Suicidal & Non-Suicidal Self Injurious Behaviors

What Are Suicidal & Non-Suicidal Self Injurious Behaviors?

Suicidal ideation and attempts are thoughts and behaviors with intent to die. Non-Suicidal Self-Injurious Behavior (NSIB) is the deliberate, self-inflicted destruction of body tissue resulting in immediate damage without suicidal intent, and the purpose is not culturally sanctioned. These behaviors are not uncommon among adults and are surprisingly common among adolescents and even pre-adolescents. NSIB can include a variety of acts but are most commonly displayed by intentional carving or cutting of the skin, scratching, burning oneself, banging or punching objects or oneself with intention of hurting oneself, or embedding objects under the skin. The appearance of NSIB can be concerning and frightening, so it is important to assess the “why” (i.e., the function) that is causing someone to self-injure.

There is growing evidence that suicidal behaviors and NSIB have different predictors and functions, and should therefore be considered clinically distinct entities. Empirical research has identified childhood sexual and physical abuse, and emotional neglect account as significant risk factors for developing NSIB in adulthood. However, it is important to note that these experiences are hardly the only reasons that individuals engage in NSIB, which is commonly conceptualized as a means of regulating emotions. Specifically, research suggests that NSIB functions as as a form of emotional avoidance and escape from unwanted emotions. Any individual struggling with difficult emotions may therefore begin engaging in NSIB, regardless of their history. In contrast, suicide most often occurs when stressors outweigh a person's ability to cope, particularly in individuals with a mental health condition. Documented risk factors for suicide include co-occurring mental health problems, chronic physical pain, terminal illness, acute loss, family history of suicide and/or mental disorders, and situational factors, such as having access to guns or being incarcerated.