Suicidal and nonsuicidal self-injurious behaviors represent perplexing yet highly prevalent public health problems. Though the behaviors are differentiable, they frequently co-occur. The nature of the association between them, however, remains poorly understood. The interpersonal theory of suicide (Joiner, 2005; Van Orden et al., 2010) offers one viable framework for enhancing our understanding in this domain. In this review, we provide an overview of the literature on nonsuicidal self-injury, its relation to suicidal behavior, and how the interpersonal theory of suicide conceptualizes this relationship. Alternative perspectives and future directions are also discussed.
BaumeisterR. F. (1990). Suicide as an escape from self. Psychological Review, 97, 90–113.
2.
BenderT.GordonK.BresinK.JoinerT. (2011). Impulsivity and suicidality: The mediating role of painful and provocative experiences. Journal of Affective Disorders, 129, 301–307.
3.
BoergersJ.SpiritoA.DonaldsonD. (1998). Reasons for adolescent suicide attempts: Associations with psychological functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1287–1293.
4.
BohusM.LimbergerM.EbnerU.GlockerF. X.SchwarzB.WernzM.LiebK. (2000). Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior. Psychiatry Research, 95, 251–260.
5.
BresinK.GordonK. H. (2011). Changes in negative affect following pain (vs. nonpainful) stimulation in individuals with and without a history of nonsuicidal self-injury. Personality Disorders: Theory, Research, and Treatment. Advance online publication. doi:10.1037/a002573610.1037/a0025736
6.
BresinK.GordonK. H.BenderT. W.GordonL. J.JoinerT. E.Jr. (2010). No pain, no change: Reductions in prior negative affect following physical pain. Motivation and Emotion, 34, 280–287.
7.
ChapmanA. L.GratzK. L.BrownM. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394.
8.
ConnerK. R.BrittonP. C.SwortsL. M.JoinerT. E.Jr. (2007). Suicide attempts among individuals with opiate dependence: The critical role of belonging. Addictive Behaviors, 32, 1395–1404.
9.
FawcettJ.ScheftnerW. A.FoggL.ClarkD. C.YoungM. A.HedekerD.GibbonsR. (1990). Time-related predictors of suicide in major affective disorder. American Journal of Psychiatry, 147, 1189–1194.
10.
FranklinJ. C.AaronR. V.ArthurM. S.ShorkeyS. P.PrinsteinM. J. (2012). Nonsuicidal self-injury and diminished pain perception: The role of emotion dysregulation. Comprehensive Psychiatry, 53, 691–700.
11.
FranklinJ. C.HesselE. T.AaronR. V.ArthurM. S.HeilbronN.PrinsteinM. J. (2010). The functions of nonsuicidal self-injury: Support for cognitive-affective regulation and opponent processes from a novel psychophysiological paradigm. Journal of Abnormal Psychology, 119, 850–862.
12.
FranklinJ. C.HesselE. T.PrinsteinM. J. (2011). Clarifying the role of pain tolerance in suicidal capability. Psychiatry Research, 189, 362–367.
13.
GordonK. H.SelbyE. A.AnestisM. D.BenderT. W.WitteT. K.BraithwaiteS.. . . JoinerT. E.Jr. (2010). The reinforcing properties of repeated self-harm. Archives of Suicide Research, 14, 329–341.
14.
HeathertonT. F.BaumeisterR. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86–108.
15.
JoinerT. E.Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
16.
JoinerT. E.Jr.PettitJ. W.WalkerR. L.VoelzZ. R.CruzJ.RuddM. D.LesterD. (2002). Perceived burdensomeness and suicidality: Two studies on the suicide notes of those attempting and those completing suicide. Journal of Social & Clinical Psychology, 21, 531–545.
17.
JoinerT. E.Jr.Van OrdenK. A.WitteT. K.SelbyE. A.RibeiroJ. D.LewisR.RuddM. D. (2009). Main predictions of the interpersonal-psychological theory of suicidal behavior: Empirical tests in two samples of young adults. Journal of Abnormal Psychology, 118, 634–646.
18.
KempermanI.RussM.ShearinE. (1997). Self-injurious behavior and mood regulation in borderline patients. Journal of Personality Disorders, 11, 146–157.
19.
KlonskyE. D. (2007). Non-suicidal self-injury: An introduction. Journal of Clinical Psychology, 63, 1039–1043.
20.
KlonskyE. D.OltmannsT. F.TurkheimerE. (2003). Deliberate self-harm in a nonclinical population: Prevalence and psychological correlates. American Journal of Psychiatry, 16, 1501–1508.
21.
MuehlenkampJ. J. (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry, 75, 324–333.
NockM. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18, 78–83.
24.
NockM. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339–363.
25.
NockM. K.PrinsteinM. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72, 885–890.
26.
OrbachI.MikulincerM.KingR.CohenD.SteinD. (1997). Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents. Journal of Consulting and Clinical Psychology, 65, 646–652.
27.
OrbachI.PalgiY.SteinD.Har-EvenD.Lotem-PelegM.AsherovJ.ElizurA. (1996). Tolerance for physical pain in suicidal subjects. Death Studies, 20, 327–341.
28.
OrbachI.SteinD.PalgiY.AsherovJ.Har-EvenD.ElizurA. (1996). Perception of physical pain in accident and suicide attempt patients: Self-preservation versus self-destruction. Journal of Psychiatric Research, 30, 307–320.
29.
RibeiroJ.PeaseJ.GutierrezP.SilvaC.BernertR.RuddM.JoinerT. (2012). Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicidal ideation and behavior in young adults in the military. Journal of Affective Disorders, 136, 743–750.
30.
RossS.HeathN. (2002). A study of the frequency of self- mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 311, 67–77.
31.
RussM. J.CampbellS. S.KakumaT.HarrisonK.ZanineE. (1999). EEG theta activity and pain insensitivity in self-injurious borderline patients. Psychiatry Research, 89, 201–214.
32.
SchmahlC.BohusM.EspositoF.TreedeR.Di SalleF.-D.GreffathW.. . . SeifritzE. (2006). Neural correlates of antinociception in borderline personality disorder. Archives of General Psychiatry, 63, 659–667.
33.
SolomonR. L. (1980). The opponent-process theory of acquired motivation: The costs of pleasure and the benefits of pain. American Psychologist, 35, 691–712.
34.
Van OrdenK. A.LynamM. E.HollarD.JoinerT. E.Jr. (2006). Perceived burdensomeness as an indicator of suicidal symptoms. Cognitive Therapy and Research, 30, 457–467.
35.
Van OrdenK. A.WitteT. K.CukrowiczK. C.BraithwaiteS. R.SelbyE. A.JoinerT. E.Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117, 575–600.
36.
Van OrdenK. A.WitteT. K.GordonK. H.BenderT. W.JoinerT. E.Jr. (2008). Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 76, 72–83.
37.
WhitlockJ.EckenrodeJ.SilvermanD. (2006). Self-injurious behaviors in a college population. Pediatrics, 117, 1939–1948.
