Adolescent self-injurers: comparing non-ideators, suicide ideators, and suicide attempters.

“Radloff, 1977) The CES-D is a 20-item self-report inventory assessing depression symptom severity in the past week.”

“BSS items had excellent reliability in our adolescent sample (a ¼ 0.92).”

“…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).”

“Multidimensional anxiety scale for children (MASC; March et al., 1997) The MASC is a 39-item self-report questionnaire assessing current anxiety symptoms.”

“For example, aggression may play a critical role in adult suicide attempts (Mann et al., 1999).”

“Snaithehamilton pleasure scale (SHAPS; Snaith et al., 1995) The SHAPS is a 14-item self-report inventory assessing respondents’ ability to experience pleasure.”

“It has strong psychometric properties and is concordant with goldstandard interviews (Sheehan et al., 2010).”

“Previous research has found that depression symptoms are more severe among ideators compared to non-suicidal adolescents (May and Klonsky, 2016; Nock et al., 2013) and is moderately associated with suicide attempts among self-injurers (Victor and Klonsky, 2014).”

“Incidences of major depression (Avenevoli et al., 2015) and risky behavior engagement (Kann et al., 2014) also comparably increase in adolescence.”

“…2005), adults who report more painful and provocative events (i.e., broad risky behaviors) have greater pain tolerance and fearlessness of death (Bender et al., 2011), two elements implicated in suicide capacity, and score higher on measures of acquired suicide capability (Van Orden et al., 2008).”

“Others have operationalized NSSI severity based on the methods employed (Lloyd-Richardson et al., 2007; Nock et al., 2006).”

“Adolescents most often report using NSSI to reduce aversive emotional states (Nock et al., 2009a,b).”

“Adolescents most often report using NSSI to reduce aversive emotional states (Nock et al., 2009a,b).”

“Research also has tested factors that differentiate adolescents who engage in NSSI alone compared to youth reporting NSSI and suicide attempts (Asarnow et al., 2011; Brausch and Gutierrez, 2010; Dougherty et al., 2009; Jacobson et al., 2008; LloydRichardson et al., 2007; Muehlenkamp et al., 2011; Muehlenkamp and Gutie…”

“NSSI frequency is concurrently associated with the number of previous suicide attempts (Andover and Gibb, 2010; Paul et al., 2015) and predicts future attempts (Whitlock et al., 2013).”

“…(Asarnow et al., 2011; Brausch and Gutierrez, 2010; Dougherty et al., 2009; Jacobson et al., 2008; LloydRichardson et al., 2007; Muehlenkamp et al., 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts alone (Csorba et al., 2009; Guertin et al., 2001; Larsson and Sund, 2008).”

“Further, drawing from research on risk factors for suicidality (May and Klonsky, 2016), we hypothesize that female gender, anxiety (particularly PTSD), and substance use disorders also will be more pronounced among ideators and attempters compared to non-ideators.”

“…in NSSI alone compared to youth reporting NSSI and suicide attempts (Asarnow et al., 2011; Brausch and Gutierrez, 2010; Dougherty et al., 2009; Jacobson et al., 2008; LloydRichardson et al., 2007; Muehlenkamp et al., 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts…”

“Previous research has found that depression symptoms are more severe among ideators compared to non-suicidal adolescents (May and Klonsky, 2016; Nock et al., 2013) and is moderately associated with suicide attempts among self-injurers (Victor and Klonsky, 2014).”

“…tested factors that differentiate adolescents who engage in NSSI alone compared to youth reporting NSSI and suicide attempts (Asarnow et al., 2011; Brausch and Gutierrez, 2010; Dougherty et al., 2009; Jacobson et al., 2008; LloydRichardson et al., 2007; Muehlenkamp et al., 2011; Muehlenkamp and…”

“, broad risky behaviors) have greater pain tolerance and fearlessness of death (Bender et al., 2011), two elements implicated in suicide capacity, and score higher on measures of acquired suicide capability (Van Orden et al.”

“For most, NSSI develops earlier than suicidality and predicts increases in both ideation and attempts over time (Asarnow et al., 2011; Grandclerc et al., 2016).”

