Suicide After Nonfatal Self-Harm

Crisis ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Eleni Karasouli ◽  
David Owens ◽  
Gary Latchford ◽  
Rachael Kelley
Keyword(s):  
Risk Factors ◽  
Hospital Care ◽  
Urgent Care ◽  
Cross Linking ◽  
Sufficient Information ◽  
Local Data ◽  
Self Injury ◽  
History Of ◽  
Self Harm ◽  
Male Subjects

Background: Nonfatal self-harm is the strongest predictor of suicide, with some of the risk factors for subsequent suicide after nonfatal self-harm being similar to those for suicide in general. However, we do not have sufficient information regarding the medical care provided to nonfatal self-harm episodes preceding suicide. Aims: Our study sought to explore hospital care and predictive characteristics of the risk of suicide after nonfatal self-harm. Method: Individuals with history of nonfatal self-harm who died by suicide were compared with those who had a nonfatal self-harm episode but did not later die by suicide. Cases were identified by cross-linking data collected through a self-harm monitoring project, 2000–2007, and comprehensive local data on suicides for the same period. Results: Dying by suicide after nonfatal self-harm was more common for male subjects than for female subjects (OR = 3.3, 95% CI = 1.7–6.6). Self-injury as the method of nonfatal self-harm was associated with higher risk of subsequent suicide than was self-poisoning (OR = 2.0, 95% CI = 1.04–3.9). More urgent care at the emergency department (OR = 2.7, 95% CI = 1.1–6.3) and admission to hospital (OR = 2.0, 95% CI = 1.0–4.0) at the index episode were related to a heightened risk of suicide. Conclusion: The findings of our study could help services to form assessment and aftercare policies.

The Voodoo Doll Self-Injury Task: A New Measure of Sub-Clinical Self-Harm Tendencies

2017 ◽  
Author(s):  
David Skylan Chester ◽  
Tchiki Davis ◽  
C. Nathan DeWall
Keyword(s):  
Risk Factors ◽  
Clinical Utility ◽  
Experimental Designs ◽  
Clinical Validity ◽  
Total N ◽  
Self Injury ◽  
Trait Level ◽  
Self Harm ◽  
Initial Support

We introduce a new measure of sub-clinical self-harm tendencies, the Voodoo Doll Self-Injury Task (VDSIT). In this computer task, participants virtually stick a number of sharp pins in a doll that represents themselves. Across five community and undergraduate samples who were not recruited based on their self-harm history or risk (total N = 1,289), VDSIT scores were higher among participants with histories of actual self-injury and were positively correlated with state and trait level motivations to self-harm. VDSIT scores did not correspond to tendencies to harm others, showed sensitivity to experimental manipulations that increase self-harm tendencies, and were positively correlated with established risk factors for self-harm (e.g., depression). The VDSIT did not, on average, elicit significant distress from participants during or after the task, even among participants who had previously engaged in self-harm. Whereas the clinical utility of this measure remains unexamined, these findings provide initial support for the VDSIT’s sub-clinical validity, which can help researchers accurately, economically, and rapidly measure state and trait level self-harm tendencies using both correlational and experimental designs.

scholarly journals Factores contextuales relacionados a las conductas de autolesión no suicidas: una revisión sistemática

2020 ◽  
Vol 31 (1) ◽  
pp. 51-59
Author(s):  
Karen Guadalupe Duarte Tánori ◽  
José Ángel Vera Noriega ◽  
Daniel Fregoso Borrego
Keyword(s):  
Risk Factors ◽  
Self Injury ◽  
Palabras Clave ◽  
Revisión Sistemática ◽  
Factores De Riesgo ◽  
Self Harm

Las conductas autolesivas implican hacerse daño sin la intención de llegar al suicidio, y son comportamientos que se consideran como un problema que va en aumento entre la población adolescente; de hecho, en México los datos estadísticos estiman que 10% de los adolescentes se autolesionan; no obstante, la investigación de los factores de riesgo contextuales que propician tales conductas se ha considerado inadecuada y limitada. Objetivo: Con la finalidad de recabar las variables y teorías actuales para abordar el problema, el propósito de esta revisión fue analizar la bibliografía especializada sobre los factores contextuales relacionados a las conductas de autolesión no suicida en adolescentes. Método: Se realizó una búsqueda exhaustiva en las bases de datos Scopus, EBSCO, Dialnet Plus y SciELO, considerando los artículos publicados de enero de 2015 a abril de 2019, y empleando las palabras clave self-injury, self-harm, adolescents, teenagers, risk factors, autolesión, adolescentes y factores de riesgo, ubicadas tanto en el título como en el resumen. Se seleccionaron diez trabajos que cumplieron los criterios de inclusión en la base bibliográfica. Resultados: Entre las variables estudiadas en los distintos artículos, relacionadas con la familia se encontraron como significativas la muerte de los padres, un historial de abuso y los conflictos familiares, mientras que en las vinculadas a la escuela la variable significativa fue la victimización en el acoso escolar.

