People may engage in self-harm or think about suicide to alleviate some types of stress, a new meta-analysis shows.
The perceived stress relief that results from these thoughts and behaviors indicates potential for therapy and other interventions, the researchers report.
The National Suicide Prevention Lifeline is at 1-800-273-8255.
Nearly one-fifth of teens and young adults engage in self-injury, while just as many teens seriously consider attempting suicide. Both are considered a risk for suicidal behavior, but studies of why people harm themselves, or think about suicide, haven’t previously been examined in a comprehensive way.
Over the past 10 years, researchers have started to ask people at risk of suicide to complete surveys multiple times per day. This type of data allows for researchers to understand the thoughts, emotions, and behaviors that precede self-injurious thoughts and actions.
The new study in Nature Human Behavior aggregates the data of these types of studies involving more than 1,600 participants around the world.
“Many researchers have been collecting this data and testing for the same finding, but there were mixed findings across studies. We wanted to see if we saw this effect when we combined these datasets,” says lead author Kevin Kuehn, a doctoral student in clinical psychology at the University of Washington.
With suicide a leading cause of death among youth and the role of self-harm, or non-suicidal self-injury (NSSI), as a risk factor, Kuehn and his team wanted to look collectively at separate studies of NSSI and suicidal thoughts.
By analyzing data of individual participants in these studies, the researchers found that high levels of emotional distress precede both self-injury and suicidal thoughts, followed by reduced stress.
Researchers point to additional data on suicide—that a majority of people who die by suicide do not receive mental health treatment, for example—and consistent findings from the meta-analysis that stress precedes self-injury.
They say this can inform prevention and intervention efforts, such as learning how to replace self-injury and suicidal thoughts with other means of reducing stress.
“The good news is that we have effective behavioral interventions, such as cognitive behavioral therapy and dialectical behavioral therapy, which teach skills for managing intense emotions to replace self-injurious thoughts and behaviors. Increasing access to these types of treatments is likely to reduce the prevalence of them,” Kuehn says.
One limit of the meta-analysis, the researchers say, is that participants in the various studies were predominantly young white women. Further research into self-injury and related thoughts and behaviors should focus on increasing the age, gender, and racial and ethnic diversity of study samples.
In addition, the meta-analysis found only modest evidence that stress, while connected to self-harm, could be used as a means for predicting when an individual might injure themselves. Future studies could try to identify more precisely when and how stress leads to self-injurious thoughts and behaviors.
Additional coauthors are from the Veterans Affairs Puget Sound Health Care System and the University of Washington.
Source: University of Washington