“NSSI frequency is concurrently associated with the number of previous suicide attempts (Andover and Gibb, 2010; Paul et al., 2015) and predicts future attempts (Whitlock et al.”

“For instance, trait impulsivitydparticularly reflexive behavioral reactivity to emotionsdis associated with NSSI (Glenn and Klonsky, 2010) and suicide attempts (Auerbach et al.”

“, 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts alone (Csorba et al., 2009; Guertin et al., 2001; Larsson and Sund, 2008).”

“…PTSD) and impulse-control disorders (e.g., conduct disorder, intermittent explosive disorder) are consistently linked to suicide attempts among ideators in community samples (e.g., Miranda et al., 2008; Nock et al., 2009a,b, 2013), but these disorders were non-significant in our models.”

“, in press) and adolescents with NSSI and previous attempts show greater delay-discounting than those with NSSI only (Dougherty et al., 2009).”

“NSSI frequency is concurrently associated with the number of previous suicide attempts (Andover and Gibb, 2010; Paul et al., 2015) and predicts future attempts (Whitlock et al.”

“For instance, risky behaviors like aggression, drug and cigarette use, and unprotected sex differentiate community adolescent ideators from attempters, while depression has far weaker effects (Liu et al., 2014; Stack, 2014; Taliaferro and Muehlenkamp, 2014).”

“…suicide attempts (Asarnow et al., 2011; Brausch and Gutierrez, 2010; Dougherty et al., 2009; Jacobson et al., 2008; LloydRichardson et al., 2007; Muehlenkamp et al., 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts alone (Csorba et al., 2009; Guertin et al., 2001;…”

“Indeed, compared to adolescents with suicide ideation only, adolescents with NSSI plus ideation report more severe symptomatology (Scott et al., 2015).”

“In community samples, psychotic symptoms confer risk for ideation and are associated with a 3-fold greater likelihood of suicide attempts (Honings et al., 2016).”

“Similarly, rates of sexual abuse are higher among attempters compared to ideators (Brezo et al., 2007; May and Klonsky, 2016; Taliaferro and Muehlenkamp, 2014) in community samples, but we did not find this effect.”

“For example, rates of attempted suicide are higher among poly-substance users compared to single substance users (Landheim et al., 2006) and a greater number of purging methods is linked to suicidality among eating disorder patients (Stein et al., 2004).”

“, 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts alone (Csorba et al., 2009; Guertin et al., 2001; Larsson and Sund, 2008).”

“, 2011; Muehlenkamp and Gutierrez, 2007) or adolescents with suicide attempts alone (Csorba et al., 2009; Guertin et al., 2001; Larsson and Sund, 2008).”

“…(BSS; Beck et al., 1979) were used to classify adolescents as: (a) non-ideators (n ¼ 96), if there was no current suicide ideation (i.e., BSS 3; Holi et al., 2005) and no past history of suicide attempts, (b) suicide ideators (n ¼ 149), if there was current ideation (i.e., BSS 4; Holi et…”

“For instance, risky behaviors like aggression, drug and cigarette use, and unprotected sex differentiate community adolescent ideators from attempters, while depression has far weaker effects (Liu et al., 2014; Stack, 2014; Taliaferro and Muehlenkamp, 2014).”

“For example, rates of attempted suicide are higher among poly-substance users compared to single substance users (Landheim et al., 2006) and a greater number of purging methods is linked to suicidality among eating disorder patients (Stein et al., 2004).”

“Further, in a study of NSSI functions among youth, using NSSI to avert suicide was most strongly associated with suicide ideation (Victor et al., 2015).”

“For instance, risky behaviors like aggression, drug and cigarette use, and unprotected sex differentiate community adolescent ideators from attempters, while depression has far weaker effects (Liu et al., 2014; Stack, 2014; Taliaferro and Muehlenkamp, 2014).”

“However, in contrast with prior findings (Stewart et al., 2017; Victor and Klonsky, 2014), this was not necessarily the case for those who engaged in a greater variety of NSSI methods.”

“(2) also reported indirect links (between NSSI and physical abuse).”