Prediction and network modelling of self-harm through daily self-report and history of self-injury

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Michael J. Kyron ◽  
Geoff R. Hooke ◽  
Andrew C. Page
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Daily Basis ◽  
Adverse Outcomes ◽  
Self Report ◽  
Public Health Issue ◽  
Short Term ◽  
Wish To Die ◽  
History Of ◽  
Self Harm

Abstract Background Self-harm is a significant public health issue, and both our understanding and ability to predict adverse outcomes are currently inadequate. The current study explores how preventative efforts could be aided through short-term prediction and modelling of risk factors for self-harm. Methods Patients (72% female, Mage = 40.3 years) within an inpatient psychiatric facility self-reported their psychological distress, interpersonal circumstances, and wish to live and die on a daily basis during 3690 unique admissions. Hierarchical logistic regressions assessed whether daily changes in self-report and history of self-harm could predict self-harm, with machine learning used to train and test the model. To assess interrelationships between predictors, network and cross-lagged panel models were performed. Results Increases in a wish to die (β = 1.34) and psychological distress (β = 1.07) on a daily basis were associated with increased rates of self-harm, while a wish to die on the day prior [odds ratio (OR) 3.02] and a history of self-harm (OR 3.02) was also associated with self-harm. The model detected 77.7% of self-harm incidents (positive predictive value = 26.6%, specificity = 79.1%). Psychological distress, wish to live and die, and interpersonal factors were reciprocally related over the prior day. Conclusions Short-term fluctuations in self-reported mental health may provide an indication of when an individual is at-risk of self-harm. Routine monitoring may provide useful feedback to clinical staff to reduce risk of self-harm. Modifiable risk factors identified in the current study may be targeted during interventions to minimise risk of self-harm.

scholarly journals Within-Person Fluctuations of Non-Suicidal Self-Injury and Implicit Associations: An Ecological Momentary Assessment of Suicide and Self-Harm Risk.

2020 ◽  
Author(s):  
Ryan Robertson
Keyword(s):  
Mixed Models ◽  
Implicit Association Test ◽  
Future Research ◽  
Implicit Associations ◽  
Self Injury ◽  
Subject Variables ◽  
History Of ◽  
Self Harm ◽  
Ecological Momentary ◽  
Momentary Assessment

While a number of studies have demonstrated that those with a history of non-suicidal self-injury (NSSI) hold greater implicit associations toward self-harm, no study has examined how these associations change daily. The proposed study was threefold: (1) replicate prior findings that those with a history of NSSI score higher on the implicit association test (IAT), (2) explore whether NSSI-IAT scores change daily, and (3) examine how these changes in NSSI-IAT scores relate to thoughts of NSSI and suicide. A sample of eligible participants completed a series of baseline measures assessing NSSI, depression, and completed the NSSI-IAT. Participants then responded to daily prompts on their mobile device about their thoughts of NSSI and suicide and completed the NSSI-IAT daily in a laboratory. Generalized linear mixed models were conducted to assess within-person variability, as well as between-subject variables in the proposed study. Future research using the NSSI-IAT daily and assessing emotional consequences of participation in studies that use daily-prompting are discussed.

Psychosocial and Clinical Predictors of Attempted Suicide, Hopelessness and Non-Suicidal Self-Injury in Adolescents on Venlafaxine

2018 ◽  
Author(s):  
Saad Salman ◽  
Fahad Hassan Shah ◽  
Jawaria Idrees ◽  
Ameerzada Khan ◽  
Muniba Tariq ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Clinical Symptoms ◽  
Clinical Predictors ◽  
Family Responsibilities ◽  
Self Injury ◽  
Causative Agents ◽  
History Of ◽  
Self Harm ◽  
Parental Marriage ◽  
Suicidal Thoughts And Behaviors

Suicide and self-harm are very common among adolescents, especially females in western and Asian countries. The Psychosocial predictors, along with hopelessness and non-suicidal harm, have not been studied properly before. Therefore, there is a need to address these issues. The objective of the study was to ascertain the psychosocial and clinical features predicting suicide attempts and non-suicidal self-injury (NSSI) in adolescents with major depression in Pakistan. The Methodology comprised of Adolescent patients (n = 121) with major depressive disorder who were hospitalized in the LRH (Lady Reading Hospital), Peshawar. The patient’s clinical symptoms, family role (family responsibilities), quality of life, physical health and relationship with friends and family members were evaluated. Participants’ suicidal thoughts and behaviors and NSSI (self-inflicted, deliberate self-harm with no intent of suicide) were analyzed and assessed during hospitalization and followed up for 28 weeks. Poor family functions, as well as family problems and social problems, were the causative agents for adolescent’s high suicidality and non-suicidal self-harm. A history of Non-suicidal self-harm treatment is a clinical marker for suicidality. The previous suicidal attempts should be evaluated in depressed juvenile patients as indicators of future suicidal intent and behavior. Both suicidal and NSSI during the therapy and after treatment persisted in depressed adolescents who participated in the study. Major causes of suicide among our study participants were lost friend(s), drug abuse, living alone or not living with the family, disturbed parental marriage, sexual abuse, and other domestic problems.

