popma, A., & Creemers, D. H. M. (2024) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2024.1384439 · Cited by 1
Agustoni, G., Hess, L., Kaess, M., & Reichl, C. (2025) · Die Psychotherapie · doi:10.1007/s00278-025-00782-5 · Cited by 1
Schwartz-Lifshitz, M., Ben-Dor, D. H., Bustan, Y., Zalsman, G., Gothelf, D., Weizman, A., & Barzilay, R. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2020.1865223 · Cited by 1
“In addition, there is a relative increase in the frequency and severity of NSSI occurring in the months prior to a SA (Glenn et al., 2017; Stewart et al., 2017; Yen et al., 2016).”
BackgroundNonsuicidal Self-Injury in Youth: A Primer for Pediatricians
Cama, S. F., & Fosbenner, S. (2021) · Pediatric Annals · doi:10.3928/19382359-20210121-01 · Cited by 1
Nonsuicidal self-injury in a clinical sample of adolescents in Serbia
Kolundžija, K., Maraš, J. S., Marković, J., & Dimic, T. (2022) · Vojnosanitetski pregled · doi:10.2298/vsp211126026k · Cited by 1
Chaves, G. (2019) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/d.47.2019.tde-26022019-123803 · Cited by 1
Interactions of factors in self-injuries among enrolled students: a network approach.
Zhang, Y.-M., Jiang, X.-M., Xie, Y., Lang, N., Liang, M.-L., Zhang, P., OuYang, L.-C., Lv, Z.-W., Liu, C.-W., Zhang, L.-P., et al. (2025) · Annals of General Psychiatry · doi:10.1186/s12991-025-00570-0
“Depression was found to differentiate SIBs with or without ideation [9].”
Implicit Emotion Regulation in Individuals with Non-Suicidal Self-Injury
Fereidooni, F. (2018)
Barn og unges selvmordsytringer
Skisland, A., & Qin, P. (2021) · Suicidologi/Nytt i suicidologi · doi:10.5617/suicidologi.8548
Peripheral and Neural Correlates of Self-Harm in Children and Adolescents: A Scoping ReviewPreprint
Sparrow-Downes, V. M., Trincao-Batra, S., Cloutier, P., Helleman, A., Salamatmanesh, M., Gardner, W., Baksh, A., Kapur, R., Sheridan, N., Suntharalingam, S., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-955587/v1
From attachment insecurity to non-suicidal self-injury: The mediating role of emotion regulation
Miles, N. (2021) · Open Access Victoria University of Wellington | Te Herenga Waka (Figshare) · doi:10.26686/wgtn.14788827.v1
PREVENCIÓN DE CONDUCTAS SUICIDAS EN NIÑOS
Vázquez, M. V., Heredia, M. E. R., Loyo, L. M. S., & Betanzos, F. G. (2022) · Revista de Psicología de la Universidad Autónoma del Estado de México · doi:10.36677/rpsicologia.v11i23.18060
Horváth, L. O. (2020) · Eötvös Loránd Tudományegyetem · doi:10.15476/elte.2020.082
Effects of Childhood Trauma on Adolescent Mental Health
Xiao, X., Zhao, Y., & Zhou, S. (2023) · Lecture Notes in Education Psychology and Public Media · doi:10.54254/2753-7048/13/20230895
Mai, Y., Soh, K. G., Saad, H. A., Deng, N., & Wang, Q. (2024) · doi:10.37766/inplasy2024.1.0084
COVID-19 Parental Job Disruptions and Adolescent Suicide
Loes, C. N. (2024) · Deviant Behavior · doi:10.1080/01639625.2024.2337127
Child Suicide News: A Comprehensive Case Study from Turkish Media
Çalbayram, N. Ç., & Balta, G. (2024) · İstatistik ve Uygulamalı Bilimler Dergisi · doi:10.52693/jsas.1592958
Examining the Construct Validity of Experimental Suicide Images Among Young Adults
Martin, L. W., Craddock, G., Hicks, O., Okusanya, I. G., & Stewart, J. G. (2025) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.70010
“This approach to categorizing participants based on SITBI-R responses has been used in prior studies (Auerbach et al. 2015; Stewart, Esposito, et al. 2017; Stewart, Glenn, et al. 2017; Stewart et al. 2019; Vergara et al. 2019).”
