Differentiating Suicide Attempt History Among Individuals with Borderline Personality Disorder Engaging in...

Suicidal behaviors and non-suicidal self-injury (NSSI) are highly prevalent and often co-occur among individuals with borderline personality disorder (BPD). Individuals with both a BPD diagnosis and NSSI are at heightened risk for suicide. However, few studies have examined which factors differentiate those with BPD and NSSI who have attempted suicide from those who have not. This study aimed to identify such clinical factors to inform suicide risk assessment within this vulnerable population.

Participants were 78 individuals with BPD and a history of NSSI. Fifty-four had a lifetime history of suicide attempt (SA). Participants completed structured interviews and self-report measures assessing childhood trauma, dissociation, and anxiety, as well as current suicidal ideation, depressive symptoms, global functioning, and demographics. Logistic regression was used to evaluate whether these factors are associated with an increased likelihood of having a lifetime SA history in this unique population.

Dissociative amnesia was associated with decreased likelihood of having a lifetime SA, while dissociative absorption was associated with increased likelihood of having such a history, while controlling for education level, current suicidal ideation, global functioning, and depression severity.

In individuals with BPD who engage in NSSI, those who have made a SA present with distinct dissociative symptoms. Future studies should further investigate other risk factors for suicidal behavior among individuals with BPD who engage in NSSI to improve suicide risk assessment in this population.