scholarly journals The Wessex Recent In-Patient Suicide Study, 2

2001 ◽  
Vol 178 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Elizabeth A. King ◽  
David S. Baldwin ◽  
Julia M. A. Sinclair ◽  
Michael J. Campbell
Keyword(s):  
Risk Factors ◽  
Care Delivery ◽  
Psychiatric Patients ◽  
Retrospective Case ◽  
Patient Suicide ◽  
Increased Risk ◽  
History Of ◽  
Self Harm ◽  
Low Sensitivity ◽  
Control Study

BackgroundPsychiatric patients have an elevated risk of suicide while in hospital.AimsTo compare social, clinical and health-care delivery factors in in-patient and out-patient suicides and their controls.MethodRetrospective case-control study of 59 in-patients and 106 controls, matched for age, gender, diagnosis and admission date. Odds ratios were calculated using conditional multiple logistic regression.ResultsThere were seven independent increased-risk factors: history of deliberate self-harm, admission under the Mental Health Act, involvement of the police in admission, depressive symptoms, violence towards property, going absent without leave and a significant care professional being on leave. When compared with out-patient suicides, in-patients were more often female and male in-patients had a psychotic illness. Unlike the out-patient suicides, social factors were not found to be significant.ConclusionsThe characteristics of inpatient and out-patient suicides differ. Identified risk factors have relatively low sensitivity and specificity.

The Validity and Utility of Risk Assessment for Inpatient Suicide

2011 ◽  
Vol 19 (6) ◽  
pp. 507-512 ◽  
Author(s):  
Matthew Large ◽  
Christopher Ryan ◽  
Olav Nielssen
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Model ◽  
Psychiatric Patients ◽  
Meta Analysis ◽  
Low Risk ◽  
Prior History ◽  
Inpatient Suicide ◽  
History Of ◽  
Self Harm

Objective: It is widely assumed that identifying clinical risk factors can allow us to determine which patients are at high risk of suicide while in hospital, and that identifying those patients can help prevent inpatient suicide. We aimed to examine the validity and utility of categorizing psychiatric patients to be at either high or low risk of committing suicide while in hospital. Method: The assumption that high-risk categorizations are valid was examined by comparing factors included in high-risk models derived from individual studies of inpatient suicide with the results of a meta-analysis of factors associated with inpatient suicide. A valid high-risk model was then applied to a hypothetical clinical setting in order to test the assumption that high-risk categorizations are useful. Results: The existing models for assessing whether inpatients are at high risk of suicide all include one or more factors that were not found to be associated with inpatient suicide by meta-analysis and were probably chance associations. Depressed mood and a prior history of self-harm are the only well-established independent risk factors for inpatient suicide. Using these risk factors to classify patients as being at high or low risk would prevent few, if any, suicides, and would come at a considerable cost in terms of more restrictive care of many patients and the reduced level of care available to the remaining patients. Conclusions: Risk categorization of individual patients has no role to play in preventing the suicide of psychiatric inpatients.

scholarly journals The psychometric properties and clinical utility of the Norwegian versions of the deliberate self-harm inventory and the inventory of statements about self-injury

2020 ◽  
Author(s):  
Johanna Vigfusdottir ◽  
Karl Yngvar Dale ◽  
Kim L. Gratz ◽  
E. David Klonsky ◽  
Egil Jonsbu ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Factor Structure ◽  
Discriminant Validity ◽  
Adult Population ◽  
Deliberate Self Harm ◽  
Self Injury ◽  
Convergent And Discriminant Validity ◽  
History Of ◽  
Self Harm ◽  
High Internal Consistency

AbstractDeliberate self-harm (DSH) is a widespread transdiagnostic health problem with increasing prevalence among adolescences, and young adults. It is therefore essential to effectively chart the epidemiology of DSH, as well as to assess the efficacy of interventions designed to modify this behavior. The aim was to translate and analyze the psychometric properties of the Norwegian versions of two instruments designed to assess DSH: the Deliberate Self-harm Inventory (DSHI) and the Inventory of Statements About Self-Injury (ISAS), as well as to assess the prevalence of DSH within a nonclinical Norwegian adult population. Of the 402 participants who completed a questionnaire packet comprising the DSHI, ISAS, general questions about DSH, and other related measures, 30.6% reported some form of DSH. Those with a history of DSH reported greater difficulties with emotion regulation than those without. Participants with and without a history of DSH did not differ in unrelated constructs, including social desirability. The frequency of specific DSH behaviors was in accordance with previous research, with cutting being the most frequent. The factor structure of DSH functions in the Norwegian ISAS was generally comparable to the factor structure of the English version. Overall, results indicate that: a) the Norwegian versions of the DSHI and ISAS behave as expected and in accordance with prior research in other languages and other populations, and b) both the DSHI and ISAS have high internal consistency and adequate construct, convergent, and discriminant validity, and may be applied to evaluate DSH in adult Norwegian populations.

