4 - (SYM 146) Moderators of the Pathway to NSSI and Suicide Attempts

Non-suicidal self-injury (NSSI) is theorized to occur in response to experiences of overwhelming distress (Wolff et al., 2019) and is an established risk factor for suicide attempts (Griep, 2020; Muehlenkamp & Brausch, 2022). Past research shows that NSSI prospectively predicts suicide attempts (Riberio et al., 2016), but may also act as a mediator of psychological distress on suicide risk (Liu et al., 2020). It is imperative to identify modifiable mechanisms that could protect against the emergence of NSSI and its conferred risk for suicide. Self-compassion appears to be a potential protective factor decreasing the likelihood of NSSI (Per et al., 2022). Similarly, perceptions of one’s resilience has been identified as a potential moderator of risk for suicidal thoughts and behaviors (Sher, 2019). The current project integrates these individual components to test a model in which NSSI mediates the relationship between distress and suicide attempts with self-compassion moderating the distress to NSSI pathway and resilience moderating the pathway from NSSI to suicide attempts. 

Data comes from 612 students with a history of NSSI (M_age = 19.64, SD = 1.50; 73.8% female; 90.6% White) who completed a brief screening survey to determine eligibility for enrollment into a related study that included items from validated scales assessing self-compassion, resilience, psychological distress, NSSI and suicide attempts. The mean frequency of past year NSSI acts was 23.27 (SD = 40.51) and 8.2% (n = 50) reported at least one past year suicide attempt. Analyses were conducted using the moderated mediation regression PROCESS macro (model 29) for SPSS with 5,000 bootstrap bias corrected estimates. The full model was significant, F (8,495) = 9.47, p < .001, explaining 13.27% of the variance in suicide attempts. Self-compassion significantly moderated the effect of distress on NSSI (t = -2.06, p < .03, 95%CI: -6.21; -0.153) and suicide attempts (t = -2.16, p < .04, 95%CI: -0.08; -0.004). Resilience moderated the effect of past year NSSI on suicide attempts (t = 2.46, p < .02, 95%CI: -0.003; -0.002) but not the effect of distress (t = 1.74, p > .08, 95%CI: -0.007; 0.111). The conditional moderated (resilience) mediation (NSSI) was not significant (effect = -0.004, 95%CI: -0.015; 0.004). These findings provide evidence that positive self-perceptions may reduce vulnerability for engagement in self-injurious behaviors. Interventions that build self-compassion and self-efficacy for coping may be fruitful avenues for reducing NSSI and suicidal behaviors.