Suicide Probability in Adolescents With a History of Childhood Maltreatment: The Role of Non-Suicidal Self-Injury, Emotion Regulation Difficulties, and Forms of Self-Criticism

BACKGROUND Suicidal attempt and non-suicidal self-injury are very common in adolescents with a history of childhood maltreatment. By identifying correlates of these kinds of high-risk behaviors, it is possible to prevent and decrease completed suicide. OBJECTIVES The aims of this study were: 1) to compare adolescents with a history of childhood maltreatment with non-suicidal self injury (NSSI) or past suicidal attempt in terms of suicide probability, and 2) to investigate the association between NSSI, forms of self-criticism, emotion regulation difficulties, and suicide probability. PATIENTS AND METHODS Participants were 169 adolescents living in Iranian social welfare centers who had a history of childhood maltreatment. The Suicide Probability Scale, Difficulties in Emotion Regulation Scale, Forms of Self-criticism, and the Non-Suicidal Self injury (NSSI) checklist were used for assessment. RESULTS Adolescents with NSSI and suicidal attempts had higher rates of suicide ideation than adolescents with NSSI-only (P < 0.05). Feelings of inadequacy, self-hatred, difficulty with impulse control, and frequency of NSSI can predict 50% variance of suicide probability (P < 0.001). CONCLUSIONS Adolescents with histories of suicidal attempts and NSSI, compared with adolescents with NSSI-only, were more prone to suicide. Self-criticism, poor impulse control, and the frequency of NSSI were the main risk factors associated with suicide probability in adolescents with a history of childhood maltreatment.