Measuring the suicidal mind: implicit cognition predicts suicidal behavior.

Suicide is difficult to predict and prevent because people who consider killing themselves often are unwilling or unable to report their intentions. Advances in the measurement of implicit cognition provide an opportunity to test whether automatic associations of self with death can provide a behavioral marker for suicide risk. We measured implicit associations about death/suicide in 157 people seeking treatment at a psychiatric emergency department. Results confirmed that people who have attempted suicide hold a significantly stronger implicit association between death/suicide and self than do psychiatrically distressed individuals who have not attempted suicide. Moreover, the implicit association of death/suicide with self was associated with an approximately 6-fold increase in the odds of making a suicide attempt in the next 6 months, exceeding the predictive validity of known risk factors (e.g., depression, suicide-attempt history) and both patients' and clinicians' predictions. These results provide the first evidence of a behavioral marker for suicidal behavior and suggest that measures of implicit cognition may be useful for detecting and predicting sensitive clinical behaviors that are unlikely to be reported.

An exploratory study of correlates, onset, and offset of non-suicidal self-injury.

The study of non-suicidal self-injury (NSSI) has focused largely on identifying diagnostic correlates and the functions of this behavior; however, little is known about the broader range of factors related to NSSI. We examined a wide array of factors hypothesized to correlate with non-suicidal self-injury (NSSI) and provided a qualitative analysis of adolescents' self-reported motivations for starting and stopping this behavior. Participants were 64 adolescents with a history of NSSI and 30 comparison adolescents without such a history matched on age, sex, and ethnicity recruited from the community and assessed during one laboratory visit. The presence of NSSI was associated with a family history of suicidal ideation, violence, and drug and alcohol abuse, but not with more general forms of psychopathology. NSSI also was associated with the presence of in utero complications, the occurrence of non-injurious repetitive behaviors during childhood, and endorsement of a homosexual or bisexual orientation. Self-injurers reported getting the idea to self-injure from peers (38%) more often than any other source, and most (78%) reported at least one reason for wanting to stop self-injury. Less than half were currently receiving treatment. This exploratory study provides new information about the correlates of NSSI that has implications for research and clinical work in this area.

Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism.

We examined the relation between child maltreatment and non-suicidal self-injury (NSSI). Participants were 86 adolescents who completed measures of child maltreatment, self-criticism, perceived criticism, depression, and NSSI. Analyses revealed significant, small-to-medium associations between specific forms of child maltreatment (physical neglect, emotional abuse, and sexual abuse) and the presence of a recent history of NSSI. Emotional and sexual abuse had the strongest relations with NSSI, and the data supported a theoretical model in which self-criticism mediates the relation between emotional abuse and engagement in NSSI. Specificity for the mediating role of self-criticism was demonstrated by ruling out alternative mediation models. Taken together, these results indicate that several different forms of childhood maltreatment are associated with NSSI and illuminate one mechanism through which maltreatment may be associated with NSSI. Future research is needed to test the temporal relation between maltreatment and NSSI and should aim to identify additional pathways to engagement in NSSI.