Nonsuicidal self-injury and disordered eating: Differences in acquired capability and suicide attempt severity

Nonsuicidal self-injury (NSSI) and eating disorders are both strongly related to suicide behaviors, and both can be conceptualized as painful and provocative events that associate with acquired capability for suicide. Individuals who self-injure report greater acquired capability than those who do not engage in these behaviors, but results are mixed in eating disorder samples. Given that NSSI and disordered eating (DE) commonly co-occur, it is important to examine how acquired capability for suicide and suicide attempt severity may differ between individuals who engage in either, both, or neither of these behaviors. It was expected that individuals with both NSSI and DE would report the greatest acquired capability, assessed by fearlessness about death and fear about suicide, and suicide attempt severity, compared to NSSI only, DE only, and controls. In a sample of 1179 undergraduates, results indicated no differences on fearlessness about death, but the NSSI + DE group reported the lowest scores on fear of suicide and greatest suicide attempt severity compared to the other groups. Differences between fearlessness about death and fear about suicide are discussed, as well as the possible additive effect of engaging in both direct (NSSI) and indirect (DE) self-harm on fear about suicide and suicide risk.