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Objective: To examine the demographic and clinical correlates of nonsuicidal self-injury., Method: This is a cross-sectional analysis of a longitudinal cohort study of the familial transmission of suicidal behavior, conducted at referral centers in Pittsburgh, Pennsylvania, and New York, New York. Participants included 291 probands with DSM-IV mood disorder, one-half of whom had attempted suicide, and 507 of their offspring. The primary outcome assessed was nonsuicidal self-injury in offspring. Psychosocial correlates of nonsuicidal self-injury were determined by comparing personal, parental, and familial characteristics of offspring with and without nonsuicidal self-injury, assessed using a variety of interview and self-report measures at study entry. Data were collected between August 1998 and August 2007., Results: Of 507 offspring, 7.7% (n=39) had engaged in nonsuicidal self-injury. The most salient correlates of nonsuicidal self-injury on multivariate logistic regression were diagnosis of depression (OR=3.78, P<.001) and greater aggression (OR=1.07, P=.01), depressive symptoms (OR=1.59, P=.009), and suicidal ideation (OR=1.24, P=.004). Parental history of abuse, as well as family histories of suicide attempt and nonsuicidal self-injury, was noncontributory., Conclusions: Nonsuicidal self-injury is associated with the presence and severity of depression, suicidal ideation, and behavioral dysregulation. On multivariate analysis, only individual predictors remained significant; this result is distinct from that for correlates of suicide attempt reported in this sample, for which familial variables played a significant role., (© Copyright 2012 Physicians Postgraduate Press, Inc.)

Objective: To determine the demographic and clinical predictors of nonsuicidal self-injury and to examine the longitudinal relationship between nonsuicidal self-injury and suicide attempt., Method: This was a longitudinal cohort study of the familial transmission of suicidal behavior. The sample consisted of probands with DSM-IV mood disorder (n = 212), 54.2% of whom were suicide attempters, and their offspring aged at least 10 years (n = 352), followed for a mean of 3.8 years. Personal, parental, and familial characteristics were assessed annually to identify the most parsimonious subset of these variables associated with nonsuicidal self-injury, the primary outcome. Data were collected between August 1998 and August 2007., Results: Of 352 offspring, 7.4% (n = 26) engaged in nonsuicidal self-injury during follow-up. In the final model examining predictors at baseline, the most severe time point, and the time point prior to nonsuicidal self-injury, only predictors from the most proximal time point were significant, namely younger age (odds ratio [OR] = 0.75, P = .002), diagnosis of current major depression (OR = 5.09, P < .001), and suicidal ideation (OR = 1.46, P = .02). In 2 of the 3 single time point models, baseline nonsuicidal self-injury was the most significant predictor of nonsuicidal self-injury during follow-up. Suicide attempt was predicted by both baseline nonsuicidal self-injury and suicide attempt, but when both were included in the model, nonsuicidal self-injury was a significant predictor (OR = 7.50, P = .009), but suicide attempter was not (OR = 3.78, P = .08); offspring aggression (OR = 1.11, P = .01) predicted suicide attempt but not nonsuicidal self-injury. Parental histories of nonsuicidal self-injury, suicide attempt, and abuse were not predictive of nonsuicidal self-injury., Conclusions: Nonsuicidal self-injury may be an earlier manifestation of a shared diathesis with suicide attempt, consisting of depression and suicidal ideation, and that diathesis may lead to suicidal behavior in the face of greater offspring aggression and family pathology. The apparent bidirectional temporal relationship between nonsuicidal self-injury and suicide attempt may be explained by this shared diathesis., (© Copyright 2012 Physicians Postgraduate Press, Inc.)