The role of suicidal motivations in foreseeing suicide risk in nonsuicidal self-injury adolescent population

Although diagnostically distinct from suicidal behaviour and, by definition, not intended to cause death, nonsuicidal self-injury (NSSI) remains one of the strongest predictors of suicide. NSSI and suicidal behaviour appear to share a suicidal state of mind, marked by detachment from life and ambivalence toward death. This study investigates suicidal risk in adolescents with NSSI by examining suicidal motivations and regulatory needs linked to psychache and by exploring their contribution to suicidal behaviour. A sample of 134 adolescents with active suicidal ideation, self-harm or recent suicide attempts was assessed using self-report measures and structured interviews. Associations between suicidal ideation, motivations and NSSI features were explored using linear regressions. Logistic regressions tested links between suicidal motivations and suicidal attempts in a filtered NSSI subsample. A hierarchical logistic regression compared the associative value of suicidal motivations and personality disorder criteria on suicidal behaviour. Suicidal ideation and motivations were significantly associated with NSSI variables. In the NSSI subsample, interpersonal influence and low fear were linked to suicide attempts. Suicidal motivations showed greater predictive power for suicidal behaviour than personality disorder traits, improving model accuracy. These findings suggest that assessing suicidal motivations in adolescents with NSSI may enhance clinical risk evaluation and support more targeted interventions.