(PS2-D82) Testing Suicide Ideation-to-action Differences Among Those with NSSI

Suicide is a leading cause of death among individuals 15 to 24 years (CDC, 2020). College students report high rates of non-suicidal self-injury (NSSI), which is an established predictor of suicide (Ribeiro et al., 2016). The integrated motivational-volitional theory (IMV theory; O'Connor & Kirtley, 2018) proposes that different factors impact the development of suicide ideation and the transition to behavior. Previous studies have demonstrated that motivational moderators such as defeat and burdensomeness can contribute to suicide ideation while volitional moderators such as acquired capability (e.g., fearlessness, habituation to pain) and impulsivity distinguish between suicide ideators and suicide attempters (Wetherall et al., 2018). It is unclear whether the same theoretical pattern persists among those who have engaged in NSSI.
The purpose of the current study was to examine whether motivational and volitional factors would differentiate between ideators and attempters in a population with a history of NSSI. We hypothesized: 1) those with NSSI only will score lower in motivational moderators (e.g., social support, burdensomeness) than suicidal ideation and attempt groups, 2) those with NSSI+suicidal ideation will not differ significantly in motivational moderators from those with suicidal attempts, but 3) will score lower on volitional moderators (e.g., impulsivity, fearlessness about death), and 4) those with NSSI only will score differently on volitional moderators than those with suicidal ideation or attempts.
Participants (n= 614, Mage = 19.5, SD = 1.96, 85% female) were recruited using the psychology department study recruitment system, and those who agreed to participate completed an anonymous online survey evaluating the study variables. We ran an ANOVA to assess group differences the variables described. NSSI only participants scored lower in burdensomeness, loneliness, suicide orientation and negative future orientation, and higher on belongingness and positive future orientation than both the NSSI+Ideation and NSSI+Attempt groups (mean differences = -1.26 to 0.881, all ps < .01). Results varied across the volitional factors, with only habituation (F (2,362) = 3.14, p < .05), fearlessness about death (F(2,363) = 3.59, p < .03), and Impulsivity (F (2,363) = 3.74, p < .03) having significant differences that were mainly between the NSSI only and ideation groups. The suicide attempt group differed from ideators on habituation only.
Our results imply that individuals who engage in NSSI only display different characteristics than those who also report suicidal ideation and attempts. While the IMV motivational moderators offered some group differentiation, we found that volitional moderators were not as good at differentiating between NSSI only/ideation/attempt groups. The lack of difference between ideators and attempters on volitional factors is contrary to what the IMV theory proposes. The fact that all participants reported NSSI suggests that the presence of NSSI may weaken the theorized differences among those who think about suicide from those who attempt. Future research is needed to examine how these moderators develop over time to influence suicidal thoughts and behaviors.