Summary: A new meta-analysis study finds that people self-harm and think about suicide as a way to reduce certain types of stress. The perceived release of stress by engaging in destructive behaviors indicates potential for therapy and other types of intervention.
Source: University of Washington
Nearly one-fifth of adolescents and young adults self-harm, while as many adolescents are seriously considering attempting suicide. Both are considered a risk for suicidal behavior, but studies on why people harm themselves or think about suicide have not been thoroughly reviewed.
Now, a new meta-analysis of 38 studies finds consistent findings and themes: that people self-harm and/or contemplate suicide to alleviate certain types of stress; and that the perceived stress relief that results from thoughts and behaviors indicates potential for therapy and other interventions.
Over the past 10 years, researchers have begun asking people at risk of suicide to complete surveys several times a day. This type of data allows researchers to understand the thoughts, emotions, and behaviors that precede thoughts and actions of self-harm.
The University of Washington performed the aggregation of data from these types of studies involving more than 1,600 participants worldwide. It was published on April 28 in Nature Human behavior.
“Many researchers have collected this data and tested for the same result, but results have been mixed across studies. We wanted to see if we saw this effect when we combined these datasets,” said Kevin Kuehn, lead author of the meta-analysis and doctoral candidate in clinical psychology at UW.
With suicide being the leading cause of death in young people and the role of self-harm or non-suicidal self-harm (NSS) as a risk factor, Kuehn and his team wanted to collectively review separate studies on ANS and suicidal thoughts.
By analyzing data from individual participants in these studies, UW researchers found that high levels of emotional distress precede both self-harm and suicidal thoughts, followed by reduced stress.
The researchers point to additional data on suicide — that a majority of people who die by suicide do not receive mental health treatment, for example — and consistent findings from the meta-analysis that stress precedes self-harm.
They say it can inform prevention and intervention efforts, such as learning to replace self-harm and suicidal thoughts with other ways to reduce stress.
“The good news is that we have effective behavioral interventions, such as cognitive-behavioral therapy and dialectical behavior therapy, that teach skills to deal with intense emotions to replace self-harming thoughts and behaviors. access to these types of treatments is likely to reduce the prevalence,” Kuehn said.
One of the limitations of the meta-analysis, according to the researchers, is that the participants in the various studies were overwhelmingly young white women.
Further research on self-harm and related thoughts and behaviors should focus on increasing the age, gender, and racial and ethnic diversity of study samples.
Additionally, the meta-analysis found only modest evidence that stress, although linked to self-harm, could be used as a way to predict when an individual might injure themselves.
Future studies may attempt to identify more precisely when and how stress leads to thoughts and behaviors of self-harm.
About this stress and mental health research news
Author: Press office
Source: University of Washington
Contact: Press Office – University of Washington
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Original research: Access closed.
“A Meta-Analysis of the Affect-Regulatory Function of Real-Time Self-Harm Thoughts and Behaviors” by Kevin S. Kuehn et al. Nature Human behavior
A meta-analysis on the function of affective regulation of self-harming thoughts and behaviors in real time
Important theories suggest that thoughts and behaviors of self-harm are negatively reinforced by a decrease in negative affect.
The present meta-analysis quantifies the effects of intensive longitudinal studies measuring negative affect and self-harming thoughts and behaviors. We obtained data from 38 of 79 studies (48%, 22 unique data sets) involving NOT= 1,644 participants (80% female, 75% white).
Meta-analyses of individual participant data revealed changes in affect before and after thoughts and behaviors of self-harm. In antecedent models, findings supported an increase in negative affect prior to nonsuicidal self-injurious behavior (k= 14, 95% CI 0.09 to 0.31) and suicidal thoughts (k= 14, 95% CI 0.03 to 0.19).
For consequence models, negative affect was reduced following thoughts of nonsuicidal self-harm (k= 6, 95% CI -0.79 to -0.44), non-suicidal self-harm behaviors (k= 14, 95% CI -0.73 to -0.19) and suicidal thoughts (k= 13, 95% CI -0.79 to -0.23).
The results, which were not moderated by sampling strategies or sample composition, support the affect-regulating function of self-harming thoughts and behaviors.