title: What bridges the gap between self-harm and suicidality? The role of forgiveness, resilience and attachment.
abstract: Self-harm is the most robust risk for completed suicide. There is a lack of understanding of why some people who self-harm escalate to suicidal behaviour when others do not. Psychological factors such as attachment, self-forgiveness and self-appraisal may be important. To determine whether factors from the Interpersonal Theory and Schematic Appraisals models are useful to identify suicidal behaviour in populations that self-harm. Specifically we investigate whether resilience factors of secure attachment, self-forgiveness and positive self-appraisals significantly influence suicidality in people who self-harm. A cross-sectional online study of 323 participants recruited from self-harm support forum. Validated self-report measures were used to assess appraisals, relationships, self-forgiveness, attachment style, suicidality and self-harm. Emotion coping and support seeking self-appraisals and self-forgiveness were negatively associated with suicidality in participants with a history of self-harm. Dismissing attachment was positively associated with suicidality. The perceived ability to cope with emotions, the perceived ability to gain support and self-forgiveness may protect against suicide in people who self-harm. Conversely the presence of dismissing attachment may increase the risk of suicidality. Findings provide therapeutic targets to reduce risk of suicidality in this high risk group.
authors.affiliation: University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom.
authors.forename: Gurmokh S
authors.initials: GS
authors.lastname: Nagra
authors.affiliation: University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom; Telethon Kids Institute, The University of Western Australia, 6008 PO Box 855, West Perth 6872, Australia.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Lin
authors.affiliation: University of Birmingham, Edgbaston, West Midlands, B15 2TT, United Kingdom; Birmingham and Solihull Mental Health NHS Foundation Trust, 50 Summer Hill Road, Birmingham B1 3RB, United Kingdom. Electronic address: r.upthegrove@bham.ac.uk.
authors.forename: Rachel
authors.initials: R
authors.lastname: Upthegrove
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D061347:Forgiveness / Q000502:physiology*; D006801:Humans; D008297:Male; D009769:Object Attachment; D055500:Resilience, Psychological; D016728:Self-Injurious Behavior / Q000503:physiopathology*; D012944:Social Support; D013405:Suicide; D055815:Young Adult
keywords: Psychological factors; Self-harm; Self-injury; Suicide