The North Staffordshire Suicide Study: a case–control study of suicide in one health district

1999 ◽  
Vol 29 (1) ◽  
pp. 27-33 ◽  
Author(s):  
A. P. BOARDMAN ◽  
A. H. GRIMBALDESTON ◽  
C. HANDLEY ◽  
P. W. JONES ◽  
S. WILLMOTT
Keyword(s):  
Risk Factors ◽  
Psychotropic Medication ◽  
One Health ◽  
Past History ◽  
Health District ◽  
Time Of Death ◽  
Deliberate Self Harm ◽  
History Of ◽  
Criminal Charges ◽  
Self Harm

Background. The aim of the study was to identify sociodemographic and clinical risk factors for death from suicide and undetermined injury in residents of one health district.Method. Data were collected on all cases of suicide (ICD-9 E950–959) and undetermined injury (ICD-9 E980–989) for residents in North Staffordshire Health District between 1991 and 1995. Controls, identified from the Coroner's inquest register, who died from other causes, were matched for age and sex.Results. Two hundred and twelve pairs of cases and matched controls were identified. Multivariate analysis (conditional logistic regression) showed that the risk of death due to suicide and undetermined death was associated with: recent separation, relationship difficulties, experience of financial difficulties, history of past criminal charges or contact with the police, a past history of deliberate self-harm, being on psychotropic medication at the time of death and a diagnosis of bipolar affective disorder. For sociodemographic variables, a univariate analysis found associations between the cases and being separated, living alone, having a past history of criminal charges and unemployment. Cases were more likely to have a psychiatric disorder, past history of deliberate self-harm and a past history of psychiatric contact for themselves or a family member. Controls were more likely to have a current medical disorder. Cases were more likely than controls to be on any form of medication at the time of death and to have received a prescription for psychotropic or non-psychotropic medication in the week and month before death. Cases were more likely than controls to have had contact with medical services in the week and month before death, with the general practitioner in the week before death and with psychiatric services at any time in the year before death. Strong associations were found between suicide and undetermined injury and life events such as recent separation and bereavement, and financial and relationship difficulties.Conclusions. The study provides an analytical investigation utilizing a dead control group, data gathered from several sources and adequate numbers of cases. It confirms many of the risk factors identified in other studies and highlights the high proportion of suicides who have been in recent contact with the criminal justice system or have been prescribed medication shortly before death.

The prediction of thoughts of death or self-harm in a population-based sample of female twins

2004 ◽  
Vol 34 (2) ◽  
pp. 301-312 ◽  
Author(s):  
A. H. FANOUS ◽  
C. A. PRESCOTT ◽  
K. S. KENDLER
Keyword(s):  
Risk Factors ◽  
Event History Analysis ◽  
Childhood Adversity ◽  
Population Based ◽  
Independent Effect ◽  
History Analysis ◽  
Religious Devotion ◽  
History Of ◽  
Self Harm ◽  
Independent Effects

Background. Although suicide is a leading cause of death, few studies have attempted to predict suicidal ideation prospectively using epidemiological samples or multivariate methods.Method. Discrete-time event history analysis was used to model the onset of thoughts of death or self-harm (TD/SH) in a population-based sample of female twins (N=2164) using variables from the demographic, psychopathological, childhood adversity, personality and life event domains. Univariate, multivariate-within domain and multivariate-across domain regression analyses were performed.Results. Most variables predicted TD/SH in the univariate analyses. However, the only variables to predict TD/SH independently were obsessive symptoms, childhood sexual abuse, rural residence, unemployment, older age, lifetime history of cocaine misuse and low levels of education, personal religious devotion and altruism, as well as divorce/separation, loss of confidant, assault, job loss and financial problems in the previous month. This final model explained 16% of the variance in TD/SH. Lifetime histories of major depression, panic disorder and alcohol misuse had no significant independent effect.Conclusions. Many variables, from all five domains of risk factors, are associated with the risk of TD/SH, but many of these effects may be mediated by other risk factors. Proximal life events and psychopathology may have more independent effects than other domains. The overall ability of these risk factors to predict TD/SH is modest. We cannot rule out that differences between these analyses and previous reports were due to our use of TD/SH as the dependent variable instead of thoughts of committing suicide per se.

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