Emotion Regulation Deficits and Nonsuicidal Self-Injury Prospectively Predict Suicide Ideation in Adolescents

Background The relationship between emotion regulation deficits and nonsuicidal self-injury (NSSI) is well established. Many studies have documented the strong relationship between NSSI and suicidal thoughts and behaviors. The relationship between emotion regulation deficits and suicide is less understood, but recent studies indicate a moderate association. This study aimed to examine the relationship between emotion regulation deficits, NSSI behavior, and suicide ideation in an unselected community sample of adolescents. It was expected that NSSI history would moderate the relationship between emotion regulation and future suicide ideation. Methods Data were collected from 367 unselected, community adolescents (mean age = 13). Self-report questionnaires assessed NSSI behavior, emotion regulation deficits, and suicide ideation at two time points, 6 months apart. Results After controlling for suicide ideation at baseline, emotion regulation deficits (experiential avoidance and interoceptive deficits) significantly predicted suicide ideation severity at follow-up, and interactions with NSSI engagement showed support for moderation. Conclusions Results of this study provide insight into the mechanisms of these relationships and have significant clinical implications for the identification of adolescents at risk for suicide behaviors.