What bridges the gap between self-harm and suicidality? The role of forgiveness, resilience and attachment

Psychiatry Res. 2016 Jul 30:241:78-82. doi: 10.1016/j.psychres.2016.04.103. Epub 2016 Apr 30.

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.

Keywords: Psychological factors; Self-harm; Self-injury; Suicide.

MeSH terms

  • Adaptation, Psychological / physiology*
  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Forgiveness / physiology*
  • Humans
  • Male
  • Object Attachment*
  • Resilience, Psychological*
  • Self-Injurious Behavior / physiopathology*
  • Social Support*
  • Suicide*
  • Young Adult