Intrapersonal and Interpersonal Functions as Pathways to Future Self-Harm Repetition and Suicide Attempts

Kathryn Jane Gardner; Elise Paul; Edward A Selby; E David Klonsky; Becky Mars

doi:10.3389/fpsyg.2021.688472

Intrapersonal and Interpersonal Functions as Pathways to Future Self-Harm Repetition and Suicide Attempts

Front Psychol. 2021 Jul 19:12:688472. doi: 10.3389/fpsyg.2021.688472. eCollection 2021.

Authors

Kathryn Jane Gardner¹, Elise Paul², Edward A Selby³, E David Klonsky⁴, Becky Mars⁵

Affiliations

¹ School of Psychology, University of Central Lancashire, Preston, United Kingdom.
² Research Department of Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, United Kingdom.
³ Department of Psychology, Rutgers University, Piscataway, NJ, United States.
⁴ Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
⁵ National Institute for Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.

Abstract

Background: Research has identified functions of non-suicidal self-harm/self-injury (NSSH) but whether functions change over time, from adolescence to early adulthood, or predict the continuation of the behavior prospectively remains unclear. This study aimed to prospectively explore whether intrapersonal and interpersonal NSSH functions in adolescence predict repetition of self-harm (regardless of suicidal intent) and incident suicide attempts in early adulthood. Methods: Participants were 528 individuals with NSSH at age 16 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the UK. Descriptive statistics were used to explore changes in functions over time from age 16 to 21, and logistic regression used to examine associations between NSSH functions and repeat self-harm and suicide attempts at age 21, 24, and 25 years. Findings: The majority of 16-year-olds with NSSH endorsed intrapersonal (e.g., affect regulatory) functions only (73% at 16 years and 64% at 21 years). Just under half of adolescents (42%) and three quarters of 21 years olds reported more than one function simultaneously. A greater number of intrapersonal functions at 16 years independently predicted future repetition of self-harm at ages 21-25 years, over and above interpersonal functions (OR = 1.46, 95% CI 1.06-2.01). Interpersonal functions during adolescence did not predict repeat self-harm or suicide attempts in adulthood. Discussion: Our findings suggest that intrapersonal but not interpersonal NSSH functions are a prospective risk factor for future self-harm and might also predict incident suicide attempts. The results highlight the central role of underlying affective difficulties and motivations in self-harm maintenance.

Keywords: Avon Longitudinal Study of Parents and Children; non-suicidal self-harm; non-suicidal self-harm functions; non-suicidal self-injury; self-harm; suicide attempt.

Abstract

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