Goldstein, A., Shachar‐Lavie, I., Krispin, O., Rom, R., Gur, E., Horesh, N., & Gvion, Y. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1564384
“Research supports a strong association between NSSI and acquired capability for suicide (33, 34) Although much of this work has focused on adult and undergraduate samples, NSSI may be particularly in fl uential during adolescence, when it is among the most common PPEs (35, 36).”
Xu, K., Ma, S., Zhang, X., He, H., & Hu, J. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-08140-8
“Once depressive symptoms develop, they are recognized as one of the most potent risk factors for suicidal behaviors in adolescents [25, 26], with approximately 38% of depressed adolescents experiencing suicidal ideation [18].”
Lanfredi, M., Macis, A., Ferrari, C., Meloni, S., Pedrini, L., Ridolfi, M. E., Zonca, V., Cattane, N., Cattaneo, A., & Rossi, R. (2021) · Figshare · doi:10.6084/m9.figshare.14532654
A Comparison of the Theoretical Models of Nonsuicidal Self-Injury
Hird, K. (2023) · VUBIR (Vrije Universiteit Brussel)
Allison, G. O., Turtil, A., May, A. M., & Weinberg, A. (2026) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-026-01406-4
“…(Auerbach et al., 2015; Ballard et al., 2016; Brausch & Gutierrez, 2010; Fawcett et al., 1990; Kelly et al., 2004; Loas et al., 2018; Nock & Kazdin, 2002), others have not (Hawes et al., 2018; Loas, 2007; Stewart et al., 2017, 2019b; Tsypes et al., 2021; Winer et al., 2016; Yaseen et al., 2016).”
Amparo, Ó. R., Cruz, Y. O., Guerra-Peña, K., & García-Batista, Z. E. (2026) · CES Psicología · doi:10.21615/cesp.7859
Mai, Y., Soh, K. G., Saad, H., Deng, N., & Wang, Q. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.106962
Machine Learning Prediction of First Suicide Attempts in Early Adolescence Among Child Ideators
Nguyen, J., Dwyer, D., Tagliaferri, S. D., Hartmann, S., Clark, S. R., Scott, I., Wigman, J. T. W., Lin, A. P., Thompson, A. D., Gao, C. X., et al. (2026) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2026.07.1245
Metadata
- Authors
- Stewart, J. G., Esposito, E. C., Glenn, C. R., Gilman, S. E., Pridgen, B., Gold, J., & Auerbach, R. P.
- Affiliations
- Harvard University (US)
- University of Rochester (US)
- National Institutes of Health (US)
- Corresponding author
- Stewart, Jeremy G.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 84
- Pages
- 105-112
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC5204373
- OpenAlex
- W2529681323
- Cited by
- 139
- References
- 54
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 19 · 2023: 14 · 2022: 15 · 2021: 24 · 2020: 11 · 2019: 14 · 2018: 11 · 2017: 7
- FWCI
- 14.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH097786)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- non-suicidal self-injury, adolescent self-injury, suicidal ideation, suicide attempts, suicide lethality, depression severity, child abuse, risk-taking, self-injury methods, suicide risk markers, psychiatric comorbidity
- MeSH terms
- Adolescent, Analysis of Variance, Depression, Female, Humans, Inpatients, Interview, Psychological, Male, Psychiatric Status Rating Scales, Surveys and Questionnaires, Risk-Taking, Suicide, Attempted, Multivariate Analysis, Self-Injurious Behavior, Suicidal Ideation
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