@article{ref1,
title="Interoceptive deficits, non-suicidal self-injury, and suicide risk: a multi-sample study of indirect effects",
journal="Psychological medicine",
year="2019",
author="Hagan, Christopher R. and Rogers, Megan L. and Brausch, Amy M. and Muehlenkamp, Jennifer J. and Joiner, Thomas E.",
volume="ePub",
number="ePub",
pages="1-12",
abstract="BACKGROUND: Interoceptive deficits (ID) have been associated with non-suicidal self-injury (NSSI) and suicidal behavior in multiple studies. Many of these studies are limited in scope, and have not fully examined possible mechanisms explaining how ID affect suicidal behavior. <br><br>METHODS: This study assesses how self-reported ID relate to suicide ideation and attempts in six distinct and geographically diverse samples of adults (n = 2706) and one sample of adolescents (n = 436). Participants responded to a variety of self-report questionnaires and interviews. <br><br>RESULTS: Contrary to our hypothesis, self-reported ID were only associated with suicidal ideation in two samples, one of which was the adolescent sample. Largely consistent with our predictions, self-reported ID exhibited an indirect effect on suicide attempts through versatility of NSSI in four of the five adult samples tested. Finally, the indirect effects of self-reported ID on suicide attempts through NSSI versatility did not act indirectly through behaviorally assessed pain tolerance. <br><br>CONCLUSIONS: We found that, in adults, self-reported ID are not associated with suicidal ideation, but are connected with a history of suicide attempts, through an indirect effect via NSSI. Our findings also indicate that the mechanism of action leading from self-reported ID to suicidal behavior may differ between adolescents and adults, and relate to suicidal behavior independent of pain tolerance. Clinical implications and future directions are discussed.<p /> <p>Language: en</p>",
language="en",
issn="0033-2917",
doi="10.1017/S0033291718003872",
url="http://dx.doi.org/10.1017/S0033291718003872"
}